ABSTRACT
Objective measures of tongue strength and endurance are used to assess lingual weakness and fatigue, and may have significant clinical value for dysphagia management. Recent studies investigating age and gender effects on tongue strength in children are limited by small sample sizes. The current study investigated age and gender effects on tongue strength with a larger sample size, and collected preliminary normative data for a paediatric population. This study also investigated the reliability of tongue endurance measures in children using a modified method, which has not previously been investigated. Using a cross-sectional design, this study examined tongue strength and endurance in 119 children aged 6 to 11 years, with no history of speech sound disorders, oro-motor deficits, dysphagia or cognitive impairment. Measures were collected using the Iowa Oral Performance Instrument. Children participated in two sessions, 45 min and 10 min in duration. Tongue strength was found to significantly increase with age (p < 0.001), while no gender effects were found. Modified tongue endurance measures involved using only one measure of maximal tongue strength to set parameters for tongue endurance scores. Despite this modification, data did not reach acceptable test-retest reliability, ICC = 0.68, p < 0.001; however, reliability improved from previous studies. These findings provide normative data for tongue strength, as a basis to compare individuals, and highlights the need for more reliable protocols for measuring tongue endurance. Normative data was collected from city-dwelling Australian children.
Subject(s)
Deglutition , Muscle Strength , Australia , Child , Cross-Sectional Studies , Humans , Reproducibility of Results , TongueABSTRACT
The authors evaluated 51 consecutive children with NF1 (aged eight to 16 years) to determine the frequency of intelectual impairment and learning disability due to NF1 alone, the profile of learning disabilities and the effect of clinical variables. 40 children completed the full assessment protocol. There was no support for a profile of predominantly visuoperceptual deficits in the NF1 population. There was no discrepancy between verbal and performance IQ, and the deficits in function were wide ranging. Clinical variables such as age, sex, socio-economic status, disease severity, macrocephaly and family history of NF1 were not associated with cognitive deficits. These results emphasise the need for developmental evaluation to be included in the routine assessment of children with NF1.
Subject(s)
Cognition Disorders/diagnosis , Learning Disabilities/diagnosis , Neurofibromatosis 1/diagnosis , Adolescent , Child , Cognition Disorders/epidemiology , Comorbidity , Humans , Incidence , Language Disorders/diagnosis , Language Disorders/epidemiology , Language Tests , Learning Disabilities/epidemiology , Neurofibromatosis 1/epidemiology , Psychological Tests , Psychomotor Disorders/diagnosis , Psychomotor Disorders/epidemiology , Severity of Illness Index , Wechsler ScalesABSTRACT
To determine whether previously reported areas of increased T2 signal intensity on MRI examination in children with neurofibromatosis type 1 (NF 1) are associated with deficits in development and learning common in this population, we evaluated 51 children with NF 1 (aged 8 to 16 years). Forty children completed the full assessment protocol (MRI, medical, psychometric, speech therapy, and occupational therapy assessments). The mean Full Scale IQ scores for the entire study population showed a left shift compared with the normal population, and the distribution of IQ scores was bimodal, suggesting that there are two populations of patients with NF 1--those with and those without a variable degree of cognitive impairment. There was no association between lower IQ scores and any clinical variable. Areas of increased T2 signal intensity unidentified bright objects (UBO+) were present in 62.5% of the study population, and their presence was not related to clinical severity, sex, age, socioeconomic status, macrocephaly, or family history of NF 1. However, compared with children without areas of increased T2 signal intensity (UBO-), the UBO+ group had significantly lower mean values for IQ and language scores and significantly impaired visuomotor integration and coordination. Children with areas of increased T2 signal intensity were at a much higher risk for impaired academic achievement. Children without increased T2 signal on MRI (UBO-) did not significantly differ from the general population in any measure of ability or performance. Areas of increased T2 signal on MRI represent dysplastic glial proliferation and aberrant myelination in the developing brain and are associated with deficits in higher cognitive function.(ABSTRACT TRUNCATED AT 250 WORDS)
