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Ullman MT, Clark GM, Pullman MY, Lovelett JT, Pierpont EI, Jiang X, Turkeltaub PE. The neuroanatomy of developmental language disorder: a systematic review and meta-analysis. Nat Hum Behav 2024; 8:962-975. [PMID: 38491094 DOI: 10.1038/s41562-024-01843-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 02/01/2024] [Indexed: 03/18/2024]
Abstract
Developmental language disorder (DLD) is a common neurodevelopmental disorder with adverse impacts that continue into adulthood. However, its neural bases remain unclear. Here we address this gap by systematically identifying and quantitatively synthesizing neuroanatomical studies of DLD using co-localization likelihood estimation, a recently developed neuroanatomical meta-analytic technique. Analyses of structural brain data (22 peer-reviewed papers, 577 participants) revealed highly consistent anomalies only in the basal ganglia (100% of participant groups in which this structure was examined, weighted by group sample sizes; 99.8% permutation-based likelihood the anomaly clustering was not due to chance). These anomalies were localized specifically to the anterior neostriatum (again 100% weighted proportion and 99.8% likelihood). As expected given the task dependence of activation, functional neuroimaging data (11 peer-reviewed papers, 414 participants) yielded less consistency, though anomalies again occurred primarily in the basal ganglia (79.0% and 95.1%). Multiple sensitivity analyses indicated that the patterns were robust. The meta-analyses elucidate the neuroanatomical signature of DLD, and implicate the basal ganglia in particular. The findings support the procedural circuit deficit hypothesis of DLD, have basic research and translational implications for the disorder, and advance our understanding of the neuroanatomy of language.
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Affiliation(s)
- Michael T Ullman
- Brain and Language Laboratory, Department of Neuroscience, Georgetown University, Washington DC, USA.
| | - Gillian M Clark
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Mariel Y Pullman
- Brain and Language Laboratory, Department of Neuroscience, Georgetown University, Washington DC, USA
- Mount Sinai Beth Israel, New York, NY, USA
| | - Jarrett T Lovelett
- Brain and Language Laboratory, Department of Neuroscience, Georgetown University, Washington DC, USA
- Department of Psychology, University of California, San Diego, La Jolla, CA, USA
| | - Elizabeth I Pierpont
- Department of Pediatrics, University of Minnesota Medical Center, Minneapolis, MN, USA
| | - Xiong Jiang
- Department of Neuroscience, Georgetown University, Washington DC, USA
| | - Peter E Turkeltaub
- Center for Brain Plasticity and Recovery, Georgetown University, Washington DC, USA
- Research Division, MedStar National Rehabilitation Network, Washington DC, USA
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2
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St John M, Tripathi T, Morgan AT, Amor DJ. To speak may draw on epigenetic writing and reading: Unravelling the complexity of speech and language outcomes across chromatin-related neurodevelopmental disorders. Neurosci Biobehav Rev 2023; 152:105293. [PMID: 37353048 DOI: 10.1016/j.neubiorev.2023.105293] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 05/11/2023] [Accepted: 06/20/2023] [Indexed: 06/25/2023]
Abstract
Speech and language development are complex neurodevelopmental processes that are incompletely understood, yet current evidence suggests that speech and language disorders are prominent in those with disorders of chromatin regulation. This review aimed to unravel what is known about speech and language outcomes for individuals with chromatin-related neurodevelopmental disorders. A systematic literature search following PRISMA guidelines was conducted on 70 chromatin genes, to identify reports of speech/language outcomes across studies, including clinical reports, formal subjective measures, and standardised/objective measures. 3932 studies were identified and screened and 112 were systematically reviewed. Communication impairment was core across chromatin disorders, and specifically, chromatin writers and readers appear to play an important role in motor speech development. Identification of these relationships is important because chromatin disorders show promise as therapeutic targets due to the capacity for epigenetic modification. Further research is required using standardised and formal assessments to understand the nuanced speech/language profiles associated with variants in each gene, and the influence of chromatin dysregulation on the neurobiology of speech and language development.
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Affiliation(s)
- Miya St John
- Speech and Language, Murdoch Children's Research Institute, Parkville, VIC, Australia; Department of Audiology and Speech Pathology, University of Melbourne, VIC, Australia.
| | - Tanya Tripathi
- Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Parkville, VIC, Australia.
| | - Angela T Morgan
- Speech and Language, Murdoch Children's Research Institute, Parkville, VIC, Australia; Department of Audiology and Speech Pathology, University of Melbourne, VIC, Australia; Speech Genomics Clinic, Royal Children's Hospital, Parkville, VIC, Australia.
| | - David J Amor
- Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Parkville, VIC, Australia; Speech Genomics Clinic, Royal Children's Hospital, Parkville, VIC, Australia; Department of Paediatrics, University of Melbourne, VIC, Australia.
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Fenchel D, Dimitrova R, Robinson EC, Batalle D, Chew A, Falconer S, Kyriakopoulou V, Nosarti C, Hutter J, Christiaens D, Pietsch M, Brandon J, Hughes EJ, Allsop J, O'Keeffe C, Price AN, Cordero-Grande L, Schuh A, Makropoulos A, Passerat-Palmbach J, Bozek J, Rueckert D, Hajnal JV, McAlonan G, Edwards AD, O'Muircheartaigh J. Neonatal multi-modal cortical profiles predict 18-month developmental outcomes. Dev Cogn Neurosci 2022; 54:101103. [PMID: 35364447 PMCID: PMC8971851 DOI: 10.1016/j.dcn.2022.101103] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 02/08/2022] [Accepted: 03/23/2022] [Indexed: 12/16/2022] Open
Abstract
Developmental delays in infanthood often persist, turning into life-long difficulties, and coming at great cost for the individual and community. By examining the developing brain and its relation to developmental outcomes we can start to elucidate how the emergence of brain circuits is manifested in variability of infant motor, cognitive and behavioural capacities. In this study, we examined if cortical structural covariance at birth, indexing coordinated development, is related to later infant behaviour. We included 193 healthy term-born infants from the Developing Human Connectome Project (dHCP). An individual cortical connectivity matrix derived from morphological and microstructural features was computed for each subject (morphometric similarity networks, MSNs) and was used as input for the prediction of behavioural scores at 18 months using Connectome-Based Predictive Modeling (CPM). Neonatal MSNs successfully predicted social-emotional performance. Predictive edges were distributed between and within known functional cortical divisions with a specific important role for primary and posterior cortical regions. These results reveal that multi-modal neonatal cortical profiles showing coordinated maturation are related to developmental outcomes and that network organization at birth provides an early infrastructure for future functional skills.
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Affiliation(s)
- Daphna Fenchel
- MRC Centre for Neurodevelopmental Disorders, King's College London, London SE1 1UL, UK; Sackler Institute for Translational Neurodevelopment, Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK
| | - Ralica Dimitrova
- Centre for the Developing Brain, Department of Perinatal Imaging & Health, School of Biomedical Engineering & Imaging Sciences, King's College London, London SE1 7EH UK
| | - Emma C Robinson
- Department of Biomedical Engineering, School of Biomedical Engineering & Imaging Sciences, King's College London, London SE1 7EU, UK
| | - Dafnis Batalle
- Sackler Institute for Translational Neurodevelopment, Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK; Centre for the Developing Brain, Department of Perinatal Imaging & Health, School of Biomedical Engineering & Imaging Sciences, King's College London, London SE1 7EH UK
| | - Andrew Chew
- Centre for the Developing Brain, Department of Perinatal Imaging & Health, School of Biomedical Engineering & Imaging Sciences, King's College London, London SE1 7EH UK
| | - Shona Falconer
- Centre for the Developing Brain, Department of Perinatal Imaging & Health, School of Biomedical Engineering & Imaging Sciences, King's College London, London SE1 7EH UK
| | - Vanessa Kyriakopoulou
- Centre for the Developing Brain, Department of Perinatal Imaging & Health, School of Biomedical Engineering & Imaging Sciences, King's College London, London SE1 7EH UK
| | - Chiara Nosarti
- Centre for the Developing Brain, Department of Perinatal Imaging & Health, School of Biomedical Engineering & Imaging Sciences, King's College London, London SE1 7EH UK; Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK
| | - Jana Hutter
- Centre for the Developing Brain, Department of Perinatal Imaging & Health, School of Biomedical Engineering & Imaging Sciences, King's College London, London SE1 7EH UK
| | - Daan Christiaens
- Centre for the Developing Brain, Department of Perinatal Imaging & Health, School of Biomedical Engineering & Imaging Sciences, King's College London, London SE1 7EH UK; Department of Electrical Engineering, ESAT/PSI, KU Leuven, Leuven, Belgium
| | - Maximilian Pietsch
- Centre for the Developing Brain, Department of Perinatal Imaging & Health, School of Biomedical Engineering & Imaging Sciences, King's College London, London SE1 7EH UK
| | - Jakki Brandon
- Centre for the Developing Brain, Department of Perinatal Imaging & Health, School of Biomedical Engineering & Imaging Sciences, King's College London, London SE1 7EH UK
| | - Emer J Hughes
- Centre for the Developing Brain, Department of Perinatal Imaging & Health, School of Biomedical Engineering & Imaging Sciences, King's College London, London SE1 7EH UK
| | - Joanna Allsop
- Centre for the Developing Brain, Department of Perinatal Imaging & Health, School of Biomedical Engineering & Imaging Sciences, King's College London, London SE1 7EH UK
| | - Camilla O'Keeffe
- Centre for the Developing Brain, Department of Perinatal Imaging & Health, School of Biomedical Engineering & Imaging Sciences, King's College London, London SE1 7EH UK
| | - Anthony N Price
- Centre for the Developing Brain, Department of Perinatal Imaging & Health, School of Biomedical Engineering & Imaging Sciences, King's College London, London SE1 7EH UK
| | - Lucilio Cordero-Grande
- Centre for the Developing Brain, Department of Perinatal Imaging & Health, School of Biomedical Engineering & Imaging Sciences, King's College London, London SE1 7EH UK; Biomedical Image Technologies, ETSI Telecomunicación, Universidad Politécnica de Madrid & CIBER-BBN, Madrid, Spain
| | - Andreas Schuh
- Biomedical Image Analysis Group, Department of Computing, Imperial College London, London SW7 2AZ, UK
| | - Antonios Makropoulos
- Biomedical Image Analysis Group, Department of Computing, Imperial College London, London SW7 2AZ, UK
| | | | - Jelena Bozek
- Faculty of Electrical Engineering and Computing, University of Zagreb, Zagreb, Croatia
| | - Daniel Rueckert
- Biomedical Image Analysis Group, Department of Computing, Imperial College London, London SW7 2AZ, UK; Institute für Artificial Intelligence and Informatics in Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Joseph V Hajnal
- Centre for the Developing Brain, Department of Perinatal Imaging & Health, School of Biomedical Engineering & Imaging Sciences, King's College London, London SE1 7EH UK
| | - Grainne McAlonan
- MRC Centre for Neurodevelopmental Disorders, King's College London, London SE1 1UL, UK; Sackler Institute for Translational Neurodevelopment, Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK; South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK
| | - A David Edwards
- MRC Centre for Neurodevelopmental Disorders, King's College London, London SE1 1UL, UK; Centre for the Developing Brain, Department of Perinatal Imaging & Health, School of Biomedical Engineering & Imaging Sciences, King's College London, London SE1 7EH UK
| | - Jonathan O'Muircheartaigh
- MRC Centre for Neurodevelopmental Disorders, King's College London, London SE1 1UL, UK; Sackler Institute for Translational Neurodevelopment, Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK; Centre for the Developing Brain, Department of Perinatal Imaging & Health, School of Biomedical Engineering & Imaging Sciences, King's College London, London SE1 7EH UK.
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4
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Gerwin KL, Brosseau-Lapré F, Weber C. Event-Related Potentials Elicited by Phonetic Errors Differentiate Children With Speech Sound Disorder and Typically Developing Peers. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:4614-4630. [PMID: 34735291 PMCID: PMC9150672 DOI: 10.1044/2021_jslhr-21-00203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 06/10/2021] [Accepted: 07/21/2021] [Indexed: 06/13/2023]
Abstract
PURPOSE A growing body of research suggests that a deficit in speech perception abilities contributes to the development of speech sound disorder (SSD). However, little work has been done to characterize the neurophysiological processes indexing speech perception deficits in this population. The primary aim of this study was to compare the neural activity underlying speech perception in young children with SSD and with typical development (TD). METHOD Twenty-eight children ages 4;1-6;0 (years;months) participated in this study. Event-related potentials (ERPs) were recorded while children completed a speech perception task that included phonetic (speech sound) and lexical (meaning) matches and mismatches. Groups were compared on their judgment accuracy for matches and mismatches as well as the mean amplitude of the phonological mapping negativity (PMN) and N400 ERP components. RESULTS Children with SSD demonstrated lower judgment accuracy across the phonetic and lexical conditions compared to peers with TD. The ERPs elicited by lexical matches and mismatches did not distinguish the groups. However, in the phonetic condition, the SSD group exhibited a more consistent left-lateralized PMN effect and a delayed N400 effect over frontal sites compared to the TD group. CONCLUSIONS These findings provide some of the first evidence of a delay in the neurophysiological processing of phonological information for young children with SSD compared to their peers with TD. This delay was not present for the processing of lexical information, indicating a unique difference between children with SSD and with TD related to speech perception of phonetic errors. Supplemental Material https://doi.org/10.23641/asha.16915579.
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Affiliation(s)
- Katelyn L. Gerwin
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing
| | | | - Christine Weber
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, IN
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5
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Fiori S, Pannek K, Podda I, Cipriani P, Lorenzoni V, Franchi B, Pasquariello R, Guzzetta A, Cioni G, Chilosi A. Neural Changes Induced by a Speech Motor Treatment in Childhood Apraxia of Speech: A Case Series. J Child Neurol 2021; 36:958-967. [PMID: 34315296 PMCID: PMC8461047 DOI: 10.1177/08830738211015800] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We report a case series of children with childhood apraxia of speech, by describing behavioral and white matter microstructural changes following 2 different treatment approaches.Five children with childhood apraxia of speech were assigned to a motor speech treatment (PROMPT) and 5 to a language, nonspeech oral motor treatment. Speech assessment and brain MRI were performed pre- and post-treatment. The ventral (tongue/larynx) and dorsal (lips) corticobulbar tracts were reconstructed in each subject. Mean fractional anisotropy and mean diffusivity were extracted. The hand corticospinal tract was assessed as a control pathway. In both groups speech improvements paralleled changes in the left ventral corticobulbar tract fractional anisotropy. The PROMPT treated group also showed fractional anisotropy increase and mean diffusivity decrease in the left dorsal corticobulbar tract. No changes were detected in the hand tract. Our results may provide preliminary support to the possible neurobiologic effect of a multimodal speech motor treatment in childhood apraxia of speech.
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Affiliation(s)
- Simona Fiori
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy,Simona Fiori, MD, PhD, Department of Developmental Neuroscience, Stella Maris Foundation, Viale del Tirreno 331, 56128, Pisa, Italy.
| | - Kerstin Pannek
- CSIRO, Health and Biosecurity, Australian E-Health Research Centre, Brisbane, Australia
| | - Irina Podda
- Parole al Centro, Studio di Logopedia e Neuropsicomotricità, Genova, Italy
| | - Paola Cipriani
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy
| | - V. Lorenzoni
- Institute of Management, Scuola Superiore Sant’Anna, Pisa, Italy
| | - Beatrice Franchi
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy
| | - Rosa Pasquariello
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy
| | - Andrea Guzzetta
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy,Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - Giovanni Cioni
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy,Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - Anna Chilosi
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy
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6
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Conti E, Retico A, Palumbo L, Spera G, Bosco P, Biagi L, Fiori S, Tosetti M, Cipriani P, Cioni G, Muratori F, Chilosi A, Calderoni S. Autism Spectrum Disorder and Childhood Apraxia of Speech: Early Language-Related Hallmarks across Structural MRI Study. J Pers Med 2020; 10:E275. [PMID: 33322765 PMCID: PMC7768516 DOI: 10.3390/jpm10040275] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 12/07/2020] [Accepted: 12/09/2020] [Indexed: 01/08/2023] Open
Abstract
Autism Spectrum Disorder (ASD) and Childhood Apraxia of Speech (CAS) are developmental disorders with distinct diagnostic criteria and different epidemiology. However, a common genetic background as well as overlapping clinical features between ASD and CAS have been recently reported. To date, brain structural language-related abnormalities have been detected in both the conditions, but no study directly compared young children with ASD, CAS and typical development (TD). In the current work, we aim: (i) to test the hypothesis that ASD and CAS display neurostructural differences in comparison with TD through morphometric Magnetic Resonance Imaging (MRI)-based measures (ASD vs. TD and CAS vs. TD); (ii) to investigate early possible disease-specific brain structural patterns in the two clinical groups (ASD vs. CAS); (iii) to evaluate predictive power of machine-learning (ML) techniques in differentiating the three samples (ASD, CAS, TD). We retrospectively analyzed the T1-weighted brain MRI scans of 68 children (age range: 34-74 months) grouped into three cohorts: (1) 26 children with ASD (mean age ± standard deviation: 56 ± 11 months); (2) 24 children with CAS (57 ± 10 months); (3) 18 children with TD (55 ± 13 months). Furthermore, a ML analysis based on a linear-kernel Support Vector Machine (SVM) was performed. All but one brain structures displayed significant higher volumes in both ASD and CAS children than TD peers. Specifically, ASD alterations involved fronto-temporal regions together with basal ganglia and cerebellum, while CAS alterations are more focused and shifted to frontal regions, suggesting a possible speech-related anomalies distribution. Caudate, superior temporal and hippocampus volumes directly distinguished the two conditions in terms of greater values in ASD compared to CAS. The ML analysis identified significant differences in brain features between ASD and TD children, whereas only some trends in the ML classification capability were detected in CAS as compared to TD peers. Similarly, the MRI structural underpinnings of two clinical groups were not significantly different when evaluated with linear-kernel SVM. Our results may represent the first step towards understanding shared and specific neural substrate in ASD and CAS conditions, which subsequently may contribute to early differential diagnosis and tailoring specific early intervention.
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Affiliation(s)
- Eugenia Conti
- IRCCS Fondazione Stella Maris, 56128 Pisa, Italy; (E.C.); (P.B.); (L.B.); (S.F.); (M.T.); (P.C.); (G.C.); (F.M.); (A.C.)
| | - Alessandra Retico
- National Institute for Nuclear Physics (INFN), Pisa Division, 56127 Pisa, Italy; (A.R.); (L.P.); (G.S.)
| | - Letizia Palumbo
- National Institute for Nuclear Physics (INFN), Pisa Division, 56127 Pisa, Italy; (A.R.); (L.P.); (G.S.)
| | - Giovanna Spera
- National Institute for Nuclear Physics (INFN), Pisa Division, 56127 Pisa, Italy; (A.R.); (L.P.); (G.S.)
| | - Paolo Bosco
- IRCCS Fondazione Stella Maris, 56128 Pisa, Italy; (E.C.); (P.B.); (L.B.); (S.F.); (M.T.); (P.C.); (G.C.); (F.M.); (A.C.)
| | - Laura Biagi
- IRCCS Fondazione Stella Maris, 56128 Pisa, Italy; (E.C.); (P.B.); (L.B.); (S.F.); (M.T.); (P.C.); (G.C.); (F.M.); (A.C.)
| | - Simona Fiori
- IRCCS Fondazione Stella Maris, 56128 Pisa, Italy; (E.C.); (P.B.); (L.B.); (S.F.); (M.T.); (P.C.); (G.C.); (F.M.); (A.C.)
| | - Michela Tosetti
- IRCCS Fondazione Stella Maris, 56128 Pisa, Italy; (E.C.); (P.B.); (L.B.); (S.F.); (M.T.); (P.C.); (G.C.); (F.M.); (A.C.)
| | - Paola Cipriani
- IRCCS Fondazione Stella Maris, 56128 Pisa, Italy; (E.C.); (P.B.); (L.B.); (S.F.); (M.T.); (P.C.); (G.C.); (F.M.); (A.C.)
| | - Giovanni Cioni
- IRCCS Fondazione Stella Maris, 56128 Pisa, Italy; (E.C.); (P.B.); (L.B.); (S.F.); (M.T.); (P.C.); (G.C.); (F.M.); (A.C.)
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Filippo Muratori
- IRCCS Fondazione Stella Maris, 56128 Pisa, Italy; (E.C.); (P.B.); (L.B.); (S.F.); (M.T.); (P.C.); (G.C.); (F.M.); (A.C.)
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Anna Chilosi
- IRCCS Fondazione Stella Maris, 56128 Pisa, Italy; (E.C.); (P.B.); (L.B.); (S.F.); (M.T.); (P.C.); (G.C.); (F.M.); (A.C.)
| | - Sara Calderoni
- IRCCS Fondazione Stella Maris, 56128 Pisa, Italy; (E.C.); (P.B.); (L.B.); (S.F.); (M.T.); (P.C.); (G.C.); (F.M.); (A.C.)
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
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Butler LK, Kiran S, Tager-Flusberg H. Functional Near-Infrared Spectroscopy in the Study of Speech and Language Impairment Across the Life Span: A Systematic Review. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2020; 29:1674-1701. [PMID: 32640168 PMCID: PMC7893520 DOI: 10.1044/2020_ajslp-19-00050] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Purpose Functional brain imaging is playing an increasingly important role in the diagnosis and treatment of communication disorders, yet many populations and settings are incompatible with functional magnetic resonance imaging and other commonly used techniques. We conducted a systematic review of neuroimaging studies using functional near-infrared spectroscopy (fNIRS) with individuals with speech or language impairment across the life span. We aimed to answer the following question: To what extent has fNIRS been used to investigate the neural correlates of speech-language impairment? Method This systematic review was preregistered with PROSPERO, the international prospective register of systematic reviews (CRD42019136464). We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol for preferred reporting items for systematic reviews. The database searches were conducted between February and March of 2019 with the following search terms: (a) fNIRS or functional near-infrared spectroscopy or NIRS or near-infrared spectroscopy, (b) speech or language, and (c) disorder or impairment or delay. Results We found 34 fNIRS studies that involved individuals with speech or language impairment across nine categories: (a) autism spectrum disorders; (b) developmental speech and language disorders; (c) cochlear implantation and deafness; (d) dementia, dementia of the Alzheimer's type, and mild cognitive impairment; (e) locked-in syndrome; (f) neurologic speech disorders/dysarthria; (g) stroke/aphasia; (h) stuttering; and (i) traumatic brain injury. Conclusions Though it is not without inherent challenges, fNIRS may have advantages over other neuroimaging techniques in the areas of speech and language impairment. fNIRS has clinical applications that may lead to improved early and differential diagnosis, increase our understanding of response to treatment, improve neuroprosthetic functioning, and advance neurofeedback.
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Affiliation(s)
- Lindsay K. Butler
- Sargent College of Health and Rehabilitation Sciences, Boston University, MA
| | - Swathi Kiran
- Sargent College of Health and Rehabilitation Sciences, Boston University, MA
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8
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Yoon HM, Jo Y, Shim WH, Lee JS, Ko TS, Koo JH, Yum MS. Disrupted Functional and Structural Connectivity in Angelman Syndrome. AJNR Am J Neuroradiol 2020; 41:889-897. [PMID: 32381544 DOI: 10.3174/ajnr.a6531] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 03/16/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE This work investigated alterations in functional connectivity (FC) and associated structures in patients with Angelman syndrome (AS) by using integrated quantitative imaging analysis and connectivity measures. MATERIALS AND METHODS We obtained 3T brain MR imaging, including resting-state functional MR imaging, diffusion tensor imaging, and 3D T1-weighted imaging from children with AS (n = 14) and age- and sex-matched controls (n = 28). The brains of patients with AS were analyzed by measuring FC, white matter microstructural analysis, cortical thickness, and brain volumes; these were compared with brains of controls. RESULTS Interregional FC analysis revealed significantly reduced intra- and interhemispheric FC, especially in the basal ganglia and thalamus, in patients with AS. Significant reductions in fractional anisotropy were found in the corpus callosum, cingulum, posterior limb of the internal capsules, and arcuate fasciculus in patients with AS. Quantitative structural analysis also showed gray matter volume loss of the basal ganglia and diffuse WM volume reduction in AS compared with the control group. CONCLUSIONS This integrated quantitative MR imaging analysis demonstrated poor functional and structural connectivity, as well as brain volume reduction, in children with AS, which may explain the motor and language dysfunction observed in this well-characterized neurobehavioral phenotype.
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Affiliation(s)
- H M Yoon
- From the Department of Radiology and Research Institute of Radiology (H.M.Y., W.H.S., J.S.L., J.H.K.)
| | - Y Jo
- Asan Institute for Life Sciences (Y.J., W.H.S.), Asan Medical Center
| | - W H Shim
- From the Department of Radiology and Research Institute of Radiology (H.M.Y., W.H.S., J.S.L., J.H.K.)
- Asan Institute for Life Sciences (Y.J., W.H.S.), Asan Medical Center
| | - J S Lee
- From the Department of Radiology and Research Institute of Radiology (H.M.Y., W.H.S., J.S.L., J.H.K.)
| | - T S Ko
- Department of Pediatrics (T.S.K., M.S.Y.), Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea
| | - J H Koo
- From the Department of Radiology and Research Institute of Radiology (H.M.Y., W.H.S., J.S.L., J.H.K.)
| | - M S Yum
- Department of Pediatrics (T.S.K., M.S.Y.), Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea.
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Pigdon L, Willmott C, Reilly S, Conti-Ramsden G, Liegeois F, Connelly A, Morgan AT. The neural basis of nonword repetition in children with developmental speech or language disorder: An fMRI study. Neuropsychologia 2020; 138:107312. [DOI: 10.1016/j.neuropsychologia.2019.107312] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 12/12/2019] [Accepted: 12/17/2019] [Indexed: 10/25/2022]
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10
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Wang J, Rice ML, Booth JR. Syntactic and Semantic Specialization and Integration in 5- to 6-Year-Old Children during Auditory Sentence Processing. J Cogn Neurosci 2020; 32:36-49. [PMID: 31596168 PMCID: PMC8905464 DOI: 10.1162/jocn_a_01477] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Previous studies have found specialized syntactic and semantic processes in the adult brain during language comprehension. Young children have sophisticated semantic and syntactic aspects of language, yet many previous fMRI studies failed to detect this specialization, possibly due to experimental design and analytical methods. In this current study, 5- to 6-year-old children completed a syntactic task and a semantic task to dissociate these two processes. Multivoxel pattern analysis was used to examine the correlation of patterns within a task (between runs) or across tasks. We found that the left middle temporal gyrus showed more similar patterns within the semantic task compared with across tasks, whereas there was no difference in the correlation within the syntactic task compared with across tasks, suggesting its specialization in semantic processing. Moreover, the left superior temporal gyrus showed more similar patterns within both the semantic task and the syntactic task as compared with across tasks, suggesting its role in integration of semantic and syntactic information. In contrast to the temporal lobe, we did not find specialization or integration effects in either the opercular or triangular part of the inferior frontal gyrus. Overall, our study showed that 5- to 6-year-old children have already developed specialization and integration in the temporal lobe, but not in the frontal lobe, consistent with developmental neurocognitive models of language comprehension in typically developing young children.
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Pigdon L, Willmott C, Reilly S, Conti-Ramsden G, Gaser C, Connelly A, Morgan AT. Grey matter volume in developmental speech and language disorder. Brain Struct Funct 2019; 224:3387-3398. [PMID: 31732792 DOI: 10.1007/s00429-019-01978-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 11/04/2019] [Indexed: 01/15/2023]
Abstract
Developmental language disorder (DLD) and developmental speech disorder (DSD) are common, yet their etiologies are not well understood. Atypical volume of the inferior and posterior language regions and striatum have been reported in DLD; however, variability in both methodology and study findings limits interpretations. Imaging research within DSD, on the other hand, is scarce. The present study compared grey matter volume in children with DLD, DSD, and typically developing speech and language. Compared to typically developing controls, children with DLD had larger volume in the right cerebellum, possibly associated with the procedural learning deficits that have been proposed in DLD. Children with DSD showed larger volume in the left inferior occipital lobe compared to controls, which may indicate a compensatory role of the visual processing regions due to sub-optimal auditory-perceptual processes. Overall, these findings suggest that different neural systems may be involved in the specific deficits related to DLD and DSD.
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Affiliation(s)
- Lauren Pigdon
- Murdoch Children's Research Institute, 50 Flemington Rd, Parkville, VIC, 3052, Australia.,Turner Institute for Brain and Mental Health, Monash University, 18 Innovation Walk, Clayton, VIC, 3800, Australia
| | - Catherine Willmott
- Turner Institute for Brain and Mental Health, Monash University, 18 Innovation Walk, Clayton, VIC, 3800, Australia.,Monash-Epworth Rehabilitation Research Centre, Monash University, 18 Innovation Walk, Clayton, VIC, 3800, Australia
| | - Sheena Reilly
- Murdoch Children's Research Institute, 50 Flemington Rd, Parkville, VIC, 3052, Australia.,Menzies Health Institute Queensland, Griffith University, G40 Level 8.86, Mount Gravatt, QLD, 4222, Australia
| | - Gina Conti-Ramsden
- Murdoch Children's Research Institute, 50 Flemington Rd, Parkville, VIC, 3052, Australia.,The University of Manchester, Oxford Rd, Manchester, M13 9PL, UK
| | - Christian Gaser
- Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany
| | - Alan Connelly
- Florey Institute of Neuroscience and Mental Health, 245 Burgundy Street, Heidelberg, VIC, 3084, Australia.,University of Melbourne, Grattan Street, Parkville, VIC, 3010, Australia
| | - Angela T Morgan
- Murdoch Children's Research Institute, 50 Flemington Rd, Parkville, VIC, 3052, Australia. .,University of Melbourne, Grattan Street, Parkville, VIC, 3010, Australia. .,Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC, 3052, Australia.
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12
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Geva S, Fernyhough C. A Penny for Your Thoughts: Children's Inner Speech and Its Neuro-Development. Front Psychol 2019; 10:1708. [PMID: 31474897 PMCID: PMC6702515 DOI: 10.3389/fpsyg.2019.01708] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 07/09/2019] [Indexed: 01/01/2023] Open
Abstract
Inner speech emerges in early childhood, in parallel with the maturation of the dorsal language stream. To date, the developmental relations between these two processes have not been examined. We review evidence that the dorsal language stream has a role in supporting the psychological phenomenon of inner speech, before considering pediatric studies of the dorsal stream's anatomical development and evidence for its emerging functional roles. We examine possible causal accounts of the relations between these two developmental processes and consider their implications for phylogenetic theories about the evolution of inner speech and the accounts of the ontogenetic relations between language and cognition.
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Affiliation(s)
- Sharon Geva
- Wellcome Centre for Human Neuroimaging, University College London, London, United Kingdom
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Terband H, Maassen B, Maas E. A Psycholinguistic Framework for Diagnosis and Treatment Planning of Developmental Speech Disorders. Folia Phoniatr Logop 2019; 71:216-227. [PMID: 31269495 DOI: 10.1159/000499426] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 03/05/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Differential diagnosis and treatment planning of developmental speech disorders (DSD) remains a major challenge in paediatric speech-language pathology. Different classification systems exist, in which subtypes are differentiated based on their theoretical cause and in which the definitions generally refer to speech production processes. Accordingly, various intervention methods have been developed aiming at different parts of the speech production process. Diagnostic classification in these systems, however, is primarily based on a description of behavioural speech symptoms rather than on underlying deficits. PURPOSE In this paper, we present a process-oriented approach to diagnosis and treatment planning of DSD. Our framework comprises two general diagnostic categories: developmental delay and developmental disorder. Within these categories, treatment goals/targets and treatment methods are formulated at the level of processes and rules/representations. CONCLUSION A process-oriented approach to diagnosis and treatment planning holds important advantages, offering direct leads for treatment aimed at the underlying impairment, tailored to the specific needs of the individual and adjusted to the developmental trajectory.
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Affiliation(s)
- Hayo Terband
- Utrecht Institute of Linguistics-OTS, Utrecht University, Utrecht, The Netherlands,
| | - Ben Maassen
- Centre for Language and Cognition (CLCG) and University Medical Centre, University of Groningen, Groningen, The Netherlands
| | - Edwin Maas
- Department of Communication Sciences and Disorders, Temple University, Philadelphia, Pennsylvania, USA
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Kurth F, Luders E, Pigdon L, Conti-Ramsden G, Reilly S, Morgan AT. Altered gray matter volumes in language-associated regions in children with developmental language disorder and speech sound disorder. Dev Psychobiol 2018; 60:814-824. [DOI: 10.1002/dev.21762] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 06/12/2018] [Accepted: 06/14/2018] [Indexed: 01/22/2023]
Affiliation(s)
- Florian Kurth
- School of Psychology; University of Auckland; Auckland New Zealand
| | - Eileen Luders
- School of Psychology; University of Auckland; Auckland New Zealand
- Murdoch Childrens Research Institute; Melbourne Australia
| | - Lauren Pigdon
- Murdoch Childrens Research Institute; Melbourne Australia
- Monash Institute of Cognitive and Clinical Neurosciences; Monash University; Melbourne Australia
| | - Gina Conti-Ramsden
- Murdoch Childrens Research Institute; Melbourne Australia
- The University of Manchester; Manchester United Kingdom
| | - Sheena Reilly
- Murdoch Childrens Research Institute; Melbourne Australia
- Menzies Health Institute Queensland, Griffith University; Southport Queensland Australia
| | - Angela T. Morgan
- Murdoch Childrens Research Institute; Melbourne Australia
- University of Melbourne; Melbourne Australia
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15
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Morgan AT, Su M, Reilly S, Conti-Ramsden G, Connelly A, Liégeois FJ. A Brain Marker for Developmental Speech Disorders. J Pediatr 2018; 198:234-239.e1. [PMID: 29705112 DOI: 10.1016/j.jpeds.2018.02.043] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 01/21/2018] [Accepted: 02/14/2018] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To characterize the organization of speech- and language-related white matter tracts in children with developmental speech and/or language disorders. STUDY DESIGN We collected magnetic resonance diffusion-weighted imaging data from 41 children, ages 9-11 years, with developmental speech and/or language disorders, and compared them with 45 typically developing controls with the same age range. We used probabilistic tractography of diffusion-weighted imaging to map language (3 segments of arcuate fasciculus, extreme capsule system) and speech motor (corticobulbar) tracts bilaterally. The corticospinal and callosal tracts were used as control regions. We compared the mean fractional anisotropy and diffusivity values between atypical and control groups, covarying for nonverbal IQ. We then examined differences between atypical subgroups: developmental speech disorder (DSD), developmental language disorder, and co-occurring developmental speech and language disorder. RESULTS Fractional anisotropy in the left corticobulbar tract was lower in the DSD than in the control group. Radial and mean diffusivity were higher in the DSD than the developmental language disorder, co-occurring developmental speech and language disorder, or control groups. There were no group differences for any metrics in the language or control tracts. CONCLUSIONS Atypical development of the left corticobulbar tract may be a neural marker for DSD. This finding is in line with reports of speech disorder after left corticobulbar damage in children and adults with brain injury. By contrast, we found no association between diffusion metrics in language-related tracts in developmental language disorder, and changes for language disorders are likely more complex.
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Affiliation(s)
- Angela T Morgan
- Murdoch Children's Research Institute and Royal Children's Hospital, Melbourne, Australia; University of Melbourne, Australia.
| | - Merina Su
- UCL Great Ormond Street Institute of Child Health, London, UK
| | - Sheena Reilly
- Murdoch Children's Research Institute and Royal Children's Hospital, Melbourne, Australia; Griffith University, Gold Coast, Australia
| | | | - Alan Connelly
- Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
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Luders E, Kurth F, Pigdon L, Conti-Ramsden G, Reilly S, Morgan AT. Atypical Callosal Morphology in Children with Speech Sound Disorder. Neuroscience 2017; 367:211-218. [PMID: 29102664 DOI: 10.1016/j.neuroscience.2017.10.039] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Revised: 10/25/2017] [Accepted: 10/26/2017] [Indexed: 12/16/2022]
Abstract
Speech sound disorder (SSD) is common, yet its neurobiology is poorly understood. Recent studies indicate atypical structural and functional anomalies either in one hemisphere or both hemispheres, which might be accompanied by alterations in inter-hemispheric connectivity. Indeed, abnormalities of the corpus callosum - the main fiber tract connecting the two hemispheres - have been linked to speech and language deficits in associated disorders, such as stuttering, dyslexia, aphasia, etc. However, there is a dearth of studies examining the corpus callosum in SSD. Here, we investigated whether a sample of 18 children with SSD differed in callosal morphology from 18 typically developing children carefully matched for age. Significantly reduced dimensions of the corpus callosum, particularly in the callosal anterior third, were observed in children with SSD. These findings indicating pronounced callosal aberrations in SSD make an important contribution to an understudied field of research and may suggest that SSD is accompanied by atypical lateralization of speech and language function.
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Affiliation(s)
- Eileen Luders
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine, Los Angeles, USA; Murdoch Childrens Research Institute, Melbourne, Australia.
| | - Florian Kurth
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine, Los Angeles, USA
| | - Lauren Pigdon
- Murdoch Childrens Research Institute, Melbourne, Australia
| | - Gina Conti-Ramsden
- Murdoch Childrens Research Institute, Melbourne, Australia; The University of Manchester and Manchester Academic Health Science Centre (MAHSC), Manchester, United Kingdom
| | - Sheena Reilly
- Murdoch Childrens Research Institute, Melbourne, Australia; Menzies Health Institute at Griffith University, Gold Coast, Queensland, Australia
| | - Angela T Morgan
- Murdoch Childrens Research Institute, Melbourne, Australia; University of Melbourne, Melbourne, Australia.
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17
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Liégeois F. Neurobiology of developmental coordination disorder: time to raise our game. Dev Med Child Neurol 2017; 59:1103. [PMID: 28884801 DOI: 10.1111/dmcn.13539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Frédérique Liégeois
- Cognitive Neuroscience and Neuropsychiatry Section, Developmental Neurosciences Programme, UCL GOS Institute of Child Health, London, UK
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Shriberg LD, Strand EA, Fourakis M, Jakielski KJ, Hall SD, Karlsson HB, Mabie HL, McSweeny JL, Tilkens CM, Wilson DL. A Diagnostic Marker to Discriminate Childhood Apraxia of Speech From Speech Delay: I. Development and Description of the Pause Marker. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2017; 60:S1096-S1117. [PMID: 28384779 PMCID: PMC5548086 DOI: 10.1044/2016_jslhr-s-15-0296] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 04/12/2016] [Accepted: 08/21/2016] [Indexed: 05/10/2023]
Abstract
Purpose The goal of this article (PM I) is to describe the rationale for and development of the Pause Marker (PM), a single-sign diagnostic marker proposed to discriminate early or persistent childhood apraxia of speech from speech delay. Method The authors describe and prioritize 7 criteria with which to evaluate the research and clinical utility of a diagnostic marker for childhood apraxia of speech, including evaluation of the present proposal. An overview is given of the Speech Disorders Classification System, including extensions completed in the same approximately 3-year period in which the PM was developed. Results The finalized Speech Disorders Classification System includes a nosology and cross-classification procedures for childhood and persistent speech disorders and motor speech disorders (Shriberg, Strand, & Mabie, 2017). A PM is developed that provides procedural and scoring information, and citations to papers and technical reports that include audio exemplars of the PM and reference data used to standardize PM scores are provided. Conclusions The PM described here is an acoustic-aided perceptual sign that quantifies one aspect of speech precision in the linguistic domain of phrasing. This diagnostic marker can be used to discriminate early or persistent childhood apraxia of speech from speech delay.
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Affiliation(s)
| | | | | | - Kathy J. Jakielski
- Department of Communication Sciences and Disorders, Augustana College, Rock Island, IL
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Murray E, Iuzzini-Seigel J. Efficacious Treatment of Children With Childhood Apraxia of Speech According to the International Classification of Functioning, Disability and Health. ACTA ACUST UNITED AC 2017. [DOI: 10.1044/persp2.sig2.61] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
There is increasing evidence for treatment approaches designed for children with childhood apraxia of speech (CAS). Despite this, no treatment has conclusive evidence to date. The CAS population is heterogeneous, with children presenting with varying symptom profiles, severity levels, and comorbidities. Consequently, treatment planning for children with CAS represents a clinical challenge. To assist clinicians in providing optimal care, this paper uses the International Classification of Functioning, Disability and Health (ICF) as a framework for identifying the body structures and functions, activities, and personal/environmental factors that should be considered when working with children with CAS. Evidence-based interventions are described and resources outlined to help guide the treatment planning process.
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Affiliation(s)
- Elizabeth Murray
- Faculty of Health Sciences, The University of Sydney
Lidcombe NSW, Australia
| | - Jenya Iuzzini-Seigel
- Communication, Movement and Learning Lab, Department of Speech Pathology and Audiology, Marquette University
Milwaukee, WI
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20
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Developmental behavioral neurology: an update. Curr Opin Pediatr 2016; 28:718-719. [PMID: 27662209 DOI: 10.1097/mop.0000000000000425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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