Perfil de atos comunicativos de crianças com transtorno do desenvolvimento de linguagem / Profile of communicative acts of children with developmental language disorder

RESUMO Objetivo Caracterizar os atos comunicativos de crianças com transtorno do desenvolvimento da linguagem, verificando a quantidade de atos comunicativos, atos comunicativos interativos e sua relação com a idade cronológica. Métodos Foram participantes 40 crianças de ambos os gêneros com diagnóstico de transtorno do desenvolvimento da linguagem com idades entre 3 anos e 2 meses e 7 anos e 11 meses. Todos os sujeitos foram avaliados com a Prova de Pragmática ABFW - Teste de Linguagem Infantil, em sua avaliação inicial. Especificamente para este estudo, focou-se na verificação da quantidade de atos comunicativos, atos comunicativos por minuto, atos comunicativos interativos e número de iniciativas comunicativas. Resultados Os dados indicaram que crianças com transtorno do desenvolvimento da linguagem apresentam alterações importantes em relação aos atos comunicativos e interações comunicativas e há correlação dessas variáveis com a idade cronológica. Conclusão Crianças com transtorno do desenvolvimento da linguagem apresentam diminuição no número de atos comunicativos, atos comunicativos interativos e interações comunicativas, quando comparadas aos valores de referência de crianças típicas, independentemente da idade.

ABSTRACT Purpose To characterize the communicative acts of children with Developmental Language Disorder, verifying the number of communicative acts, interactive communicative acts, and their relationship with chronological age. Methods Forty children of both sexes with a diagnosis of Developmental Language Disorder aged between 3 years and seven years and 11 months were subjects. All subjects were assessed with the ABFW Pragmatics Test - Child Language Test in their initial assessment. Specifically, this study focused on verifying the number of communicative acts, communicative acts per minute, interactive communicative acts, and the number of communicative initiatives. Results The data indicate that children with Developmental Language Disorder present significant alterations concerning communicative acts and communicative interactions, and there is a correlation between these variables and chronological age. Conclusion Children with Developmental Language Disorder show a decrease in the number of communicative acts, interactive communicative acts, and communicative interactions when compared to the reference values of typical children, regardless of age.

Revisión de la intervención mediante lectura dialógica en niños con trastornos del desarrollo del lenguaje / A review of dialogic reading intervention in children with developmental language disorder

Resumen Introducción: La lectura dialógica es una de las técnicas más empleadas y estudiadas en el marco de las actividades de lectura compartida de libros entre niños y adultos. La presente revisión siste mática tiene como objetivo principal analizar sus efectos en el lenguaje de niños hablantes tardíos o con trastorno del desarrollo del lenguaje, no asociados a otra condición. Métodos: Se llevó a cabo una revisión sistemática de la literatura siguiendo las orientaciones del PRISMA Statement, mediante la consulta con diferentes bases de datos. Resultados: Las investigaciones revisadas muestran progresos en el lenguaje de los niños en indicadores léxicos, gramaticales y pragmáticos. También se observan cambios en el lenguaje de los adultos que aplican la intervención, tanto en el uso de las estrategias propias de la técnica como en las características gramaticales y suprasegmentales de su lenguaje. Discusión: La evidencia sobre la efectividad de la lectura dialógica en niños con trastornos del desarrollo lenguaje es prometedora pero presenta limitaciones importantes relativas, funda mentalmente, al diseño, la validez social y la fiabilidad de las intervenciones. Otras cuestiones destacables hacen referencia a los libros o materiales con los que se interactúa y a las medidas empleadas para valorar su efectividad.

Abstract Introduction: Dialogic reading is one of the most used and studied techniques within the fra me of shared book reading activities between children and adults. The current review aims to analyze its effects in late talkers and children with developmental language disorder, that is, not associated to other condition. Methods: A systematic review of the literature was carried out following PRISMA Statement gui delines. Results: The investigations reviewed show advances in children's lexical, grammatical and pragma tic indicators of language functioning. Likewise, changes are observed in the language of adults who apply the intervention, both in the use of dialogic reading strategies and in the grammatical and suprasegmental features of the language addressed to children. Discussion: The evidence about the effectivity of dialogic reading in late talkers and children with developmental language disorders is promising but has important limitations that are mainly related to the design, social validity and reliability of interventions. Other remarka ble issues relate to the books or materials employed and the measures used to assess its effectiveness.

A Sentence Repetition Task in Spanish language: a valid tool for early language assessment

ABSTRACT Purpose Sentence Repetition Tasks (SRT) have been widely used to assess early language abilities in different languages and populations. In addition, it has been proved that performance in SRTs serve as a clinical marker to detect language difficulties. However, most of the research has been conducted in English language and with children older than 4 years of age. Despite this scarcity, [1] developed a SRT for monolingual Spanish-speaking children between 2 and 4 years of age. Initial findings showed that it is a useful tool for discriminating children with different linguistic levels. In addition, the task showed concurrent validity with a nonword repetition task. In the current study we want to explore the predictive validity of this task. Methods We conducted a longitudinal study including 20 monolingual Spanish-Speaking children who were tested twice, at 33 months of age and six months later. In addition to the SRT, participants completed a nonword repetition task [2] and the Spanish version of the Merrill-Palmer-R Developmental Scales [3]. Results showed strong and positive relationships between the different tests when first assessed. We also found strong and predictive relationships between the SRT at time 1 and SRT and the Merrill-Palmer-R at time 2. Conclusion We conclude that the SRT developed [1] is a valid tool for examining early language abilities and its changes over time.

Early-stage language characteristics of language-related developmental diseases / 中华实用儿科临床杂志

Objective:To explore the early-stage language characteristics of children with autism spectrum disorder (ASD), global developmental delay (GDD), and developmental language disorder (DLD) at the same deve-lopmental level, thus providing references for their diagnosis.Methods:Clinical data of 719 children, involving 382 ASD patients, 198 DLD patients and 139 GDD patients presented to the Children′s Hospital Affiliated to Chongqing Medical University from January 2018 to January 2020 were retrospectively analyzed. Chi- square test was used to compare the developmental distribution of 3 groups.Variance analysis was used to analyze difference of developmental levels among 3 groups.Correlation analysis was used to analyse relationship between language and nonverbal abilities.At the same developmental, student′s t test was used to compare ASD with GDD, ASD with DLD in language ability, and difference of expression with receptive and visual related language. Results:The nonverbal developmental levels of ASD, GDD, DLD children were significantly different ( χ2=414.64, P<0.01). Language abilities were correlated with non-verbal developmental levels( r=0.60, P<0.05). The receptive and visual-related language abilities of ASD children with abnormal developmental level were more delayed compared with that of expressive language ( t=6.97, 3.58, 13.29, 6.85, 9.09, 7.27, all P<0.01). Expressive language of DLD children with normal developmental level was worse than visual-related and receptive language( t=-2.21, -3.61, all P<0.05). In GDD children with mild delayed development, receptive language was worse than expressive and visual-related language ( t=4.12, -4.24, all P<0.01), GDD children with moderate and worse development had worse visual-related and receptive language than the expression ( t=2.46, 2.68, all P<0.01). No significant differences in the expressive, receptive and visual-related language were detected in ASD and DLD children with normal development level and those with delayed development level (all P>0.05). Receptive and visual related language of ASD children with marginal delayed development level were significantly worse than those of DLD children ( t=-4.64, -4.60, all P<0.01), whereas no significant diffe-rence in the expression was detected ( P>0.05). In ASD children with mild delayed developmental level, the receptive and visual-related language were worse than those of GDD children( t=-4.11, -4.68, all P<0.01), whereas no significant difference in the expression was detected ( P>0.05). Conclusions:In early childhood, ASD children with abnormal developmental levels present severe delay in receptive and visual related language.DLD children with normal development have an obvious delay in expressive language.The language abilities of GDD children are globally delayed, especially the receptive language.In the marginal and mild delayed developmental level, ASD is featured by obvious delay of receptive and visual-related language.In normal and worse delayed development levels, the development of language in ASD, DLD and GDD children is similar.

La bioética en la investigación de funciones ejecutivas en niños con trastorno específico del lenguaje / Bioethics in Researching Executive Functions in Children with Specific Language Impairment / A bioética na pesquisa de funções executivas em crianças com transtorno específico da linguagem

Resumen: En la actualidad, mucho se habla sobre bioética. Desafortunadamente, en lo que respecta a los lineamientos que deben regular y velar por la dignidad y los derechos de los niños, no existe una coherencia con el nivel de desarrollo técnico contemplado en las investigaciones en el área de los trastornos específicos del lenguaje y las funciones ejecutivas. Para esta investigación se realizaron tres búsquedas diferenciadas en bases de datos de Web of Science, Scopus, Scielo, Biblioteca del Congreso Nacional de Chile y fuentes grises con los descriptores "specific language impairment", "SLI", "executive functions", "memory", "attention", "inhibition", "bioética", "principios de bioética", "bioética infantil", "investigación científica" y "derechos del niño", reparando, específicamente, en la presencia o ausencia de lineamientos éticos declarados en su metodología o procedimiento de trabajo para analizar de forma crítica su progresión desde los años ochenta hasta la actualidad. En las conclusiones se ha evidenciado que los principios bioéticos generales no son demasiado pertinentes si no se acompañan por políticas nacionales e internacionales que velen por la dignidad de los niños. Por este motivo, contar con disposiciones bioéticas específicas y sistematizadas para la población pediátrica, en la que se incluyen los estudios de FE y TEL, es fundamental. Así es posible abolir todos los dilemas bioéticos que puedan surgir de los vacíos que las actuales leyes presentan. Por esta razón, es indispensable un replanteamiento de principios para este rango etario.

Abstract: Much is said about bioethics. Unfortunately, concerning the guidelines that must regulate and ensure the dignity and rights of children, there is no coherence with the technical development level of research on specific language impairment and executive functions. For this study, three differentiated searches were carried out in Web of Science, Scopus, Scielo, Library of the National Congress of Chile, and gray sources using the descriptors "specific language impairment," "SLI," "executive functions," "memory," "attention," "inhibition," "bioética," "principios de bioética," "bioética infantil," "investigación científica," and "derechos del niño." We paid particular attention to the presence or absence of ethical guidelines in the methods or working procedures to critically analyze their progression from the eighties to these days. The conclusions show that general bioethical principles are irrelevant if not accompanied by national and international policies that safeguard the dignity of children. Having specific and systematized bioethical provisions for the pediatric population, including fe and tel studies, will solve all the bioethical dilemmas that may arise from the loopholes in current laws. Therefore, rethinking the principles for this age range is crucial.

Resumo: Na atualidade, muito se fala sobre bioética. Infelizmente, no que diz respeito aos lineamentos que devem regularizar e zelar pela dignidade e pelos direitos das crianças, não há uma coerência com o nível de desenvolvimento técnico contemplado nas pesquisas na área dos transtornos específicos da linguagem e das funções executivas. Para esta pesquisa, foram realizadas três buscas diferenciadas em bases de dados de Web of Science, Scopus, SciELO, Biblioteca del Congreso Nacional de Chile e fontes da literatura cinzenta com os descritores "specific language impairment", "sli", "executive functions", "memory", "attention", "inhibition", "bioética", "principios de bioética", "bioética infantil", "investigación científica" e "derechos del niño", salientando, em específico, a presença ou a ausência de lineamentos éticos declarados em sua metodologia ou procedimento de trabalho para analisar de forma crítica sua progressão desde os anos 1980 até a atualidade. Nas conclusões, evidencia-se que os princípios bioéticos gerais não são muito pertinentes se não são acompanhados por políticas nacionais e internacionais que zelem pela dignidade das crianças. Por esse motivo, contar com disposições bioéticas específicas e sistematizadas para a população pediátrica, na qual são incluídos os estudos de fe e tel, é fundamental. Assim, é possível abolir todos os dilemas bioéticos que possam surgir das lacunas que as atuais leis apresentam. Por essa razão, é indispensável uma reconsideração de princípios para essa faixa etária.

Dyslexia and developmental language disorder: cognitive-linguistic differences in reading / Dislexia e transtorno do desenvolvimento da linguagem: diferenças cognitivo-linguísticas na leitura / Dislexia y trastorno del desarrollo del lenguaje: diferencias cognitivo-lingüísticas en lectura

Reading comprehension is a product of the performance of both decoding ability and language comprehension. The difficulty in reading comprehension may be due to a deficit in any of these skills. The study aimed to verify the underlying reading skills in two clinical groups, Developmental Dyslexia (DD) and Developmental Language Disorder (DLD), seeking their similarities and differences. The sample included children from the early years of schooling. Both groups were assessed for reading comprehension skills, word reading speed, phonological processing and comprehension, and language production. The comparison between the two groups showed that the groups were similar in phonological skills but differed in oral language comprehension and production skills. In this ability, the DD group had a higher performance compared to the DLD group. The study concluded that different forms of intervention are necessary to supply the specific weaknesses of each group.

A compreensão da leitura é produto do desempenho das habilidades de decodificação e compreensão da linguagem. A dificuldade de compreensão da leitura pode ser a consequência de um déficit em qualquer uma dessas habilidades. O objetivo do estudo foi verificar as habilidades subjacentes de leitura em dois grupos clínicos, dislexia do desenvolvimento (DD) e transtorno do desenvolvimento da linguagem (TDL), buscando suas similaridades e diferenças. A amostra foi de crianças nos anos iniciais da escolarização. Avaliaram-se os grupos em compreensão leitora, velocidade de leitura de palavras, processamento fonológico e compreensão e produção de linguagem. Os resultados das comparações entre os dois grupos mostraram que eles foram similares nas habilidades fonológicas, mas diferiram nas habilidades de compreensão e produção da linguagem oral. Nesta habilidade, o grupo DD obteve maior desempenho quando comparado ao grupo TDL. Concluiu-se que diferentes formas de intervenção são necessárias para suprir as fragilidades específicas de cada grupo.

La comprensión lectora es un producto del desempeño de la capacidad de decodificación y la comprensión del lenguaje. La dificultad en la comprensión lectora puede ser la consecuencia de un déficit en cualquiera de estas habilidades. El objetivo del estudio fue verificar las habilidades de lectura subyacentes en dos grupos clínicos, dislexia del desarrollo (DD) y trastorno del desarrollo del lenguaje (TDL), buscando sus similitudes y diferencias. La muestra fueron niños de los primeros años de escolaridad. Los grupos fueron evaluados en comprensión lectora, velocidad de lectura de palabras, procesamiento fonológico, comprensión y producción del lenguaje. Los resultados de la comparación entre los dos grupos mostraron que los grupos eran similares en habilidades fonológicas, pero diferían en las habilidades de comprensión y producción del lenguaje oral. En esta capacidad, el grupo DD tuvo un mayor rendimiento en comparación con el TDL. Se concluyó que son necesarias diferentes formas de intervención para suplir las debilidades específicas de cada grupo.

Morphosyntactic evaluation protocol (MEP): validation of content / Protocolo de avaliação morfossintática (PAM): validação de conteúdo

Abstract: Introduction: the use of language assessment instruments in the area of speech-language-therapy is essential for the diagnosis and, consequently, for therapeutic planning. In Brazil, there is a shortage of instruments constructed and validated in the morphosyntax area. Morphosyntactic Evaluation Protocol (MEP) was constructed based on the main syntactic characteristics of the period of acquisition of children's language, on the Portuguese grammatical structure and the application in a pilot study. Objective: To verify the validity of MEP content. Methods: for the validation process, the instrument was applied and analyzed through a questionnaire by three judges, a linguist and two speech-language specialists with experience in assisting children with Language Development Disorder. The Index of Judges' Reliability was used to compare the results of the protocol application and the Cronbach's Alpha tests, Spearman-Brown and Content Validity Index (CVI) in the questionnaire responses. Results: the statistical tests applied in the validation of content legitimized the reliability of the instrument with indexes considered substantial for both alpha coefficients, higher than 0.80, Spearman and the CVI test had a maximum concept of 1.0. Conclusion: there were compliance and compatibility in the answers of the experts, which indicates the reliability of the instrument. The results of the statistical tests legitimize the reliability of the instrument with indexes considered substantial for alpha and Spearman coefficient. In the future, the protocol may help characterize the syntactic profile of children with language developmental disorder.

Resumo: Introdução: a utilização de instrumentos de avaliação de linguagem na área da Fonoaudiologia é essencial para a realização do diagnóstico e, consequentemente, para o planejamento terapêutico. No Brasil há escassez de instrumentos construídos e validados na área da morfossintaxe. Protocolo de Avaliação Morfossintática (PAM) foi construído com base nas principais características sintáticas do período de aquisição da linguagem infantil, na estrutura gramatical da língua portuguesa e na aplicação em estudo piloto. Objetivo: verificar a validade de conteúdo do PAM. Método: para o processo de validação, o instrumento foi aplicado e analisado por meio de questionário por três juízes, um linguista e dois fonoaudiólogos especialistas em linguagem com experiência no atendimento de crianças com transtorno de linguagem. Foi usado o Índice de Fidedignidade entre os juízes para comparação dos resultados da aplicação do protocolo e os testes Alpha de Cronbach, Spearman-Brown e Índice de Validade de Conteúdo (IVC) nas respostas do questionário. Resultados: os testes estatísticos aplicados na validação de conteúdo legitimaram a fidedignidade do instrumento com índices considerados substanciais tanto para coeficiente alpha, maior que 0,80, Spearman e o teste IVC teve conceito máximo de 1,0. Conclusão: houve conformidade e compatibilidade nas respostas dos especialistas o que indica confiabilidade do instrumento. Os resultados dos testes estatísticos legitimam a fidedignidade com índices considerados substanciais tanto para coeficiente Alpha, como Spearman. No futuro, o protocolo poderá auxiliar na caracterização do perfil sintático de crianças com alterações no desenvolvimento de linguagem.

Well Baby Clinic: Developmental Guidance according to the Parent's Chief Complaints

Despite the relatively high prevalence (5~10%) of developmental disability, the early identification for such problems remains difficult. Doctors who care children with developmental delay tried to find out these disorders as early as possible in order to apply an early intervention and reduce the long-term disabilities among them. Identification of a delayed young child by routine out-patient's clinic mandates a careful search for an underlying etiology. This article discusses the available approaches for the infants and young children with various kinds of developmental disabilities, according to the parent's chief complaints including 'unable to walk', 'unable to speak', 'unable to control temper', and 'unable to contact his or her eyes'.

The Neuroradiological Findings of Children with Developmental Language Disorder

PURPOSE: To investigate the general characteristics of glucose metabolism distribution and the functional deficit in the brain of children with developmental language delay (DLD), we compared functional neuroradiological studies such as positron emission tomography (PET) of a patient group of DLD children and a control group of attention- deficit hyperactivity disorder (ADHD) children. PATIENTS AND METHODS: Seventeen DLD children and 10 ADHD children under 10 years of age were recruited and divided into separate groups consisting of children less than 5 years of age or between 5 and 10 years of age. The PET findings of 4 DLD children and 6 control children whose ages ranged from 5 to 10 years were compared by Statistical Parametric Mapping (SPM) analysis. RESULTS: All of the DLD children revealed grossly normal findings in brain MRIs, however, 87.5% of them showed grossly abnormal findings in their PET studies. Abnormal findings were most frequent in the thalamus. The patient group showed significantly decreased glucose metabolism in both frontal, temporal and right parietal areas (p < 0.005) and significantly increased metabolism in both occipital areas (p < 0.05) as compared to the control group. CONCLUSION: This study reveals that DLD children may show abnormal findings on functional neuroradiological studies, even though structural neuroradiological studies such as a brain MRI do not show any abnormal findings. Frequent abnormal findings on functional neuroradiological studies of DLD children, especially in the subcortical area, suggests that further research with quantitative assessments of functional neuroradiological studies recruiting more DLD children and age-matched normal controls could be helpful for understanding the pathophysiology of DLD and other disorders confined to the developmental disorder spectrum.

The Clinical Features of Children with Developmental Language Disorder / 대한소아신경학회지

PURPOSE: Children with developmental language disorder occupy considerable health care resources, particularly in the preschool ages. The exact size of problem for health planning remains somewhat problematic, as differences in reported estimates of prevalencies reflect the range of definitions used. In this study, we evaluated the clinical features of children with developmental language disorder and examined effctiveness of the Gesell Screening Inventory and REEL scale to assess language development. METHODS: The 171 children were involved in the study, they were referred to Child Development Clinic in Kangnam St. Mary's Hospital for evaluation of suspected language problem. Among the children, 75 cases between 15 and 54 months of age were included as developmental language disorder in this study. RESULTS: 1) The mean age of subjects was 31.4 months and the ratio of male to female was 6.5:1. 2) The mean gestational age of the subjects was 38.8 weeks. The proportion of full-term infants was 82.7% and the one of premature infants was 17.3%. 3) According to the birth ordering history, the proportion of the first baby was 82.7%, the one of second baby was 13.3% and the one of third baby was 4%. 4) Ten children had been checked up the MRI, four of them had abnormal findings, 23 children had been checked up the EEG and two of them showed abnormal findings. 5) The mean age of first spontaneous word with used meaning was 13.8 months. 6) According to the Gesell Screening Inventory, the proportion of children who had less than DQ 70 had showed 4% in motor sector, 17% in adaptive sector, 66.7% in laguage sector and 33.3% in personal social sector. 7) According to the REEL Scale, the proportion of children who had less DQ 70 had showed 70.7% of in receptive language sector and 90.7% in expressive language sector. 8) The proportion of the children who had been maintaining language disorder was 17.3% and that of those who showed normal linguistic development was 82.7% on the follow-up test 6 months later. CONCLUSION: The large proportion of the children who had language delay was developmental language disorder without organic problem. Most of them showed symptom improvement on the follow up test 6 months later.

The Diagnostic Significance of Clinical Characteristics and Neuroimaging Findings for Diagnosis of Children with Developmental Delay / 대한소아신경학회지

PURPOSE: In order to identify developmental disability and help the patients earlier, the diagnostic significance of clinical characteristics and neuroimaging findings for diagnosis of children with developmental delay was studied. METHODS: The clinical records and diagnostic procedures including head size, gestational age, Denver developmental screening test, brain MRI, EEG, brainstem auditory evoked potential (BAEP), chromosomal karyotyping, and final diagnosis of 96 patients with developmental delay were retrospectively reviewed. RESULTS: The final diagnosis of 96 children with developmental disability were cerebral palsy (41.7%), minimal cerebral dysfunction (17.7%), developmental language disorder (14.6%), autism (13.5%), and mental retardation with or without hearing impairment (12.5%), in order of frequency. Of the 40 cases with cerebral palsy, 36 cases (90%) had abnormal MRI. There was a significant difference between cerebral palsy and the others of developmental disabilities in MRI abnormality. Of the 55 EEGs, abnormal findings was shown in 26 cases (68.9%). All of the 5 patients with developmental language disorders had normal EEG, and 20 cases (68.9%) of the 29 patients with cerebral palsy showed abnormal EEG. There was a significant difference between cerebral palsy and developmental language disorder in EEG. Prematurity was in 22 cases (22.9%) of 96 patients, 16 cases (40%) in cerebral palsy, and none in autism. There was a significant difference between cerebral palsy and autism in gestational age. Microcephaly was present in 42 cases (43.7%) among 96 patients, and 2 cases (14.3%) in developmental language disorder, 24 cases (60%) in cerebral palsy. There was a significant difference between cerebral palsy and developmental language disorder in head circumference. CONCLUSION: There was a diagnostic significant difference of head circumference and EEG, gestational age, and brain MRI for comparison of patients with cerebral palsy and developmental language disorder, cerebral palsy and autism, and cerebral palsy and the other developmental disabilities, respectively.

The Preliminary Study of Quantitative Morphology of the Corpus Callosum, Thalamus, Cerebellum and Pons in Autistic Disorder and Developmental Language Disorder / 신경정신의학

OBJECTIVES: This study aimed to planimetrically measure the corpus callosum, cerebellum, pons and thalamus in the boys with autistic disorder and developmental language disorder. METHODS: The midsagittal brain MR images of 8 autistic and 8 developmental language disorder subjects who met the DSM-III-R diagnostic criteria and 10 comparison subjects were collected. MR images were redigitalized with flatbed scanner and the data were analyzed with NIH IMAGE 1.61 software. Pixel counting and area measurements were done. The corpus callosum was divided into seven regions and the cerebellar vermis was divided into three regions. RESULTS: In autistic subjects, the rostrum of corpus callosum was found to have significantly smaller area than comparison and developmental language disorder subjects. In developmental language disorder subjects, the thalamus was significantly larger than comparison subjects. The cerebellar vermis and pons did not differ among three groups. CONCLUSION: The rostrum of the corpus callosum in autistic disorder was significantly smaller. This finding supports the theory of abnormal prefrontal lobe development in autistic disorder.