1
|
Day DB, LeWinn KZ, Karr CJ, Loftus CT, Carroll KN, Bush NR, Zhao Q, Barrett ES, Swan SH, Nguyen RHN, Trasande L, Moore PE, Adams Ako A, Ji N, Liu C, Szpiro AA, Sathyanarayana S. Subpopulations of children with multiple chronic health outcomes in relation to chemical exposures in the ECHO-PATHWAYS consortium. ENVIRONMENT INTERNATIONAL 2024; 185:108486. [PMID: 38367551 PMCID: PMC10961192 DOI: 10.1016/j.envint.2024.108486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 02/01/2024] [Accepted: 02/05/2024] [Indexed: 02/19/2024]
Abstract
A multimorbidity-focused approach may reflect common etiologic mechanisms and lead to better targeting of etiologic agents for broadly impactful public health interventions. Our aim was to identify clusters of chronic obesity-related, neurodevelopmental, and respiratory outcomes in children, and to examine associations between cluster membership and widely prevalent chemical exposures to demonstrate our epidemiologic approach. Early to middle childhood outcome data collected 2011-2022 for 1092 children were harmonized across the ECHO-PATHWAYS consortium of 3 prospective pregnancy cohorts in six U.S. cities. 15 outcomes included age 4-9 BMI, cognitive and behavioral assessment scores, speech problems, and learning disabilities, asthma, wheeze, and rhinitis. To form generalizable clusters across study sites, we performed k-means clustering on scaled residuals of each variable regressed on study site. Outcomes and demographic variables were summarized between resulting clusters. Logistic weighted quantile sum regressions with permutation test p-values associated odds of cluster membership with a mixture of 15 prenatal urinary phthalate metabolites in full-sample and sex-stratified models. Three clusters emerged, including a healthier Cluster 1 (n = 734) with low morbidity across outcomes; Cluster 2 (n = 192) with low IQ and higher levels of all outcomes, especially 0.4-1.8-standard deviation higher mean neurobehavioral outcomes; and Cluster 3 (n = 179) with the highest asthma (92 %), wheeze (53 %), and rhinitis (57 %) frequencies. We observed a significant positive, male-specific stratified association (odds ratio = 1.6; p = 0.01) between a phthalate mixture with high weights for MEP and MHPP and odds of membership in Cluster 3 versus Cluster 1. These results identified subpopulations of children with co-occurring elevated levels of BMI, neurodevelopmental, and respiratory outcomes that may reflect shared etiologic pathways. The observed association between phthalates and respiratory outcome cluster membership could inform policy efforts towards children with respiratory disease. Similar cluster-based epidemiology may identify environmental factors that impact multi-outcome prevalence and efficiently direct public policy efforts.
Collapse
Affiliation(s)
- Drew B Day
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, 1920 Terry Avenue, Seattle, Washington 98101, USA.
| | - Kaja Z LeWinn
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, 675 18th Street, San Francisco, CA 94143, USA
| | - Catherine J Karr
- Department of Environmental and Occupational Health, University of Washington, 4245 Roosevelt Way NE, Seattle, WA 98105, USA; Department of Epidemiology, University of Washington, 4245 Roosevelt Way NE, Seattle, WA 98105, USA; Department of Pediatrics, University of Washington, 4245 Roosevelt Way NE, Seattle, WA 98105, USA
| | - Christine T Loftus
- Department of Environmental and Occupational Health, University of Washington, 4245 Roosevelt Way NE, Seattle, WA 98105, USA
| | - Kecia N Carroll
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY 10029, USA; Department of Pediatrics, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY 10029, USA
| | - Nicole R Bush
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, 675 18th Street, San Francisco, CA 94143, USA; Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA
| | - Qi Zhao
- Department of Preventive Medicine, Division of Preventive Medicine, University of Tennessee Health Science Center, 66 North Pauline Street, Memphis, TN 38163, USA
| | - Emily S Barrett
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, 683 Hoes Lane West, Piscataway, NJ 08854, USA; Environmental and Occupational Health Sciences Institute, Rutgers University, 170 Frelinghuysen Road, Piscataway, NJ 08854, USA
| | - Shanna H Swan
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY 10029, USA
| | - Ruby H N Nguyen
- Department of Epidemiology and Community Health, University of Minnesota, 420 Delaware Street Southeast, Minneapolis, Minnesota 55455, USA
| | - Leonardo Trasande
- Department of Pediatrics, New York University Grossman School of Medicine, 550 First Avenue, New York, NY 10016, USA
| | - Paul E Moore
- Division of Allergy, Immunology, and Pulmonary Medicine, Department of Pediatrics, Vanderbilt University Medical Center, 2200 Children's Way, Nashville, TN 37232, USA
| | - Ako Adams Ako
- Department of Pediatrics, Children's Hospital at Montefiore, 3415 Bainbridge Avenue, Bronx, NY 10467, USA
| | - Nan Ji
- Division of Environmental Health, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 1845 N Soto St, MC 9239, Los Angeles, CA, 90039, USA
| | - Chang Liu
- Department of Psychology, Washington State University, Johnson Tower, Pullman, WA 99164, USA
| | - Adam A Szpiro
- Department of Biostatistics, University of Washington, 3980 15th Avenue NE, Seattle, WA 98195, USA
| | - Sheela Sathyanarayana
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, 1920 Terry Avenue, Seattle, Washington 98101, USA; Department of Environmental and Occupational Health, University of Washington, 4245 Roosevelt Way NE, Seattle, WA 98105, USA; Department of Epidemiology, University of Washington, 4245 Roosevelt Way NE, Seattle, WA 98105, USA; Department of Pediatrics, University of Washington, 4245 Roosevelt Way NE, Seattle, WA 98105, USA
| |
Collapse
|
2
|
Carollo A, Bonassi A, Lim M, Gabrieli G, Setoh P, Dimitriou D, Aryadoust V, Esposito G. Developmental disabilities across the world: A scientometric review from 1936 to 2020. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 117:104031. [PMID: 34333315 DOI: 10.1016/j.ridd.2021.104031] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 06/07/2021] [Accepted: 07/12/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Developmental disabilities have been largely studied in the past years. Their etiological mechanisms have been underpinned to the interactions between genetic and environmental factors. These factors show variability across the world. Thus, it is important to understand where the set of knowledge obtained on developmental disabilities originates from and whether it is generalizable to low- and middle-income countries. AIMS This study aims to understand the origins of the available literature on developmental disabilities, keeping a focus on parenting, and identify the main trend of research. METHODS AND PROCEDURE A sample of 11,315 publications from 1936 to 2020 were collected from Scopus and a graphical country analysis was conducted. Furthermore, a qualitative approach enabled the clustering of references by keywords into four main areas: "Expression of the disorder", "Physiological Factors", "How it is studied" and "Environmental factors". For each area, a document co-citation analysis (DCA) on CiteSpace software was performed. OUTCOMES AND RESULTS Results highlight the leading role of North America in the study of developmental disabilities. Trends in the literature and the documents' scientific relevance are discussed in details. CONCLUSIONS AND IMPLICATIONS Results demand for investigation in different socio-economical settings to generalize our knowledge. What this paper adds? The current paper tries to provide insight into the origins of the literature on developmental disabilities with a focus on parenting, together with an analysis of the trends of research in the field. The paper consisted of a multi-disciplinary and multi-method review. In fact, the review tried to integrate the analysis of the relation between developmental disabilities with a closer look at the scientific contributions to the field across the world. Specifically, the paper integrates a total of 11,315 papers published on almost a century of research (from 1936 to 2020). An initial qualitative analysis on keywords was combined to a subsequent quantitative approach in order to maximize the comprehension of the impact of almost a century of scientific contributions. Specifically, documents were studied with temporal and structural metrics on a scientometric approach. This allowed the exploration of patterns within the literature available on Scopus in a quantitative way. This method not only assessed the importance of single documents within the network. As a matter of fact, the document co-citation analysis used on CiteSpace software provided insight into the relations existing between multiple documents in the field of research. As a result, the leading role of North America in the literature of developmental disabilities and parenting emerged. This was accompanied by the review of the main trends of research within the existing literature.
Collapse
Affiliation(s)
- Alessandro Carollo
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy
| | - Andrea Bonassi
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy; Mobile and Social Computing Lab, Bruno Kessler Foundation, Trento, Italy
| | - Mengyu Lim
- Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
| | - Giulio Gabrieli
- Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
| | - Peipei Setoh
- Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
| | - Dagmara Dimitriou
- Sleep Research and Education Laboratory, UCL Institute of Education, London, United Kingdom
| | - Vahid Aryadoust
- National Institute of Education, Nanyang Technological University, Singapore, Singapore
| | - Gianluca Esposito
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy; Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
| |
Collapse
|
3
|
Hackenberg B, Büttner M, Große L, Martin E, Cordier D, Matthias C, Läßig AK. [Impact of the COVID-19 pandemic on speech therapy for children with Speech and Language Disorders]. Laryngorhinootologie 2021. [PMID: 34507370 DOI: 10.1055/a-1613-5747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE In December 2019, the COVID-19 pandemic began to spread around the world and caused massive restrictions in our daily life. Many educational facilities and practices delivering speech therapy were temporally closed (so-called lockdown). Children with a speech and language disorder were forced to pause their therapy. The aim of this study was to describe if and how speech therapy was delivered during lockdown and what psychological burden was associated to affected parents. MATERIAL AND METHODS Parents of children with a speech and language disorder were asked about their child´s therapy during lockdown and about their fears and worries associated with it. RESULTS For 17 patients speech therapy was paused during lockdown while 20 patients could continue their therapy. Children speaking a language other than German had a higher risk for having their therapy paused during lockdown (Odds ratio = 5.11, with 95 % confidence interval = 1.09-32.54). Parents whose children did not receive speech therapy during lockdown were more worried about their child's development. CONCLUSIONS There is no common concept on how speech therapy can be delivered safely during lockdown. Possible barriers to healthcare might be more pronounced during the pandemic and parents experience a high psychosocial burden.
Collapse
Affiliation(s)
- Berit Hackenberg
- Otorhinolaryngolgy, Head and Neck Surgery, Johannes-Gutenberg-Universität Mainz, Hals-Nasen-Ohrenklinik und Poliklinik, Mainz, Germany
| | | | - Lisa Große
- Otorhinolaryngolgy, Head and Neck Surgery, Johannes-Gutenberg-Universität Mainz, Hals-Nasen-Ohrenklinik und Poliklinik, Mainz, Germany
| | - Evgenia Martin
- Schwerpunkt Kommunikationsstörungen der Hals-Nasen-Ohren-Klinik und Poliklinik - Plastische Operationen, Unimedizin Mainz, Germany
| | - Dahlia Cordier
- Schwerpunkt Kommunikationsstörungen der Hals-Nasen-Ohren-Klinik und Poliklinik - Plastische Operationen, Unimedizin Mainz, Germany
| | - Christoph Matthias
- Otorhinolaryngolgy, Head and Neck Surgery, Johannes-Gutenberg-Universität Mainz, Hals-Nasen-Ohrenklinik und Poliklinik, Mainz, Germany
| | - Anne Katrin Läßig
- Schwerpunkt Kommunikationsstörungen der Hals-Nasen-Ohren-Klinik und Poliklinik - Plastische Operationen, Unimedizin Mainz, Germany
| |
Collapse
|
4
|
Hayiou-Thomas ME, Smith-Woolley E, Dale PS. Breadth versus depth: Cumulative risk model and continuous measure prediction of poor language and reading outcomes at 12. Dev Sci 2020; 24:e12998. [PMID: 32449284 DOI: 10.1111/desc.12998] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 03/09/2020] [Accepted: 05/02/2020] [Indexed: 01/20/2023]
Abstract
This study examines whether, and how, multiple risks in early childhood are associated with an increased likelihood of a poor language or literacy outcome in early adolescence. Using data from 210 participants in the longitudinal Twins Early Developmental Study, we focus on the following risk factors at age 4: family risk, and poor language, speech, emergent literacy and nonverbal skills. The outcomes of interest at age 12 are language, reading fluency and reading comprehension. We contrast a 'cumulative risk' model, counting the presence or absence of each risk factor (breadth), with a model that also considers the severity of the early deficits (depth). A 'cumulative risk index' correlated modestly but significantly with outcome (r = 0.32-0.40). Odds ratios confirmed that having many risk factors (3-6) confers a higher probability of a poor outcome (OR 7.86-17.71) than having one or two (OR 3.65-7.28). Logistic regression models showed that predictive validity is not improved by including information about the severity of each deficit. Even with rich information on children's risk status at age 4, we can make only a moderately accurate prediction of the likelihood of a language or literacy disorder 8 years later (Area Under the Curve = 0.74-0.84; Positive Predictive Value = 0.33-0.55, Negative Predictive Value = 0.86-0.91). Taken together, and consistent with the idea of 'cumulative risk', these results suggest that the breadth of risk is a core predictor of outcome, and furthermore, that the severity of early deficits does not add significantly to this prediction.
Collapse
Affiliation(s)
| | | | - Philip S Dale
- Department of Speech & Hearing Sciences, University of New Mexico, Albuquerque, NM, USA
| |
Collapse
|
5
|
REFERENCES. Monogr Soc Res Child Dev 2018. [DOI: 10.1111/mono.12354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
6
|
Armstrong R, Scott J, Copland D, McMahon K, Khan A, Najman JM, Alati R, Arnott W. Predicting receptive vocabulary change from childhood to adulthood: A birth cohort study. JOURNAL OF COMMUNICATION DISORDERS 2016; 64:78-90. [PMID: 27973323 DOI: 10.1016/j.jcomdis.2016.10.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Revised: 10/07/2016] [Accepted: 10/13/2016] [Indexed: 06/06/2023]
Abstract
This study examined the parental and early childhood risk factors of different receptive vocabulary developmental profiles from childhood to adulthood. The sample (n=1914), comprised of monolingual English speaking participants, from the Mater University of Queensland Study of Pregnancy (MUSP). Receptive vocabulary was measured using the Peabody Picture Vocabulary Test-Revised (PPVT-R) at the 5 and 21-year follow ups. Four vocabulary profiles were evident: persistently typical, persistently impaired, later onset of difficulties, and resolved delays. The presence of internalising behaviours at 5 years, lower paternal educational attainment, and maternal smoking during pregnancy were associated with later onset vocabulary impairment. These findings have clinical and educational implications for identifying children 'at risk' of later deterioration in language skills.
Collapse
Affiliation(s)
- Rebecca Armstrong
- The University of Queensland, School of Health and Rehabilitation Sciences, St Lucia, QLD 4072, Australia; The University of Queensland, Centre for Clinical Research, Level 3, Bld 71/918, Royal Brisbane and Women's Hospital, Herston, QLD 4029, Australia; The University of Queensland, Centre for Advanced Imaging, St Lucia, QLD 4072, Australia.
| | - James Scott
- The University of Queensland, Centre for Clinical Research, Level 3, Bld 71/918, Royal Brisbane and Women's Hospital, Herston, QLD 4029, Australia; The Royal Brisbane and Women's Hospital, Herston, QLD 4029, Australia
| | - David Copland
- The University of Queensland, School of Health and Rehabilitation Sciences, St Lucia, QLD 4072, Australia; The University of Queensland, Centre for Clinical Research, Level 3, Bld 71/918, Royal Brisbane and Women's Hospital, Herston, QLD 4029, Australia
| | - Katie McMahon
- The University of Queensland, Centre for Advanced Imaging, St Lucia, QLD 4072, Australia
| | - Asaduzzaman Khan
- The University of Queensland, School of Health and Rehabilitation Sciences, St Lucia, QLD 4072, Australia
| | - Jake M Najman
- The University of Queensland, Schools of Public Health and Social Science, St Lucia, QLD 4072, Australia
| | - Rosa Alati
- The University of Queensland, Schools of Public Health and Social Science, St Lucia, QLD 4072, Australia
| | - Wendy Arnott
- The University of Queensland, School of Health and Rehabilitation Sciences, St Lucia, QLD 4072, Australia; Hear and Say Centre, Brisbane, QLD 4060, Australia
| |
Collapse
|
7
|
Atkinson L, Beitchman J, Gonzalez A, Young A, Wilson B, Escobar M, Chisholm V, Brownlie E, Khoury JE, Ludmer J, Villani V. Cumulative risk, cumulative outcome: a 20-year longitudinal study. PLoS One 2015; 10:e0127650. [PMID: 26030616 PMCID: PMC4452593 DOI: 10.1371/journal.pone.0127650] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Accepted: 04/17/2015] [Indexed: 12/03/2022] Open
Abstract
Cumulative risk (CR) models provide some of the most robust findings in the developmental literature, predicting numerous and varied outcomes. Typically, however, these outcomes are predicted one at a time, across different samples, using concurrent designs, longitudinal designs of short duration, or retrospective designs. We predicted that a single CR index, applied within a single sample, would prospectively predict diverse outcomes, i.e., depression, intelligence, school dropout, arrest, smoking, and physical disease from childhood to adulthood. Further, we predicted that number of risk factors would predict number of adverse outcomes (cumulative outcome; CO). We also predicted that early CR (assessed at age 5/6) explains variance in CO above and beyond that explained by subsequent risk (assessed at ages 12/13 and 19/20). The sample consisted of 284 individuals, 48% of whom were diagnosed with a speech/language disorder. Cumulative risk, assessed at 5/6-, 12/13-, and 19/20-years-old, predicted aforementioned outcomes at age 25/26 in every instance. Furthermore, number of risk factors was positively associated with number of negative outcomes. Finally, early risk accounted for variance beyond that explained by later risk in the prediction of CO. We discuss these findings in terms of five criteria posed by these data, positing a "mediated net of adversity" model, suggesting that CR may increase some central integrative factor, simultaneously augmenting risk across cognitive, quality of life, psychiatric and physical health outcomes.
Collapse
Affiliation(s)
| | - Joseph Beitchman
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
| | | | | | - Beth Wilson
- Social Planning Toronto, Toronto, Ontario, Canada
| | | | | | - Elizabeth Brownlie
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
| | | | | | | |
Collapse
|
8
|
Eadie P, Nguyen C, Carlin J, Bavin E, Bretherton L, Reilly S. Stability of language performance at 4 and 5 years: measurement and participant variability. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2014; 49:215-227. [PMID: 24741700 DOI: 10.1111/1460-6984.12065] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Language impairment (LI) in the preschool years is known to vary over time. Stability in the diagnosis of LI may be influenced by children’s individual variability, the measurement error of commonly used assessment instruments and the cut-points used to define impairment. AIMS To investigate the agreement between two different age-based versions of a language assessment instrument and the stability of the classification of LI using the two measures over a 12-month period. METHODS & PROCEDURES A total of 945 participants completed the Clinical Evaluation of Language Fundamentals(CELF—Preschool 2 or 4th Edn) at 4 and 5 years of age. Agreement and stability were analysed using Bland–Altman plots, correlation and odds ratios. Sensitivity and specificity were calculated for two thresholds of the CELF-P2 using the diagnostic category on the child’s subsequent CELF-4. OUTCOMES & RESULTS For all CELF scores, mean differences for the cohort between 4 and 5 years were within 1.5 scale score units. In contrast, at the individual level variability was found across the range of scores and was of a greater magnitude than previously reported. Stability in LI classification was low, with 36% of 5-year-olds with LI (defined as a standard score below –1.25) classified as typical at 4 years, even though odds ratios calculated from classifications at the two time points suggested that 4-year-olds with LI had 23 times greater odds than their typical peers to receive a diagnosis of LI at 5 years. The CELF-P2 did not demonstrate adequate levels of diagnostic accuracy for LI at 5 years: sensitivity of 64% and specificity of 92.9%. CONCLUSIONS Substantial variability across the entire range of possible CELF scores was observed in this community cohort between the ages of 4 and 5 years. The stability of LI classification was lower than that reported in previous research conducted primarily on smaller clinical cohorts. The current study’s results suggest that the variability observed in developmental language pathways is the result of a combination of limitations in measurement instruments, individual children’s abilities and the arbitrary nature of the boundaries defining LI.
Collapse
|
9
|
Bretherton L, Prior M, Bavin E, Cini E, Eadie P, Reilly S. Developing relationships between language and behaviour in preschool children from the Early Language in Victoria Study: implications for intervention. EMOTIONAL AND BEHAVIOURAL DIFFICULTIES 2013. [DOI: 10.1080/13632752.2013.854956] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
10
|
Conti-Ramsden G, Mok PL, Pickles A, Durkin K. Adolescents with a history of specific language impairment (SLI): strengths and difficulties in social, emotional and behavioral functioning. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:4161-9. [PMID: 24077068 PMCID: PMC3830176 DOI: 10.1016/j.ridd.2013.08.043] [Citation(s) in RCA: 92] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Revised: 08/27/2013] [Accepted: 08/28/2013] [Indexed: 05/22/2023]
Abstract
Adolescents with specific language impairment (SLI) are at a greater risk of emotional and behavioral problems compared to their typically developing (TD) peers, but little is known about their self-perceived strengths and difficulties. In this study, the self-reported social, emotional and behavioral functioning of 139 adolescents with a history of SLI and 124 TD individuals at age 16 was examined. The self-report version of the Strengths and Difficulties Questionnaire (SDQ) was used to assess their prosocial behavior and levels of peer, emotional and behavioral difficulties. Associations of these areas of functioning with gender, verbal and non-verbal skills were also investigated. Adolescents with a history of SLI were more likely than their TD peers to report higher levels of peer problems, emotional symptoms, hyperactivity and conduct problems. The majority of adolescents in both groups (87% SLI and 96% TD), however, reported prosocial behavior within the typical range. Difficulty with peer relations was the strongest differentiator between the groups, with the odds of reporting borderline or abnormally high levels of peer problems being 12 times higher for individuals with a history of SLI. Adolescents with poorer receptive language skills were also more likely to report higher levels of emotional and behavioral difficulties. The findings of this study identify likely traits that may lead to referral to services.
Collapse
Affiliation(s)
- Gina Conti-Ramsden
- School of Psychological Sciences, Communication and Deafness, The University of Manchester, Oxford Road, Manchester M13 9PL, UK
- Corresponding author. Tel.: +44 0 161 275 3514.
| | - Pearl L.H. Mok
- School of Psychological Sciences, Communication and Deafness, The University of Manchester, Oxford Road, Manchester M13 9PL, UK
| | - Andrew Pickles
- Institute of Psychiatry, King's College London, 16 De Crespigny Park, London SE5 8AF, UK
| | - Kevin Durkin
- School of Psychological Sciences and Health, University of Strathclyde, 40 George Street, Glasgow G1 1QE, UK
| |
Collapse
|
11
|
Johnson CJ, Beitchman JH, Brownlie EB. Twenty-year follow-up of children with and without speech-language impairments: family, educational, occupational, and quality of life outcomes. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2010; 19:51-65. [PMID: 19644128 DOI: 10.1044/1058-0360(2009/08-0083)] [Citation(s) in RCA: 182] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
PURPOSE Parents, professionals, and policy makers need information on the long-term prognosis for children with communication disorders. Our primary purpose in this report was to help fill this gap by profiling the family, educational, occupational, and quality of life outcomes of young adults at 25 years of age (N = 244) from the Ottawa Language Study, a 20-year, prospective, longitudinal study of a community sample of individuals with (n = 112) and without (n = 132) a history of early speech and/or language impairments. A secondary purpose of this report was to use data from earlier phases of the study to predict important, real-life outcomes at age 25. METHOD Participants were initially identified at age 5 and subsequently followed at 12, 19, and 25 years of age. Direct assessments were conducted at all 4 time periods in multiple domains (demographic, communicative, cognitive, academic, behavioral, and psychosocial). RESULTS At age 25, young adults with a history of language impairments showed poorer outcomes in multiple objective domains (communication, cognitive/academic, educational attainment, and occupational status) than their peers without early communication impairments and those with early speech-only impairments. However, those with language impairments did not differ in subjective perceptions of their quality of life from those in the other 2 groups. Objective outcomes at age 25 were predicted differentially by various combinations of multiple, interrelated risk factors, including poor language and reading skills, low family socioeconomic status, low performance IQ, and child behavior problems. Subjective well-being, however, was primarily associated with strong social networks of family, friends, and others. CONCLUSION This information on the natural history of communication disorders may be useful in answering parents' questions, anticipating challenges that children with language disorders might encounter, and planning services to address those issues.
Collapse
|
12
|
Abstract
Es wird ein Überblick über Evaluationsstudien zur Sprachtherapie gegeben. Obwohl die Aussagefähigkeit vieler Therapiestudien durch methodische Mängel begrenzt ist, kann als ausreichend gesichert gelten, dass sich die sprachlichen Fähigkeiten eines Kindes durch eine logopädische Behandlung auf den meisten Sprachebenen zumindest kurzfristig verbessern lassen. Am ausgeprägtesten sind Behandlungserfolge hinsichtlich der Lautbildungsfähigkeit und des aktiven Wortschatzes. Weniger deutlich sind die Effekte in Bezug auf grammatische Fähigkeiten und die sprachliche Kompetenz bei komplexeren Anforderungen, (z. B. beim Erzählen). Ob auch Kinder mit ausgeprägten Sprachverständnisstörungen von einer Therapie profitieren, ist noch ungeklärt.
Collapse
|
13
|
Kruse CKHE. A follow-up report of German kindergarten children and preschoolers with expressive developmental language disorder. LOGOP PHONIATR VOCO 2009. [DOI: 10.1080/140154398434220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
14
|
Hollands K, van Kraayenoord CE, McMahon S. Support to adolescents experiencing language difficulties: A survey of speech-language pathologists. ACTA ACUST UNITED AC 2009. [DOI: 10.1080/14417040500125251] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
15
|
Jung HY, Ko TS, Kim HD, Yim SY, Kim MO, Hong SK. Korean Academy of Medical Sciences Pediatric Impairment Guideline for brain lesion. J Korean Med Sci 2009; 24 Suppl 2:S323-9. [PMID: 19503690 PMCID: PMC2690078 DOI: 10.3346/jkms.2009.24.s2.s323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2009] [Accepted: 05/06/2009] [Indexed: 11/25/2022] Open
Abstract
The permanent impairment evaluation for children in developmental stage is very difficult and it is even impossible in some cases. The impairment evaluation for developing children has not yet been included in the guideline of the American Medical Association. Due to frequent medical and social demands in Korea, we developed an impairment evaluation guideline for motor impairment, intellectual disability/mental retardation, developmental speech-language disorder and epilepsy caused by pediatric cerebral injuries, or cerebral lesions other than the developmental disorders such as autism. With the help of various literature and foreign institutions, we developed our in order to develop a scientific guideline for pediatric impairment that is suited to Korean cultural background and social condition.
Collapse
Affiliation(s)
- Han-Young Jung
- Department of Physical & Rehabilitation Medicine, Inha University College of Medicine, Incheon, Korea
| | - Tae-Sung Ko
- Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Heung-Dong Kim
- Department of Pediatrics, Severance Children's Hospital, Yonsei Universtiy College of Medicine, Seoul, Korea
| | - Shin-Young Yim
- Department of Physical Medicine & Rehabilitation, Ajou University School of Medicine, Suwon, Korea
| | - Myeong-Ok Kim
- Department of Physical & Rehabilitation Medicine, Inha University College of Medicine, Incheon, Korea
| | - Seung-Kwon Hong
- Department of Biomedical & Health Care Informatics, Seoul National University College of Medicine, Seoul, Korea
| |
Collapse
|
16
|
Skibbe LE, Grimm KJ, Stanton-Chapman TL, Justice LM, Pence KL, Bowles RP. Reading Trajectories of Children With Language Difficulties From Preschool Through Fifth Grade. Lang Speech Hear Serv Sch 2008; 39:475-86. [DOI: 10.1044/0161-1461(2008/07-0016)] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose
The current work examined which theory of reading development, the
cumulative reading trajectory
or the
compensatory trajectory of development,
most accurately represents the reading trajectories of children with language difficulties (LD) relative to their peers with typical language (TL) skills. Specifically, initial levels of reading skills, overall rate of growth, and patterns of growth were examined.
Method
Children were classified according to whether or not they exhibited LD at 54 months of age (LD
n
= 145; TL
n
= 653), using data from the National Institute of Child Health and Human Development’s Early Child Care Research Network (see NICHD, 1993). A latent shape growth curve model was used to model reading skills at 4 time points from preschool through fifth grade.
Results
In comparison to children with TL, children with LD showed lower reading skills in preschool, but their overall reading growth was faster. All children developed the skills associated with reading more rapidly at earlier ages compared to later ages. Children with LD continued to exhibit reading skills that were substantially lower than those of children with TL during fifth grade.
Conclusion
Results supported the compensatory trajectory of development. Speech-language pathologists are encouraged to adopt evidence-based practices in order to boost reading outcomes for children with LD beginning in preschool.
Collapse
|
17
|
Beverly BL, McGuinness TM, Blanton DJ. Communication and Academic Challenges in Early Adolescence for Children Who Have Been Adopted From the Former Soviet Union. Lang Speech Hear Serv Sch 2008; 39:303-13. [DOI: 10.1044/0161-1461(2008/029)] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose
This was a Time II survey of outcomes for children, now ages 9 to 13 years, who were almost 4 years old on average when they were adopted from the former Soviet Union.
Method
As part of a larger study (see T. McGuinness, R. Ryan, & C. Broadus Robinson, 2005), parents of 55 children (
M
age = 11 years) were surveyed regarding their children’s speech-language, behavior, and eligibility for special education. The children’s mean length of institutionalization was 36 months.
Results
A total of 45, or 82%, of the children had at least one special education label. The most frequent was communication disorder, which was reported for 34 children, or 62%. The frequency of attention deficit hyperactivity disorder (ADHD) was high, 42%. The ratio of boys to girls for communication disorders and ADHD was 1.5:1. Girls who were adopted after 36 months of age were 4 times more likely than girls who were adopted before 36 months to be labeled ADHD, and children with low birth weight exhibited learning disabilities twice as often as children with normal birth weight.
Conclusion
Speech-language, learning, and attention deficits for late-adopted, early adolescent children were higher than expected. These children from the former Soviet Union experienced substantial preadoption adversity associated with lengthy orphanage stays and poor care. Gender and low birth weight were also factors.
Collapse
Affiliation(s)
| | | | - Debra J. Blanton
- Bureau of Indian Affairs/Bureau of Indian Education, Crownpoint, NM
| |
Collapse
|
18
|
Beitchman JH, Jiang H, Koyama E, Johnson CJ, Escobar M, Atkinson L, Brownlie EB, Vida R. Models and determinants of vocabulary growth from kindergarten to adulthood. J Child Psychol Psychiatry 2008; 49:626-34. [PMID: 18341544 DOI: 10.1111/j.1469-7610.2008.01878.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Increasing evidence suggests that childhood language problems persist into early adulthood. Nevertheless, little is known about how individual and environmental characteristics influence the language growth of individuals identified with speech/language problems. METHOD Individual growth curve models were utilised to examine how speech/language impairment and environmental variables (socioeconomic status, family separation, and maternal factors) influence vocabulary development from age 5 to 25. Participants were taken from a community sample of children initially diagnosed with speech/language problems at age 5 and their sex- and age-matched controls. RESULTS The language impaired group had significantly poorer receptive vocabulary than the speech impaired and control groups throughout the 20-year period. Family income was a significant predictor of vocabulary growth when considered separately, but ceased to be a predictor when language impairment status was taken into account. Maternal education and family separation were determinants of vocabulary at age 5, over and above language impairment status. CONCLUSION Language impairment is a significant risk factor for vocabulary development from childhood to adulthood. Individuals with speech impairment were less impaired on receptive vocabulary than individuals with language impairment. Further investigation into maternal and familial risk factors may provide targets for early intervention with children at risk for language impairment.
Collapse
|
19
|
Abstract
This article discusses screening of language development in a pediatric office setting. It describes the relationship between language delay and various developmental disorders. It provides recent recommendations regarding the efficacy of formal language screening instruments, and suggests developmental guidelines for clinical observations. Referrals for specialty evaluations and services for evaluation and treatment are presented. The article offers suggestions for counseling parents when a language disorder is suspected.
Collapse
Affiliation(s)
- Robert L Schum
- Section of Child Development, Department of Pediatrics, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA.
| |
Collapse
|
20
|
Watier L, Dellatolas G, Chevrie-Muller C. Difficultés de langage et de comportement à 3 ans et demi et retard en lecture au cours élémentaire. Rev Epidemiol Sante Publique 2006; 54:327-39. [PMID: 17088697 DOI: 10.1016/s0398-7620(06)76728-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Early detection of specific language impairment and dyslexia in children is an important public health problem. Longitudinal studies are needed for the distinction of real impairments from simple transitory delays. METHODS Teachers filled a 29-item questionnaire on language and behavior for 695 children aged 3.5 years. Four years later (at second grade of primary school) the same children were evaluated for reading and writing. Statistical analysis focused on the relationships between teacher's early observations and reading delay 4 years later. Associated factors were age, sex, educational level and bilinguism of the parents, and area of the school. RESULTS The delay in written language acquisition (8.5% of the children) was significantly associated with low educational level (but not bilinguism) of the parents and to the area of the school. In univariate analysis, most of the teacher's early negative assessments were significantly related to reading/writing delay, with the exception of some behavioral problems. However, when the effect of associated factors was taken into account only a few items, mainly concerning language expression, remained significantly associated with later reading/writing delay. CONCLUSION These data show a major role of associated factors (educational level of the parents, area of the school) in reading delay, and help to select specific teacher's observations for an early prediction of this delay.
Collapse
Affiliation(s)
- L Watier
- Inserm U472--IFR 69--Epidémiologie et Biostatistique, 16, avenue Paul-Vaillant-Couturier, 94807 Villejuif Cedex.
| | | | | |
Collapse
|
21
|
Hardoff D, Jaffe M, Cohen A, Jonas R, Lerrer-Amisar D, Tirosh E. Emotional and behavioral outcomes among adolescents with mild developmental deficits in early childhood. J Adolesc Health 2005; 36:70.e14-9. [PMID: 15661599 DOI: 10.1016/j.jadohealth.2004.02.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2003] [Accepted: 02/06/2004] [Indexed: 11/30/2022]
Abstract
PURPOSES To evaluate emotional and behavioral outcomes in adolescents who in early childhood were treated for mild developmental deficits; and to identify predictive factors in early childhood, for future emotional and social competence abnormalities. METHODS The records of children referred to Hanna Khoushi Child Development Center in Haifa for mild developmental delay were reviewed. Parents and adolescents were requested to complete the Child Behavior Checklist (CBCL) and the Youth Self-Report (YSR) 12 to 16 years after discharge from the Child Development Center. Analysis of the two questionnaires and identification of predictive variables in early childhood for emotional problems and social competence difficulties during adolescence were performed, using ANOVA Student's T-test, Chi-square, and multiple regression. RESULTS The most frequent developmental diagnoses on admission to the Child Development Center were mild motor (27.3%) or language (23.2%) deficits. Of the treated children, 53.4% were discharged without any developmental deficit. All CBCL and YSR T-scores were within the nonpsychopathology range. No notable differences were found between the study scores and the scores regarding typical Israeli and American youths. Significant differences were, however, observed in self-perception of internalizing emotional problems between male and female adolescents: T-scores of 51.9 +/- 8.0 vs. 47.4 +/- 10.8, respectively (p < .05). Motor and language deficits were associated with lower general competence than general developmental delay and emotional developmental disturbances (T-scores: 47.9 vs. 49.1 and 50.9, p< .05). Admission to the Center after the age of 18 months was associated with higher T-scores for general as well as externalizing problems when compared with scores associated with admission before the age of 18 months (by 5.75 points for both parameters, p < .001). CONCLUSION The perception of parents and children with minor developmental deficits observed in early childhood regarding their emotional and social competence during adolescence is similar to typical youths.
Collapse
Affiliation(s)
- Daniel Hardoff
- Division of Adolescent Medicine, Bnai Zion Medical Center, Haifa, Israel.
| | | | | | | | | | | |
Collapse
|
22
|
Sundheim STPV, Voeller KKS. Psychiatric implications of language disorders and learning disabilities: risks and management. J Child Neurol 2004; 19:814-26. [PMID: 15559896 DOI: 10.1177/08830738040190101001] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This article reviews the relationship between different learning disabilities, language disorders, and the psychiatric disorders that are commonly associated with learning disabilities and language disorder: attention-deficit hyperactivity disorder (ADHD), anxiety disorders, depression, and conduct or antisocial personality disorder. The complex associations between language disorders and specific learning disabilities--dyslexia, nonverbal learning disorder, dyscalculia--and the various psychiatric disorders are discussed. Clinical vignettes are presented to highlight the impact of these disorders on a child's social and psychological development and the importance of early recognition and treatment.
Collapse
Affiliation(s)
- Suzanne T P V Sundheim
- Western Institute for Neurodevelopmental Studies and Interventions, Boulder, CO 80302, USA.
| | | |
Collapse
|
23
|
Highly significant linkage to the SLI1 locus in an expanded sample of individuals affected by specific language impairment. Am J Hum Genet 2004; 74:1225-38. [PMID: 15133743 PMCID: PMC1182086 DOI: 10.1086/421529] [Citation(s) in RCA: 116] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2004] [Accepted: 03/26/2004] [Indexed: 11/03/2022] Open
Abstract
Specific language impairment (SLI) is defined as an unexplained failure to acquire normal language skills despite adequate intelligence and opportunity. We have reported elsewhere a full-genome scan in 98 nuclear families affected by this disorder, with the use of three quantitative traits of language ability (the expressive and receptive tests of the Clinical Evaluation of Language Fundamentals and a test of nonsense word repetition). This screen implicated two quantitative trait loci, one on chromosome 16q (SLI1) and a second on chromosome 19q (SLI2). However, a second independent genome screen performed by another group, with the use of parametric linkage analyses in extended pedigrees, found little evidence for the involvement of either of these regions in SLI. To investigate these loci further, we have collected a second sample, consisting of 86 families (367 individuals, 174 independent sib pairs), all with probands whose language skills are >/=1.5 SD below the mean for their age. Haseman-Elston linkage analysis resulted in a maximum LOD score (MLS) of 2.84 on chromosome 16 and an MLS of 2.31 on chromosome 19, both of which represent significant linkage at the 2% level. Amalgamation of the wave 2 sample with the cohort used for the genome screen generated a total of 184 families (840 individuals, 393 independent sib pairs). Analysis of linkage within this pooled group strengthened the evidence for linkage at SLI1 and yielded a highly significant LOD score (MLS = 7.46, interval empirical P<.0004). Furthermore, linkage at the same locus was also demonstrated to three reading-related measures (basic reading [MLS = 1.49], spelling [MLS = 2.67], and reading comprehension [MLS = 1.99] subtests of the Wechsler Objectives Reading Dimensions).
Collapse
|
24
|
Hugdahl K, Gundersen H, Brekke C, Thomsen T, Rimol LM, Ersland L, Niemi J. FMRI brain activation in a finnish family with specific language impairment compared with a normal control group. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2004; 47:162-72. [PMID: 15072536 DOI: 10.1044/1092-4388(2004/014)] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The aim of the present study was to investigate differences in brain activation in a family with SLI as compared to intact individuals with normally developed language during processing of language stimuli. Functional magnetic resonance imaging (fMRI) was used to monitor changes in neuronal activation in temporal and frontal lobe areas in 5 Finnish family members with specific language impairment (SLI) and 6 individuals in an intact control group. Magnetic resonance (MR) image acquisitions were made while the participants listened to series of isolated vowel sounds, pseudowords, and real words. The stimuli were digitized single Finnish vowel sounds, 3-phoneme pseudowords, and 3- and 4-phoneme real words. MR scanning was made with a 1.5 T Siemens Vision Plus scanner, and the auditory stimuli were presented according to an event-related fMRI design. The results showed significant differences between the family with SLI and the intact control group with regard to brain activation in areas in the temporal and frontal lobes. Temporal lobe activation differences were most pronounced in the middle temporal gyrus bordering the superior temporal sulcus. The control participants also activated an area in the inferior frontal lobe in BA 44. It is concluded that individuals with SLI showed reduced activation in brain areas that are critical for speech processing and phonological awareness. The present functional brain imaging data fit well with other recent imaging data that also showed structural abnormalities in the same and neighboring areas.
Collapse
Affiliation(s)
- Kenneth Hugdahl
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway.
| | | | | | | | | | | | | |
Collapse
|
25
|
Tomblin JB, Zhang X, Buckwalter P, O'Brien M. The stability of primary language disorder: four years after kindergarten diagnosis. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2003; 46:1283-96. [PMID: 14700355 DOI: 10.1044/1092-4388(2003/100)] [Citation(s) in RCA: 97] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The rates of change in the language status of children with language impairment unaccompanied by other developmental or sensory disorders (primary language disorder) were studied in a longitudinal sample of 196 children who were followed from kindergarten through 4th grade. Previous studies have shown that children with such language impairments have moderate rates of improvement during this age range. Also, those with the most specific deficits have the greatest likelihood of improvement. Cole and colleagues have hypothesized that such results could be due to the effect of regression to the mean (K. Cole, I. Schwartz, A. Notari, P. Dale, & P. Mills, 1995). This study used a baseline measure of language that was independent of the measure used for diagnosis in order to control for factors leading to regression to the mean. Patterns of change using the kindergarten diagnostic measure were compared to those using the baseline measure. Rates of diagnostic change between kindergarten and subsequent observation intervals showed patterns of change similar to those of past research. Comparisons using the baseline measure revealed no significant change in relative language status across the 4-year time period. The results showed that when the conditions for regression to the mean were controlled, the poor language of children with language impairments was very likely to persist during the primary school years.
Collapse
Affiliation(s)
- J Bruce Tomblin
- Department of Speech Pathology and Audiology, The University of Iowa, Iowa City 52242, USA.
| | | | | | | |
Collapse
|
26
|
A genomewide scan identifies two novel loci involved in specific language impairment. Am J Hum Genet 2002; 70:384-98. [PMID: 11791209 PMCID: PMC384915 DOI: 10.1086/338649] [Citation(s) in RCA: 173] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2001] [Accepted: 11/12/2001] [Indexed: 11/03/2022] Open
Abstract
Approximately 4% of English-speaking children are affected by specific language impairment (SLI), a disorder in the development of language skills despite adequate opportunity and normal intelligence. Several studies have indicated the importance of genetic factors in SLI; a positive family history confers an increased risk of development, and concordance in monozygotic twins consistently exceeds that in dizygotic twins. However, like many behavioral traits, SLI is assumed to be genetically complex, with several loci contributing to the overall risk. We have compiled 98 families drawn from epidemiological and clinical populations, all with probands whose standard language scores fall > or =1.5 SD below the mean for their age. Systematic genomewide quantitative-trait-locus analysis of three language-related measures (i.e., the Clinical Evaluation of Language Fundamentals-Revised [CELF-R] receptive and expressive scales and the nonword repetition [NWR] test) yielded two regions, one on chromosome 16 and one on 19, that both had maximum LOD scores of 3.55. Simulations suggest that, of these two multipoint results, the NWR linkage to chromosome 16q is the most significant, with empirical P values reaching 10(-5), under both Haseman-Elston (HE) analysis (LOD score 3.55; P=.00003) and variance-components (VC) analysis (LOD score 2.57; P=.00008). Single-point analyses provided further support for involvement of this locus, with three markers, under the peak of linkage, yielding LOD scores >1.9. The 19q locus was linked to the CELF-R expressive-language score and exceeds the threshold for suggestive linkage under all types of analysis performed-multipoint HE analysis (LOD score 3.55; empirical P=.00004) and VC (LOD score 2.84; empirical P=.00027) and single-point HE analysis (LOD score 2.49) and VC (LOD score 2.22). Furthermore, both the clinical and epidemiological samples showed independent evidence of linkage on both chromosome 16q and chromosome 19q, indicating that these may represent universally important loci in SLI and, thus, general risk factors for language impairment.
Collapse
|
27
|
Mawhood L, Howlin P, Rutter M. Autism and developmental receptive language disorder--a comparative follow-up in early adult life. I: Cognitive and language outcomes. J Child Psychol Psychiatry 2000; 41:547-59. [PMID: 10946748 DOI: 10.1111/1469-7610.00642] [Citation(s) in RCA: 221] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In this paper we compare adult outcome in a group of young men with autism and a group with developmental receptive language disorders. The two groups were first assessed in early childhood, when aged 7 to 8 years of age. Although matched at that time for nonverbal IQ (mean 92-93) and expressive language ability, the Autism group was significantly more impaired on most measures of social and communication skills and stereotyped behaviours. A later follow-up, in mid-childhood, suggested that although the groups were still quite distinct, social and behavioural problems had become more apparent in the Language group. The current study was completed when the participants were aged, on average, 23 to 24 years. The findings indicated that verbal IQ and receptive language scores had improved significantly more in the Autism group than in the Language group over time. Moreover, although the Language group were less severely impaired in their social use of language, many showed a number of abnormal features in this domain. There were no differences between the groups on tests of reading or spelling. Discriminant function analysis, which had clearly distinguished between the groups as children, now showed much greater overlap between them. Regression analysis indicated that although early language ability appeared to be related to outcome in the Autism group, in the Language group there was little association between measures of childhood functioning and later progress. The implications of these findings for understanding the nature of the underlying deficit in autism and the relationship between the two disorders are discussed.
Collapse
Affiliation(s)
- L Mawhood
- Department of Psychology, St George's Hospital Medical School, London, UK
| | | | | |
Collapse
|
28
|
Howlin P, Mawhood L, Rutter M. Autism and developmental receptive language disorder--a follow-up comparison in early adult life. II: Social, behavioural, and psychiatric outcomes. J Child Psychol Psychiatry 2000; 41:561-78. [PMID: 10946749 DOI: 10.1111/1469-7610.00643] [Citation(s) in RCA: 362] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This paper focuses on general social functioning in two groups of young men, one with autism and one with developmental receptive language disorders, who were first assessed at the ages of 7-8 years. At that time, although matched for nonverbal IQ (mean 92-93) and expressive language, the Language group showed significantly fewer social and behavioural problems. At follow-up, when aged on average, 23 to 24 years, the Autism group continued to show significantly more impairments in terms of stereotyped behaviour patterns, social relationships, jobs, and independence. However, problems in all these areas were also common in the Language group. Many still lived with their parents, few had close friends or permanent jobs, and ratings of social interaction indicated abnormalities in a number of different areas. On a composite measure of social competence only 10% of the Language group was assessed as having severe social difficulties compared to 74% of the Autism group. Nevertheless, 65% were rated as having moderate social problems and only 25% were rated as being of near/normal social functioning. Two individuals in the Language group, but none in the Autism group, had also developed a florid paranoid psychosis in late adolescence. As in the follow-up of cognitive and linguistic functioning (see Mawhood et al., 2000, this volume, pp. 547-559), discriminant function analysis, which had clearly distinguished between the groups as children, now showed much greater overlap between them. Regression analysis indicated that although early language ability appeared to be related to outcome in the Autism group, there was little association between any measures of childhood functioning and prognosis in the Language group. Theoretically, these findings have implications for our understanding of the nature of autism and other pervasive language disorders, and of the relationship between them. Practically, they demonstrate the very persistent problems experienced by individuals with developmental language disorders, and their need for much greater help and support than is presently available.
Collapse
Affiliation(s)
- P Howlin
- Department of Psychology, St George's Hospital Medical School, London, UK
| | | | | |
Collapse
|
29
|
Moss EM, Batshaw ML, Solot CB, Gerdes M, McDonald-McGinn DM, Driscoll DA, Emanuel BS, Zackai EH, Wang PP. Psychoeducational profile of the 22q11.2 microdeletion: A complex pattern. J Pediatr 1999; 134:193-8. [PMID: 9931529 DOI: 10.1016/s0022-3476(99)70415-4] [Citation(s) in RCA: 230] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To examine the psychoeducational profile associated with the chromosome 22q11.2 microdeletion (DiGeorge/velocardiofacial syndrome). STUDY DESIGN Thirty-three patients (aged 6 to 27 years) with a 22q11.2 microdeletion underwent psychoeducational testing as part of a comprehensive evaluation. Nonparametric statistics were used to compare verbal and performance IQ, academic achievement scores, and receptive versus expressive language scores. Post hoc comparisons were made of IQ subtest scores and of language versus verbal IQ. RESULTS Full-scale IQ ranged from the normal to the moderately retarded range. Mean verbal IQ was significantly higher than mean performance IQ. In a similar manner, mean reading and spelling scores were superior to the mean mathematics score, although achievement scores typically were in the range of verbal IQ. In addition, many children showed clinically significant language impairments, with mean language scores lower than mean verbal IQ. CONCLUSIONS The IQ and academic profiles are reminiscent of a "nonverbal learning disability," although achievement was not discrepant from IQ. The coincidence of language impairment with a relative strength in reading belies a unique neuropsychologic profile. Educational programming for these children must address both verbal and nonverbal deficits.
Collapse
Affiliation(s)
- E M Moss
- Children's Seashore House, Philadelphia, Pennsylvania 19104-4388, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Practice parameters for the assessment and treatment of children and adolescents with language and learning disorders. AACAP. J Am Acad Child Adolesc Psychiatry 1998; 37:46S-62S. [PMID: 9785728 DOI: 10.1097/00004583-199810001-00004] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
These parameters describe the aims and approach to diagnosis, treatment, and monitoring of children and adolescents with language and learning disorders (LLDs). LLDs are among the most common developmental disorders the clinician is likely to encounter. About 50% of children with an LLD also have a comorbid Axis I psychiatric disorder. The diagnosis of an LLD requires a discrepancy, based on age and intelligence, between potential and achievement. The clinician collaborates with parents and school personnel to clarify the diagnosis, implement appropriate treatment and remediation, and monitor progress. The clinician is instrumental in identifying and treating comorbid conditions, including determining the appropriateness of medication. Long-term prognosis depends on the type and severity of the LLD, the availability of remediation, and the presence of a supportive family and school environment.
Collapse
|
31
|
Beitchman JH, Brownlie EB, Inglis A, Wild J, Ferguson B, Schachter D, Lancee W, Wilson B, Mathews R. Seven-year follow-up of speech/language impaired and control children: psychiatric outcome. J Child Psychol Psychiatry 1996; 37:961-70. [PMID: 9119943 DOI: 10.1111/j.1469-7610.1996.tb01493.x] [Citation(s) in RCA: 85] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
This study examined the 7-year psychiatric outcome of 202 speech/language (S/L) impaired and control children selected from a community sample at age 5 years. Children with S/L at age 5 years were more likely to be psychiatric cases at age 12.5 years than were normal controls, even if their S/L improved. Controlling for concurrent psychiatric disorder, S/L impairment at age 5 years was still associated with an increased rate of psychiatric disorder at 12.5 years. Psychiatric disorder at age 12.5 years was more likely to co-occur with language disorder than with speech disorder.
Collapse
Affiliation(s)
- J H Beitchman
- Child and Family Studies, Clarke Institute of Psychiatry, Toronto, Canada
| | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Beitchman JH, Wilson B, Brownlie EB, Walters H, Lancee W. Long-term consistency in speech/language profiles: I. Developmental and academic outcomes. J Am Acad Child Adolesc Psychiatry 1996; 35:804-14. [PMID: 8682762 DOI: 10.1097/00004583-199606000-00021] [Citation(s) in RCA: 132] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE This study examined the 7-year developmental and academic outcome of speech/language-impaired and control children selected from a community sample. METHOD Speech/language and psychiatric measures were administered to the children at ages 5 and 12.5 years. Using children's age 5 speech/language test results, a cluster analysis was performed to ascertain whether specific linguistic subgroups would emerge. The long-term consistency of these subgroups was explored. The association between time 1 speech/language clusters and linguistic, cognitive and academic measures at time 2 were examined. RESULTS Four groups were identified in the cluster analysis: high overall, poor articulation, poor comprehension, and low overall. Children with pervasive language problems continued to perform poorly on linguistic, cognitive, and academic measures, while those with comprehension problems fared slightly better but still had more difficulties than those with normal language. The poor articulation cluster had few articulation errors at follow-up. CONCLUSIONS Empirically supported speech/language classifications identified as early as age 5 continued to be relevant into late childhood. Pervasive speech/language impairment in early childhood was associated with increased risk of poor linguistic and academic outcome at follow-up, while isolated articulatory problems improved over time. These findings reveal the urgent need for early intervention among children with pervasive speech/language impairment.
Collapse
Affiliation(s)
- J H Beitchman
- Clarke Institute of Psychiatry, Toronto, Ontario, Canada
| | | | | | | | | |
Collapse
|
33
|
Beitchman JH, Wilson B, Brownlie EB, Walters H, Inglis A, Lancee W. Long-term consistency in speech/language profiles: II. Behavioral, emotional, and social outcomes. J Am Acad Child Adolesc Psychiatry 1996; 35:815-25. [PMID: 8682763 DOI: 10.1097/00004583-199606000-00022] [Citation(s) in RCA: 131] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE This study examined the 7-year behavioral, emotional, and social outcome of speech/language-impaired and control children selected from a community sample. METHOD Speech/language and psychosocial measures were administered to the children at ages 5 and 12.5 years. Using children's age 5 speech/language test results, a cluster analysis was performed to ascertain whether specific linguistic subgroups would emerge. The association between speech/language cluster at age 5 and psychosocial functioning at age 12.5 was examined. RESULTS Children with receptive and pervasive speech/language problems at age 5 demonstrated greater behavioral disturbance than children without such impairment. Controlling for initial behavioral status, early childhood language profile was still associated with behavioral and social competence ratings, 7 years later. Children without receptive language problems showed superior social adjustment. CONCLUSIONS Empirically supported speech/language classifications identified as early as age 5 were associated with behavioral disturbance in late childhood. Receptive and pervasive speech/language impairment in early childhood was associated with the greatest risk at follow-up. Early auditory comprehension problems may be a specific risk factor for later aggressive and hyperactive symptoms. These findings identify the need for effective intervention with speech/language-impaired children.
Collapse
|