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Morere DA, Allen TE. Sign language delays in deaf 3- to 5-year-olds with hearing parents. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2024:enae041. [PMID: 39363852 DOI: 10.1093/jdsade/enae041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Revised: 09/03/2024] [Accepted: 09/11/2024] [Indexed: 10/05/2024]
Abstract
Deaf children of hearing parents (DOH) are at risk for early language delays (ELD) due to environmental and etiological factors, compounding the previously reported higher incidence of ELD in deaf children of deaf parents (DOD) compared to the general population. Archival data from the online database of the Visual Communication and Sign Language Checklist yielded 147 ratings of DOH 3- to 5-year-old children whose parents reported American sign language (ASL) being used in the home at least equally to spoken language. Research goals included (1) examining the incidence of ELD in this cohort, (2) investigating differences in outcomes based on the scaling method used, (3) exploring patterns among the ratings of DOH children identified with ELD, (4) comparing the DOH outcomes to published DOD data, and (5) investigating differences between ratings and individual children. The DOH outcomes suggested an incidence of ELD twice that of the previous DOD sample, with a higher percentage of more severe delays. Even DOH children not identified with ELD demonstrated less well-developed ASL skills than their DOD peers. This emphasizes the need for ongoing monitoring of early ASL skills to allow for early identification of needs and adjustment of interventions to address ASL development.
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Affiliation(s)
- Donna A Morere
- Department of Psychology, Gallaudet University, Washington DC, United States
- Science of Learning Center on Visual Language and Visual Learning, Gallaudet University, Washington DC, United States
| | - Thomas E Allen
- Science of Learning Center on Visual Language and Visual Learning, Gallaudet University, Washington DC, United States
- Educational Neuroscience Program, Gallaudet University, Washington DC, United States
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2
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Nora A, Rinkinen O, Renvall H, Service E, Arkkila E, Smolander S, Laasonen M, Salmelin R. Impaired Cortical Tracking of Speech in Children with Developmental Language Disorder. J Neurosci 2024; 44:e2048232024. [PMID: 38589232 PMCID: PMC11140678 DOI: 10.1523/jneurosci.2048-23.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 03/25/2024] [Accepted: 03/26/2024] [Indexed: 04/10/2024] Open
Abstract
In developmental language disorder (DLD), learning to comprehend and express oneself with spoken language is impaired, but the reason for this remains unknown. Using millisecond-scale magnetoencephalography recordings combined with machine learning models, we investigated whether the possible neural basis of this disruption lies in poor cortical tracking of speech. The stimuli were common spoken Finnish words (e.g., dog, car, hammer) and sounds with corresponding meanings (e.g., dog bark, car engine, hammering). In both children with DLD (10 boys and 7 girls) and typically developing (TD) control children (14 boys and 3 girls), aged 10-15 years, the cortical activation to spoken words was best modeled as time-locked to the unfolding speech input at ∼100 ms latency between sound and cortical activation. Amplitude envelope (amplitude changes) and spectrogram (detailed time-varying spectral content) of the spoken words, but not other sounds, were very successfully decoded based on time-locked brain responses in bilateral temporal areas; based on the cortical responses, the models could tell at ∼75-85% accuracy which of the two sounds had been presented to the participant. However, the cortical representation of the amplitude envelope information was poorer in children with DLD compared with TD children at longer latencies (at ∼200-300 ms lag). We interpret this effect as reflecting poorer retention of acoustic-phonetic information in short-term memory. This impaired tracking could potentially affect the processing and learning of words as well as continuous speech. The present results offer an explanation for the problems in language comprehension and acquisition in DLD.
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Affiliation(s)
- Anni Nora
- Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo FI-00076, Finland
- Aalto NeuroImaging (ANI), Aalto University, Espoo FI-00076, Finland
| | - Oona Rinkinen
- Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo FI-00076, Finland
- Aalto NeuroImaging (ANI), Aalto University, Espoo FI-00076, Finland
| | - Hanna Renvall
- Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo FI-00076, Finland
- Aalto NeuroImaging (ANI), Aalto University, Espoo FI-00076, Finland
- BioMag Laboratory, HUS Diagnostic Center, Helsinki University Hospital, Helsinki FI-00029, Finland
| | - Elisabet Service
- Department of Linguistics and Languages, Centre for Advanced Research in Experimental and Applied Linguistics (ARiEAL), McMaster University, Hamilton, Ontario L8S 4L8, Canada
- Department of Psychology and Logopedics, University of Helsinki, Helsinki FI-00014, Finland
| | - Eva Arkkila
- Department of Otorhinolaryngology and Phoniatrics, Head and Neck Center, Helsinki University Hospital and University of Helsinki, Helsinki FI-00014, Finland
| | - Sini Smolander
- Department of Otorhinolaryngology and Phoniatrics, Head and Neck Center, Helsinki University Hospital and University of Helsinki, Helsinki FI-00014, Finland
- Research Unit of Logopedics, University of Oulu, Oulu FI-90014, Finland
- Department of Logopedics, University of Eastern Finland, Joensuu FI-80101, Finland
| | - Marja Laasonen
- Department of Otorhinolaryngology and Phoniatrics, Head and Neck Center, Helsinki University Hospital and University of Helsinki, Helsinki FI-00014, Finland
- Department of Logopedics, University of Eastern Finland, Joensuu FI-80101, Finland
| | - Riitta Salmelin
- Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo FI-00076, Finland
- Aalto NeuroImaging (ANI), Aalto University, Espoo FI-00076, Finland
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Morere DA, Allen TE, Jaeger M, Winthrop D. Sign language delays in deaf 3- to 5-year-olds with deaf parents. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2024; 29:115-133. [PMID: 38079616 PMCID: PMC10993463 DOI: 10.1093/deafed/enad059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 11/08/2023] [Accepted: 11/12/2023] [Indexed: 03/21/2024]
Abstract
Research has demonstrated that deaf children of deaf signing parents (DOD) are afforded developmental advantages. This can be misconstrued as indicating that no DOD children exhibit early language delays (ELDs) because of their early access to a visual language. Little research has studied this presumption. In this study, we examine 174 ratings of DOD 3- to 5-year-old children, for whom signing in the home was indicated, using archival data from the online database of the Visual Communication and Sign Language Checklist. Our goals were to (1) examine the incidence of ELDs in a cohort of DOD children; (2) compare alternative scaling strategies for identifying ELD children; (3) explore patterns among behavioral ratings with a view toward developing a greater understanding of the types of language behaviors that may lie at the root of language delays; and (4) suggest recommendations for parents and professionals working with language-delayed DOD children. The results indicated that a significant number of ratings suggested ELDs, with a subset significantly delayed. These children likely require further evaluation. Among the less delayed group, ASL skills, rather than communication or cognition, were seen as the major concern, suggesting that even DOD children may require support developing linguistically accurate ASL. Overall, these findings support the need for early and ongoing evaluation of visual language skills in young DOD children.
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Affiliation(s)
- Donna A Morere
- Department of Psychology, Gallaudet University, Washington, D.C., United States
- Science of Learning Center on Visual Language and Visual Learning, Gallaudet University, Washington, D.C., United States
| | - Thomas E Allen
- Science of Learning Center on Visual Language and Visual Learning, Gallaudet University, Washington, D.C., United States
- Educational Neuroscience Program, Gallaudet University, Washington, D.C., United States
| | - Maura Jaeger
- Center for Language Science, Penn State University, State College, PA, United States
| | - Dana Winthrop
- Center for Language Science, Penn State University, State College, PA, United States
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Parks KMA, Hannah KE, Moreau CN, Brainin L, Joanisse MF. Language abilities in children and adolescents with DLD and ADHD: A scoping review. JOURNAL OF COMMUNICATION DISORDERS 2023; 106:106381. [PMID: 37797400 DOI: 10.1016/j.jcomdis.2023.106381] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 09/22/2023] [Accepted: 09/22/2023] [Indexed: 10/07/2023]
Abstract
PURPOSE There is an emerging view that attention-deficit/hyperactivity disorder (ADHD) is marked by problems with language difficulties, an idea reinforced by the fact that ADHD is highly comorbid with developmental language disorder (DLD). This scoping review provides an overview of literature on language abilities in children with DLD and ADHD while highlighting similarities and differences. METHOD A comprehensive search was performed to examine the literature on language abilities in the two disorders, yielding a total of 18 articles that met the inclusion criteria for the present review. Qualitative summaries are provided based on the language domain assessed. RESULTS The current literature suggests children and adolescents with ADHD have better morphosyntax/grammar, general/core language abilities, receptive, and expressive abilities than those with DLD. Further, that performance is comparable on assessments of semantic and figurative language but varies by sample on assessments of phonological processing, syntax, narrative language, and vocabulary. CONCLUSION Evidence presented points to children and adolescents with DLD as having greater language difficulties compared to those with ADHD, but with some important caveats. Despite limitations related to the paucity of studies and inconsistencies in how the two types of disorders are identified, our review provides a necessary and vital step in better understanding the language profiles of these two highly prevalent childhood disorders. These findings are useful in optimizing language outcomes and treatment efficacy for children and adolescents with ADHD and DLD.
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Affiliation(s)
- Kaitlyn M A Parks
- Western University, Department of Psychology, London, ON, Canada; Western University, Brain and Mind Institute, London, ON, Canada.
| | - Kara E Hannah
- Western University, Department of Psychology, London, ON, Canada; Western University, Brain and Mind Institute, London, ON, Canada
| | - Christine N Moreau
- Western University, Department of Psychology, London, ON, Canada; Western University, Brain and Mind Institute, London, ON, Canada
| | - Leah Brainin
- Western University, Department of Psychology, London, ON, Canada; Western University, Brain and Mind Institute, London, ON, Canada
| | - Marc F Joanisse
- Western University, Department of Psychology, London, ON, Canada; Western University, Brain and Mind Institute, London, ON, Canada
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Previously Marzena Szkodo MOR, Micai M, Caruso A, Fulceri F, Fazio M, Scattoni ML. Technologies to support the diagnosis and/or treatment of neurodevelopmental disorders: A systematic review. Neurosci Biobehav Rev 2023; 145:105021. [PMID: 36581169 DOI: 10.1016/j.neubiorev.2022.105021] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 12/13/2022] [Accepted: 12/23/2022] [Indexed: 12/27/2022]
Abstract
In recent years, there has been a great interest in utilizing technology in mental health research. The rapid technological development has encouraged researchers to apply technology as a part of a diagnostic process or treatment of Neurodevelopmental Disorders (NDDs). With the large number of studies being published comes an urgent need to inform clinicians and researchers about the latest advances in this field. Here, we methodically explore and summarize findings from studies published between August 2019 and February 2022. A search strategy led to the identification of 4108 records from PubMed and APA PsycInfo databases. 221 quantitative studies were included, covering a wide range of technologies used for diagnosis and/or treatment of NDDs, with the biggest focus on Autism Spectrum Disorder (ASD). The most popular technologies included machine learning, functional magnetic resonance imaging, electroencephalogram, magnetic resonance imaging, and neurofeedback. The results of the review indicate that technology-based diagnosis and intervention for NDD population is promising. However, given a high risk of bias of many studies, more high-quality research is needed.
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Affiliation(s)
| | - Martina Micai
- Research Coordination and Support Service, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy.
| | - Angela Caruso
- Research Coordination and Support Service, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy.
| | - Francesca Fulceri
- Research Coordination and Support Service, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy.
| | - Maria Fazio
- Department of Mathematics, Computer Science, Physics and Earth Sciences (MIFT), University of Messina, Viale F. Stagno d'Alcontres, 31, 98166 Messina, Italy.
| | - Maria Luisa Scattoni
- Research Coordination and Support Service, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy.
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Lajunen HR, Laasonen M, Lahti-Nuuttila P, Leminen M, Smolander S, Kunnari S, Arkkila E, Lauronen L. Is epileptiform activity related to developmental language disorder? Findings from the HelSLI study. Clin Neurophysiol Pract 2023; 8:65-70. [PMID: 37188277 PMCID: PMC10176248 DOI: 10.1016/j.cnp.2023.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 02/12/2023] [Accepted: 03/31/2023] [Indexed: 05/17/2023] Open
Abstract
Objective To study if interictal epileptiform discharges (IEDs) are associated with language performance or pre-/perinatal factors in children with developmental language disorder (DLD). Methods We recorded routine EEG in wake and sleep in 205 children aged 2.9-7.1 years with DLD, without neurologic diseases or intellectual disability. We examined the language performance of the children and collected data on pre-/perinatal factors. Results Interictal epileptiform discharges were not associated with lower language performance. Children with so-called "rolandic", i.e. centrotemporoparietal, IEDs had better language skills, but age explained this association. Most pre-/perinatal factors evaluated did not increase the risk of rolandic IEDs, except for maternal smoking (OR 4.4, 95% CI 1.4-14). We did not find electrical status epilepticus during slow-wave sleep (ESES)/spike-and-wave activation in sleep (SWAS) in any children. Conclusions Interictal epileptiform discharges are not associated with lower language performance, and ESES/SWAS is not common in children with DLD. Significance Routine EEGs do not bring additional information about language performance in children with DLD who do not have any neurologic diseases, seizures, intellectual disability, or regression of language development.
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Affiliation(s)
- Hanna-Reetta Lajunen
- Department of Clinical Neurophysiology, University of Helsinki and Helsinki University Hospital, Finland
- Corresponding author at: Department of Clinical Neurophysiology, University of Helsinki and Helsinki University Hospital, PO Box 800, 00029 HUS, Finland.
| | - Marja Laasonen
- Department of Otorhinolaryngology and Phoniatrics, Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Logopedics, School of Humanities, Philosophical Faculty, University of Eastern Finland, Joensuu, Finland
| | - Pekka Lahti-Nuuttila
- Department of Otorhinolaryngology and Phoniatrics, Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Miika Leminen
- Unit of Analytics and Data Services, Helsinki University Hospital, Helsinki, Finland
| | - Sini Smolander
- Department of Otorhinolaryngology and Phoniatrics, Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Research Unit of Logopedics, Faculty of Humanities, University of Oulu, Finland
| | - Sari Kunnari
- Research Unit of Logopedics, Faculty of Humanities, University of Oulu, Finland
| | - Eva Arkkila
- Department of Otorhinolaryngology and Phoniatrics, Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Leena Lauronen
- Department of Clinical Neurophysiology, University of Helsinki and Helsinki University Hospital and Epilepsia Helsinki, Finland
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Nitin R, Shaw DM, Rocha DB, Walters CE, Chabris CF, Camarata SM, Gordon RL, Below JE. Association of Developmental Language Disorder With Comorbid Developmental Conditions Using Algorithmic Phenotyping. JAMA Netw Open 2022; 5:e2248060. [PMID: 36580336 PMCID: PMC9857086 DOI: 10.1001/jamanetworkopen.2022.48060] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
IMPORTANCE Developmental language disorder (DLD) is a common (with up to 7% prevalence) yet underdiagnosed childhood disorder whose underlying biological profile and comorbidities are not fully understood, especially at the population level. OBJECTIVE To identify clinically relevant conditions that co-occur with DLD at the population level. DESIGN, SETTING, AND PARTICIPANTS This case-control study used an electronic health record (EHR)-based population-level approach to compare the prevalence of comorbid health phenotypes between DLD cases and matched controls. These cases were identified using the Automated Phenotyping Tool for Identifying Developmental Language Disorder algorithm of the Vanderbilt University Medical Center EHR, and a phenome enrichment analysis was used to identify comorbidities. An independent sample was selected from the Geisinger Health System EHR to test the replication of the phenome enrichment using the same phenotyping and analysis pipeline. Data from the Vanderbilt EHR were accessed between March 2019 and October 2020, while data from the Geisinger EHR were accessed between January and March 2022. MAIN OUTCOMES AND MEASURES Common and rare comorbidities of DLD at the population level were identified using EHRs and a phecode-based enrichment analysis. RESULTS Comorbidity analysis was conducted for 5273 DLD cases (mean [SD] age, 16.8 [7.2] years; 3748 males [71.1%]) and 26 353 matched controls (mean [SD] age, 14.6 [5.5] years; 18 729 males [71.1%]). Relevant phenotypes associated with DLD were found, including learning disorder, delayed milestones, disorders of the acoustic nerve, conduct disorders, attention-deficit/hyperactivity disorder, lack of coordination, and other motor deficits. Several other health phenotypes not previously associated with DLD were identified, such as dermatitis, conjunctivitis, and weight and nutrition, representing a new window into the clinical complexity of DLD. CONCLUSIONS AND RELEVANCE This study found both rare and common comorbidities of DLD. Comorbidity profiles may be leveraged to identify risk of additional health challenges, beyond language impairment, among children with DLD.
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Affiliation(s)
- Rachana Nitin
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, Tennessee
- Department of Otolaryngology–Head & Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Douglas M. Shaw
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Daniel B. Rocha
- Phenomic Analytics and Clinical Data Core, Geisinger, Danville, Pennsylvania
- NewYork-Presbyterian Hospital, New York
| | - Courtney E. Walters
- Department of Otolaryngology–Head & Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
- Vanderbilt University Neuroscience Program, Vanderbilt University, Nashville, Tennessee
- Loma Linda School of Medicine, Loma Linda University, Loma Linda, California
| | | | - Stephen M. Camarata
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Reyna L. Gordon
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, Tennessee
- Department of Otolaryngology–Head & Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee
- Department of Psychology, Vanderbilt University, Nashville, Tennessee
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jennifer E. Below
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
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Jokihaka S, Laasonen M, Lahti-Nuuttila P, Smolander S, Kunnari S, Arkkila E, Pesonen AK, Heinonen K. Cross-Sectional and Longitudinal Associations Between Quality of Parent-Child Interaction and Language Ability in Preschool-Age Children With Developmental Language Disorder. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:2258-2271. [PMID: 35583982 DOI: 10.1044/2022_jslhr-21-00479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
PURPOSE This study explores whether the quality of parent-child interaction is associated with language abilities cross-sectionally and longitudinally up to preschool-age among children with developmental language disorder (DLD). METHOD Participants were 97 monolingual children with DLD and their parents from the Helsinki Longitudinal SLI study, HelSLI (baseline, age in years;months, M = 4;3, SD = 0;10), of which 71 pairs were followed longitudinally (age in years;months, M = 6;6, SD = 0;5). Video recordings from three play sessions were scored for child, parent, and dyadic behavior using Erickson's sensitivity scale protocol and mutually responsive orientation at baseline. Children's expressive and receptive language and language reasoning ability were assessed at baseline, and expressive and receptive language were assessed at follow-up. RESULTS At baseline, engaged child behavior, parent's supportive guidance, and fluent and attuned dyadic behavior were associated with better receptive language ability, and engaged child behavior and dyadic synchrony were positively associated with language reasoning ability in 3- to 6-year-olds. The child's positive engagement and fluent and attuned dyadic behavior at baseline were associated with better expressive and receptive language abilities at follow-up in 6- to 7-year-olds, respectively. CONCLUSIONS Fluent and attuned dyadic behavior is associated with better receptive language ability in preschool-age children. Parent behavior alone was not associated with language ability. A connected and mutually attuned parent-child relationship could be a protective factor for language development for children with DLD.
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Affiliation(s)
- Suvi Jokihaka
- Department of Otorhinolaryngology and Phoniatrics - Head and Neck Surgery, Helsinki University Hospital, Finland
- Doctoral School in Health Sciences, University of Helsinki, Finland
| | - Marja Laasonen
- Department of Otorhinolaryngology and Phoniatrics - Head and Neck Surgery, Helsinki University Hospital, Finland
- Department of Logopedics, School of Humanities, Philosophical Faculty, University of Eastern Finland, Joensuu
| | - Pekka Lahti-Nuuttila
- Department of Otorhinolaryngology and Phoniatrics - Head and Neck Surgery, Helsinki University Hospital, Finland
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
| | - Sini Smolander
- Department of Otorhinolaryngology and Phoniatrics - Head and Neck Surgery, Helsinki University Hospital, Finland
- Department of Logopedics, School of Humanities, Philosophical Faculty, University of Eastern Finland, Joensuu
- Research Unit of Logopedics, University of Oulu, Finland
| | - Sari Kunnari
- Research Unit of Logopedics, University of Oulu, Finland
| | - Eva Arkkila
- Department of Otorhinolaryngology and Phoniatrics - Head and Neck Surgery, Helsinki University Hospital, Finland
| | - Anu-Katriina Pesonen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
| | - Kati Heinonen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
- Department of Psychology/Welfare Sciences, Faculty of Social Sciences, Tampere University, Finland
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Esmael A, Elsherbeny S, Abbas M. Association of epileptiform brain activity and specific language impairment (SLI) in preschool children. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2021. [DOI: 10.1186/s41983-021-00269-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Epileptiform activities can cause transient or permanent deficits that affect the children during development and may be accompanied by neurodevelopmental disorders like specific language impairment.
Objectives
The objective of this study was to find if there is a possible association and the impact of epilepsy and epileptiform activity in children with specific language impairment.
Patients and methods
The study was conducted on 80 children suffering from specific language impairment and 80 age and sex match healthy control children. Computed tomography brain was performed and electroencephalography was recorded for children. Intelligence quotient level, cognitive age, social, and phoniatric assessment were done for all patients.
Results
Eighty children with specific language impairment (51 males and 29 females) with a mean age of 4.11 ± 1.93. Patients with specific language impairment showed significantly higher rates of abnormal electroencephalography (P = 0.006) and epilepsy (P < 0.001) compared to the control group. Spearman correlation demonstrated a highly negative significant relationship linking the language, intelligence quotient with abnormal electroencephalography and epilepsy (r = − 0.91, P < 0.01 and r = − 0.91, P < 0.01 respectively). Also, there was a moderately inverse significant relationship linking the cognitive age, social with abnormal electroencephalography, and epilepsy (r = − 0.70, P < 0.05 and r = − 0.65, P < 0.05 respectively).
Conclusion
Epileptiform activities even without epilepsy in preschool children may alter normal language function. Specific language impairment was associated with lower intelligence quotient levels, social, and cognitive age.
Trial registration
ClinicalTrials.gov ID: NCT04141332
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Holmes J, Guy J, Kievit RA, Bryant A, Mareva S, Gathercole SE. Cognitive Dimensions of Learning in Children With Problems in Attention, Learning, and Memory. JOURNAL OF EDUCATIONAL PSYCHOLOGY 2021; 113:1454-1480. [PMID: 35855686 PMCID: PMC7613068 DOI: 10.1037/edu0000644] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
A data-driven, transdiagnostic approach was used to identify the cognitive dimensions linked with learning in a mixed group of 805 children aged 5 to 18 years recognised as having problems in attention, learning and memory by a health or education practitioner. Assessments included phonological processing, information processing speed, short-term and working memory, and executive functions, and attainments in word reading, spelling, and maths. Data reduction methods identified three dimensions of phonological processing, processing speed and executive function for the sample as a whole. This model was comparable for children with and without ADHD. The severity of learning difficulties in literacy was linked with phonological processing skills, and in maths with executive control. Associations between cognition and learning were similar across younger and older children and individuals with and without ADHD, although stronger links between learning-related problems and both executive skills and processing speed were observed in children with ADHD. The results establish clear domain-specific cognitive pathways to learning that distinguish individuals in the heterogeneous population of children struggling to learn.
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Affiliation(s)
- Joni Holmes
- MRC Cognition and Brain Sciences Unit, University of Cambridge
| | - Jacalyn Guy
- MRC Cognition and Brain Sciences Unit, University of Cambridge
| | | | - Annie Bryant
- Department of Clinical Psychology, Faculty of Medicine and Health Sciences, University of East Anglia
| | - Silvana Mareva
- MRC Cognition and Brain Sciences Unit, University of Cambridge
| | - the CALM Team
- MRC Cognition and Brain Sciences Unit, University of Cambridge
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Davis R, Fletcher-Watson S, Digard BG. Autistic People's Access to Bilingualism and Additional Language Learning: Identifying the Barriers and Facilitators for Equal Opportunities. Front Psychol 2021; 12:741182. [PMID: 34630254 PMCID: PMC8492951 DOI: 10.3389/fpsyg.2021.741182] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 08/23/2021] [Indexed: 12/01/2022] Open
Abstract
Bilingualism is a valuable tool that enriches and facilitates cultural, social and lived experiences for autistic and non-autistic people alike. Research consistently finds no negative effects of bilingualism and highlights the potential for positive effects across cognitive and socio-cultural domains for autistic and non-autistic children. Yet parents of autistic children remain concerned that bilingualism will cause delays in both cognitive and language development and are still frequently advised by practitioners to raise their child monolingually. Evidently, findings from research are not reflected in practice or subsequent advice, and it is essential to identify ways to ensure equal access to additional language learning. We briefly summarise the existing literature on bilingualism and autism, considering perspectives from the bilingual autistic community, and experimental research. We identify the most pertinent barriers to participation for autistic bilingual children in terms of familial, clinical and educational perspectives. We propose novel solutions to promote additional language learning and suggest changes to practice that will contribute to an evidence base for families and practitioners. This commentary makes innovative recommendations at both the individual and societal level to ensure that autistic bilingual people have equal rights and opportunities to language learning and are optimally supported in accessing them.
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Affiliation(s)
- Rachael Davis
- Salvesen Mindroom Research Centre, University of Edinburgh, Edinburgh, United Kingdom
| | - Sue Fletcher-Watson
- Salvesen Mindroom Research Centre, University of Edinburgh, Edinburgh, United Kingdom
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Plym J, Lahti-Nuuttila P, Smolander S, Arkkila E, Laasonen M. Structure of Cognitive Functions in Monolingual Preschool Children With Typical Development and Children With Developmental Language Disorder. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:3140-3158. [PMID: 34255982 DOI: 10.1044/2021_jslhr-20-00546] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Purpose Developmental language disorder (DLD) is defined by persistent difficulties with language, but a growing body of evidence suggests that it is also associated with domain-general and nonverbal information-processing deficits. However, the interconnections between cognitive functions, both nonverbal and language related, are still unclear. With the aim of gaining more comprehensive insight into the cognitive deficits related to DLD, we investigated and compared the cognitive structure of children with DLD and typically developing (TD) children. Method As a part of the Helsinki longitudinal SLI study, monolingual Finnish preschoolers (N = 154; TD group: n = 66, DLD group: n = 88) were assessed with 23 tasks measuring nonverbal and verbal reasoning, language processing, memory, visuomotor functions, attention, and social cognition. Exploratory factor analysis and structural equation modeling were performed to examine latent constructs and to test measurement invariance between the TD and DLD groups. Results Measurement invariance was not found across the TD and DLD groups. Best fitting structure for TD children included factors reflecting verbal abilities, processing speed/short-term memory, visuomotor functions, and visuoconstructive abilities/nonverbal reasoning. The DLD group's structure comprised nonverbal abilities, naming/expressive language, verbal comprehension, and verbal/declarative memory. Conclusions The findings suggest that the structure of cognitive functions differs in TD children and children with DLD already at preschool age. Nonverbal functions seem more unified, whereas verbal functions seem more varying in preschoolers with DLD compared to TD children. The results can be used in future research for prognosis of DLD and planning interventions.
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Affiliation(s)
- Jade Plym
- Department of Otorhinolaryngology and Phoniatrics-Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Finland
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
| | - Pekka Lahti-Nuuttila
- Department of Otorhinolaryngology and Phoniatrics-Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Finland
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
| | - Sini Smolander
- Department of Otorhinolaryngology and Phoniatrics-Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Finland
- Research Unit of Logopedics, University of Oulu, Finland
| | - Eva Arkkila
- Department of Otorhinolaryngology and Phoniatrics-Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Finland
| | - Marja Laasonen
- Department of Otorhinolaryngology and Phoniatrics-Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Finland
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
- Department of Logopedics, School of Humanities, Philosophical Faculty, University of Eastern Finland, Finland
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Bonti E, Kamari A, Sofologi M, Giannoglou S, Porfyri GN, Tatsiopoulou P, Kougioumtzis G, Efstratopoulou M, Diakogiannis I. Similarities and Differences in the Learning Profiles of Adolescents with SLD and SLI in Mathematics-A Preliminary Analysis. Brain Sci 2021; 11:brainsci11070850. [PMID: 34202177 PMCID: PMC8301888 DOI: 10.3390/brainsci11070850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 06/22/2021] [Accepted: 06/22/2021] [Indexed: 11/16/2022] Open
Abstract
SLI and SLD constitute two independent neurodevelopmental disorders, which frequently cause challenges in the diagnosis process, especially due to their nature. This has caused disagreement among clinicians regarding their recognition as separate or overlapping disorders. The objective of the study was to enlighten the path of valid diagnosis and intervention during adolescence when the two disorders change their manifestation and overlap. Two hundred Greek adolescents (140 boys and 60 girls), 124 already diagnosed with SLD and 76 diagnosed with SLI, 12-16 years old, participated in the study. All participants were assessed in reading, oral and written language and mathematics (mathematical operations and mathematical reasoning) along with IQ testing. In order to determine statistically significant differences, the chi-square test, independent samples t-test, odds ratios and their 95 per cent confidence intervals were implemented. The results revealed that the SLI group presented significantly greater difficulties than SLD in their overall cognitive-mental profile and in most language and mathematical measurements (number concept, executive-procedural part of solving operations and mathematical reasoning). The similarity of the two groups was mainly detected in their deficient metacognitive, metalinguistic and metamnemonic strategies. The research concludes that SLD adolescents managed to overcome their difficulties to a significant degree, while adolescents with SLI still struggle with many learning areas.
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Affiliation(s)
- Eleni Bonti
- First Psychiatric Clinic, "Papageorgiou" General Hospital, Ring Road Thessaloniki, N. Efkarpia, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54603 Thessaloniki, Greece
- Department of Education, School of Education, University of Nicosia, Nicosia 2417, Cyprus
| | - Afroditi Kamari
- First Psychiatric Clinic, "Papageorgiou" General Hospital, Ring Road Thessaloniki, N. Efkarpia, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54603 Thessaloniki, Greece
| | - Maria Sofologi
- Laboratory of Psychology, Department of Early Childhood Education, School of Education, University of Ioannina, 45110 Ioannina, Greece
- Institute of Humanities and Social Sciences, University Research Center of Ioannina (URCI), 45110 Ioannina, Greece
| | - Sofia Giannoglou
- First Psychiatric Clinic, "Papageorgiou" General Hospital, Ring Road Thessaloniki, N. Efkarpia, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54603 Thessaloniki, Greece
| | - Georgia-Nektaria Porfyri
- First Psychiatric Clinic, "Papageorgiou" General Hospital, Ring Road Thessaloniki, N. Efkarpia, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54603 Thessaloniki, Greece
| | - Paraskevi Tatsiopoulou
- First Psychiatric Clinic, "Papageorgiou" General Hospital, Ring Road Thessaloniki, N. Efkarpia, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54603 Thessaloniki, Greece
| | - Georgios Kougioumtzis
- Department of Turkish and Modern Asian Studies, National and Kapodistrian University of Athens, 10680 Athens, Greece
| | - Maria Efstratopoulou
- Department of Special Education (CEDU), United Arab Emirates University (UAEU), Al Ain 112612, United Arab Emirates
| | - Ioannis Diakogiannis
- First Psychiatric Clinic, "Papageorgiou" General Hospital, Ring Road Thessaloniki, N. Efkarpia, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54603 Thessaloniki, Greece
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Lahti-Nuuttila P, Service E, Smolander S, Kunnari S, Arkkila E, Laasonen M. Short-Term Memory for Serial Order Moderates Aspects of Language Acquisition in Children With Developmental Language Disorder: Findings From the HelSLI Study. Front Psychol 2021; 12:608069. [PMID: 33959064 PMCID: PMC8096175 DOI: 10.3389/fpsyg.2021.608069] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 03/08/2021] [Indexed: 11/13/2022] Open
Abstract
Previous studies of verbal short-term memory (STM) indicate that STM for serial order may be linked to language development and developmental language disorder (DLD). To clarify whether a domain-general mechanism is impaired in DLD, we studied the relations between age, non-verbal serial STM, and language competence (expressive language, receptive language, and language reasoning). We hypothesized that non-verbal serial STM differences between groups of children with DLD and typically developing (TD) children are linked to their language acquisition differences. Fifty-one children with DLD and sixty-six TD children participated as part of the HelSLI project in this cross-sectional study. The children were 4-6-year-old monolingual native Finnish speakers. They completed several tests of language and cognitive functioning, as well as new game-like tests of visual and auditory non-verbal serial STM. We used regression analyses to examine how serial STM moderates the effect of age on language. A non-verbal composite measure of serial visual and auditory STM moderated cross-sectional development of receptive language in the children with DLD. This moderation was not observed in the TD children. However, we found more rapid cross-sectional development of non-verbal serial STM in the TD children than in the children with DLD. The results suggest that children with DLD may be more likely to have compromised general serial STM processing and that superior non-verbal serial STM may be associated with better language acquisition in children with DLD.
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Affiliation(s)
- Pekka Lahti-Nuuttila
- Department of Otorhinolaryngology and Phoniatrics, Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Elisabet Service
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Linguistics and Languages, Centre for Advanced Research in Experimental and Applied Linguistics, McMaster University, Hamilton, ON, Canada
| | - Sini Smolander
- Department of Otorhinolaryngology and Phoniatrics, Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Research Unit of Logopedics, University of Oulu, Oulu, Finland
| | - Sari Kunnari
- Research Unit of Logopedics, University of Oulu, Oulu, Finland
| | - Eva Arkkila
- Department of Otorhinolaryngology and Phoniatrics, Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Marja Laasonen
- Department of Otorhinolaryngology and Phoniatrics, Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Logopedics, School of Humanities, Philosophical Faculty, University of Eastern Finland, Joensuu, Finland
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Smolander S, Laasonen M, Arkkila E, Lahti-Nuuttila P, Kunnari S. L2 vocabulary acquisition of early sequentially bilingual children with TD and DLD affected differently by exposure and age of onset. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2021; 56:72-89. [PMID: 33179849 DOI: 10.1111/1460-6984.12583] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 07/09/2020] [Accepted: 10/04/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Language exposure is known to be a key factor influencing bilingual vocabulary development in typically developing (TD) children. There is, however, a lack of knowledge in terms of exposure effects in children with developmental language disorder (DLD) and, especially, in interaction with age of onset (AoO) of second language acquisition. AIMS In the Helsinki longitudinal SLI study (HelSLI), we investigated the receptive and expressive second language (L2) vocabulary performance and cross-sectional vocabulary development of sequentially bilingual children with TD and DLD in order to resolve whether the groups could be differentiated based on their vocabulary performance. More importantly, we examined the effects of AoO and exposure in the vocabulary performance of these two bilingual groups. METHODS & PROCEDURES A total of 70 children with DLD from a hospital clinic and 82 with TD from kindergartens were recruited. Children were 3-7 years old with different AoOs for the L2 and varying degrees of language exposure. Multiple regression analysis was used to compare the groups in two receptive and three expressive vocabulary tests while considering the effects of AoO and language exposure. OUTCOMES & RESULTS Children with TD outperformed children with DLD in both receptive and expressive vocabulary measures. Exposure predicted vocabulary but AoO did not. The effect of exposure was different in TD and DLD groups in receptive but not in expressive vocabulary. Additionally, the interaction of exposure and AoO was found for receptive vocabulary, but similarly in both groups. With increasing exposure, a difference in performance between the groups became more notable in receptive vocabulary compared with the expressive vocabulary. CONCLUSIONS & IMPLICATIONS Bilingual children with TD and DLD can be differentiated by using L2 vocabulary tests when exposure is taken into consideration. Non-significant AoO effects in 3-7 year olds suggest flexibility in terms of when to start L2 immersion. However, exposure is important, and especially children with DLD would need a substantial amount of it relative to their TD peers, so that they would not fall even further behind over time. Differences in benefiting from exposure in receptive mode might offer clinicians and kindergarten personnel an insight for evaluating challenges in bilingual development. Severe challenges in vocabulary development in the DLD group also call for both individually targeted small-group activities for learning words as well as strategies for strengthening vocabulary in various environments and everyday life situations. What this paper adds What is already known on the subject Language exposure is often found to explain more of the variation compared with AoO in early L2 vocabulary. On the other hand, it has been suggested by some researchers, but not all, that AoO effects would be found. Exposure and AoO might also interact differently depending on the task and whether the development is typical or disordered. Contrary to the clinical observation, diagnostic value of receptive vocabulary has often been questioned. What this paper adds to existing knowledge This study indicates that receptive vocabulary might be useful in differentiating bilingual TD and DLD. Language exposure effects differ between TD and DLD groups, but depending on task. Lower performance, but also slower cross-sectional development, is found in receptive vocabulary for children with DLD. Interaction between language exposure and AoO stresses the importance of taking both into consideration when studying bilingual development. What are the potential or actual clinical implications of this work? L2 vocabulary tests can be used in differentiating bilingual children with TD and DLD when exposure is taken into consideration. Difficulties using exposure and, hence, slower development in children with DLD suggest that especially receptive vocabulary might be diagnostic by the accumulating exposure. Investing in ways of supporting vocabulary development through small-group activities and in everyday situations of bilingual children at risk of DLD is highly recommended. This is important to prevent them from incrementally falling further behind their TD peers over time. A limited AoO effect suggests that families have more flexibility in terms of when to place their child in L2 immersion in their early years.
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Affiliation(s)
- Sini Smolander
- Department of Otorhinolaryngology and Phoniatrics, Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Research Unit of Logopedics, University of Oulu, Oulu, Finland
| | - Marja Laasonen
- Department of Otorhinolaryngology and Phoniatrics, Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Eva Arkkila
- Department of Otorhinolaryngology and Phoniatrics, Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Pekka Lahti-Nuuttila
- Department of Otorhinolaryngology and Phoniatrics, Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Sari Kunnari
- Research Unit of Logopedics, University of Oulu, Oulu, Finland
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Developmental Language Disorder: Wake and Sleep Epileptiform Discharges and Co-morbid Neurodevelopmental Disorders. Brain Sci 2020; 10:brainsci10120910. [PMID: 33256068 PMCID: PMC7760604 DOI: 10.3390/brainsci10120910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 11/20/2020] [Accepted: 11/21/2020] [Indexed: 11/16/2022] Open
Abstract
Developmental language disorder (DLD) is frequently associated with other developmental diseases and may lead to a handicap through adolescence or adulthood. The aim of our retrospective study was to characterize DLD subgroups, their etiological factors and clinical comorbidities, and the role of epileptiform discharges in wake and sleep recordings. Fifty-five children (42 male, mean age 6.2 ± 1.4 years, range 4-9 years) were included in the present study and underwent phoniatric, psychologic, neurologic, as well as wake and nocturnal electroencephalography (EEG) or polysomnography (PSG) examinations. A receptive form of DLD was determined in 34 children (63.0%), and an expressive form was found in 20 children (37.0%). Poor cooperation in one child did not permit exact classification. DLD children with the receptive form had significantly lower mean phonemic hearing (79.1% ± 10.9) in comparison with those with the expressive form (89.7% ± 6.2, p < 0.001). A high amount of perinatal risk factors was found in both groups (50.9%) as well as comorbid developmental diseases. Developmental motor coordination disorder was diagnosed in 33 children (61.1%), and attention deficit or hyperactivity disorder was diagnosed in 39 children (70.9%). Almost one half of DLD children (49.1%) showed abnormalities on the wake EEG; epileptiform discharges were found in 20 children (36.4%). Nocturnal EEG and PSG recordings showed enhanced epileptiform discharges, and they were found in 30 children (55.6%, p = 0.01). The wake EEG showed focal discharges predominantly in the temporal or temporo-parieto-occipital regions bilaterally, while in the sleep recordings, focal activity was shifted to the fronto-temporo-central areas (p < 0.001). Almost all epileptiform discharges appeared in non-rapid eye movement (NREM) sleep. A close connection was found between DLD and perinatal risk factors, as well as neurodevelopmental disorders. Epileptiform discharges showed an enhancement in nocturnal sleep, and the distribution of focal discharges changed.
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Walters CE, Nitin R, Margulis K, Boorom O, Gustavson DE, Bush CT, Davis LK, Below JE, Cox NJ, Camarata SM, Gordon RL. Automated Phenotyping Tool for Identifying Developmental Language Disorder Cases in Health Systems Data (APT-DLD): A New Research Algorithm for Deployment in Large-Scale Electronic Health Record Systems. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2020; 63:3019-3035. [PMID: 32791019 PMCID: PMC7890229 DOI: 10.1044/2020_jslhr-19-00397] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 04/23/2020] [Accepted: 05/19/2020] [Indexed: 05/13/2023]
Abstract
Purpose Data mining algorithms using electronic health records (EHRs) are useful in large-scale population-wide studies to classify etiology and comorbidities (Casey et al., 2016). Here, we apply this approach to developmental language disorder (DLD), a prevalent communication disorder whose risk factors and epidemiology remain largely undiscovered. Method We first created a reliable system for manually identifying DLD in EHRs based on speech-language pathologist (SLP) diagnostic expertise. We then developed and validated an automated algorithmic procedure, called, Automated Phenotyping Tool for identifying DLD cases in health systems data (APT-DLD), that classifies a DLD status for patients within EHRs on the basis of ICD (International Statistical Classification of Diseases and Related Health Problems) codes. APT-DLD was validated in a discovery sample (N = 973) using expert SLP manual phenotype coding as a gold-standard comparison and then applied and further validated in a replication sample of N = 13,652 EHRs. Results In the discovery sample, the APT-DLD algorithm correctly classified 98% (concordance) of DLD cases in concordance with manually coded records in the training set, indicating that APT-DLD successfully mimics a comprehensive chart review. The output of APT-DLD was also validated in relation to independently conducted SLP clinician coding in a subset of records, with a positive predictive value of 95% of cases correctly classified as DLD. We also applied APT-DLD to the replication sample, where it achieved a positive predictive value of 90% in relation to SLP clinician classification of DLD. Conclusions APT-DLD is a reliable, valid, and scalable tool for identifying DLD cohorts in EHRs. This new method has promising public health implications for future large-scale epidemiological investigations of DLD and may inform EHR data mining algorithms for other communication disorders. Supplemental Material https://doi.org/10.23641/asha.12753578.
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Affiliation(s)
- Courtney E. Walters
- Department of Otolaryngology, Vanderbilt University Medical Center, Nashville, TN
- Neuroscience Program, College of Arts and Science, Vanderbilt University, Nashville, TN
| | - Rachana Nitin
- Department of Otolaryngology, Vanderbilt University Medical Center, Nashville, TN
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN
| | - Katherine Margulis
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
- Kennedy Krieger Institute, Baltimore, MD
| | - Olivia Boorom
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Daniel E. Gustavson
- Department of Otolaryngology, Vanderbilt University Medical Center, Nashville, TN
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN
| | - Catherine T. Bush
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Lea K. Davis
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Jennifer E. Below
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Nancy J. Cox
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Stephen M. Camarata
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Reyna L. Gordon
- Department of Otolaryngology, Vanderbilt University Medical Center, Nashville, TN
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN
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Early behavioral markers for neurodevelopmental disorders in the first 3 years of life: An overview of systematic reviews. Neurosci Biobehav Rev 2020; 116:183-201. [DOI: 10.1016/j.neubiorev.2020.06.027] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 06/22/2020] [Accepted: 06/23/2020] [Indexed: 01/08/2023]
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