Intensive computer-based phonics training in the educational setting of children with Down syndrome: An explorative study.

Children with Down syndrome (DS) using intensive computer-based phonics (GraphoGame, GG) were studied. The children's independence and improvement in phonological processing, letter knowledge, word decoding, and reading strategies were investigated. Seventeen children (5-16 years) with DS participated in a crossover design through 8 weeks (one period), with three test sessions separated by 4 weeks. Children were randomly assigned to GG intervention or regular schooling (RS). All children completed one period and eight children completed two periods. A majority gradually became independent in managing GG. At the group level, very little benefit was found from working with GG. At the individual level, several children with mild to severe intellectual disabilities showed increased decoding of trained words. After one period of GG and RS, an increase in alphabetically decoded words was found. The finding suggests that when individual challenges are considered, computer-based phonics may be beneficial for children with DS in their educational setting.

Speech, language, and cognition in preschool children with epilepsy.

We studied expressive and receptive language, oral motor ability, attention, memory, and intelligence in 20 6-year-old children with epilepsy (14 females, six males; mean age 6y 5mo, range 6y-6y 11mo) without learning disability, cerebral palsy (CP), and/or autism, and in 30 reference children without epilepsy (18 females, 12 males; mean age 6y 5mo, range 6y-6y 11mo). Ten children had partial, six primarily generalized, and four unclassified epilepsy. Fourteen were having monotherapy and six were taking two or more antiepileptic drugs; 13 children were free from seizures 3 months before the assessment. Results show no statistically significant difference between the groups concerning Verbal IQ, expressive and receptive grammar, and receptive vocabulary. The children with epilepsy had a significantly lower Performance IQ and lower scores in tests of oral motor ability, articulation, emerging literacy, auditory attention, short-term memory, and rapid word retrieval. Parent ratings revealed no significant difference in communicative ability. Polytherapy and early onset of epilepsy influenced some results. Preschool children with epilepsy without learning disability, CP, and/or autism may have receptive verbal ability within the normal range but visuoperceptual, auditory attentional, and speech-language difficulties that could affect school achievement. Careful testing of children with epilepsy who appear to be functioning within the normal range is needed because this may reveal specific impairments that require appropriate professional input.

Gender differences in outcome after neonatal intensive care: speech and language skills are less influenced in boys than in girls at 6.5 years.

AIM: To study language development at age 6.5 y in 230 children who had required neonatal intensive care (NIC) and 71 full-term neonatally healthy control children, all born in 1986-1989, with a focus on comparison between genders. METHODS: Eight aspects of spontaneous speech, 3 fine motor functions, 10 linguistic areas, Peabody Picture Vocabulary Test, and digit recall (ITPA) were assessed. RESULTS: Achievements for gender and gestational age groups were analysed (group I, 23-31 wk; subgroup IA, 23-27 wk; IB, 28-31 wk; group II, 32-36 wk; group III, >36 wk), with children with congenital malformations as a separate group. As a group, at 6.5 y NIC girls had more developed spontaneous speech than NIC boys, and performed better than NIC boys in some linguistic areas. NIC girls of group I had lower results than control girls in spontaneous speech aspects such as speech motor function, interaction and motivation, and in many areas of linguistic skills. In contrast, NIC boys of group I had higher results than control boys in auditory memory, and only regarding information and speech motor function in spontaneous speech were their results lower. Analysis of results of matched pairs of group I NIC girls versus control girls and group I NIC boys versus control boys revealed even more marked differences between NIC girls and their matched controls than between NIC boys and their matched controls. CONCLUSION: Language development in extremely or very preterm NIC boys seems to be less influenced than that in NIC girls by the need for and administration of NIC. The neonatal factors associated with low scores in girls are different from those in boys.

Linguistic skills at 6 1/2 years of age in children who required neonatal intensive care in 1986-1989.

UNLABELLED: Linguistic skills at 6 1/2 y of age, corrected for gestational age at birth, were examined in a cohort of 230 children who had required neonatal intensive care (NIC) in 1986-89, and in 71 fullterm neonatally healthy control children (C) matched to the NIC children born at < 32 gestational weeks. Ten linguistic areas were assessed. The 10th percentile score of the controls was identified in each linguistic area and used for comparisons. In 77.5% of the controls and 63.5% of the NIC children, no score was lower than the 10th percentile score of the controls. Scores lower than the 10th percentile score were more common in NIC children born at term or at 23-31 wk, and within this group of children those born at 23-27 wk, than in controls. CONCLUSION: In preterm children of < 32 wk the results in the linguistic areas of imitation of articulatory positions, comprehension of logical grammatical constructions, phonemes and word fluency differed from those of the matched controls, and in NIC children born at > or = 32 weeks the results for imitation of articulatory positions, articulatory patterns and sentences, auditory discrimination and word fluency were poorer than those of the controls.

Spontaneous speech at 6 1/2 years of age in children who required neonatal intensive care in 1986-1989.

UNLABELLED: Spontaneous speech at 6 1/2 y of age was studied in a follow-up of 230 children born in 1986-89 who had required neonatal intensive care (NIC) and 71 fullterm neonatally healthy control children. Eight aspects of spontaneous speech were examined: Information, speech motor function, sound pattern, word finding, word selection, grammar, interaction and motivation. The results were analysed in relation to gestational age groups (group I, 23-31 wk; subgroup IA, 23-27 wk; IB, 28-31 wk; group II, 32-36 wk; group III, >36 wk) and a separate group of children with congenital malformations (IWCM). Between 66.7% (group IA) and 55.7% (group III) had no obvious deviations in any aspect of spontaneous speech compared with 80.3% of controls. Children born at <32 wk of gestation (group I) had few pronounced deviations in speech motor function or formal aspects of spontaneous speech. No ability, or hardly any ability, in an aspect of spontaneous speech was only found in children born at >32 wk. Deviations in prosody and poor facial expressions accompanying spontaneous speech were more common in group I than in controls. CONCLUSION: Most children who needed intensive care neonatally had well-developed spontaneous speech.

Speech and language skills in children who required neonatal intensive care: evaluation at 6.5 y of age based on interviews with parents.

Speech and language skills at 6.5 y of age were studied in a follow-up of a cohort of children who had required neonatal intensive care (NIC) at Uppsala University Children's Hospital. An interview with the parents indicated that preterm and full-term NIC children were older than control children when they reached certain stages in language development (short sentences, intelligible speech). Absence of babbling was more common in NIC children born at 23-27 wk than in other preterm NIC children, and occurrence of stuttering was more commonly noticed in preterm NIC children born at 23-27 wk than in those born at >32 wk and controls.

Speech and language skills in children who required neonatal intensive care. II. Linguistic skills at 6 1/2 years of age.

Linguistic skills at 6 1/2 y of age were examined in a cohort of 284 children requiring neonatal intensive care (NIC) and in 40 controls. Ten linguistic areas were assessed. The results are presented for gestational age groups. The 10th percentile score of the controls was identified in each linguistic area. Seventy percent of the controls and <27% of the NIC children had no score lower than the 10th percentile score. Scores lower than the 10th percentile score were more common in NIC children born at term or at 23-31 wk, and within the latter group in those born at 28-31 wk, than in those born at 32-36 wk gestational age. The linguistic areas of auditory discrimination, imitation of articulatory positions and imitation of sentences were most frequently affected. NIC children born at 32-36 wk performed better in the last two areas than those born at <32 wk. To be a twin and born at 28-31 wk was associated with an increased risk of having more than five scores lower than the 10th percentile score of the controls.

Speech and language skills in children who required neonatal intensive care. I. Spontaneous speech at 6.5 years of age.

Spontaneous speech at age 6.5 years was studied separately in a follow-up of speech and language skills in a regional cohort of 284 children requiring neonatal intensive care and in 40 controls. Eight aspects of spontaneous speech were evaluated in a conversation: A1, information; A2, speech motor function; A3, sound pattern; A4, word finding; A5, word selection; A6, grammar; A7, interaction; and A8, motivation. The children were grouped by gestational age. Most children had well developed spontaneous speech. The different groups showed very few differences in types of deviations in spontaneous speech. All groups differed from the controls in speech motor function and formal language (A2-A6), but only one child, born at <32 weeks, had a pronounced deviation in one of these aspects. Obvious deviations in one or more aspects of spontaneous speech were more common among children born at 28-31 weeks and in those born fullterm (> or =37 weeks) than among extremely preterm children born at 23-27 weeks.

Assessment of speech and language skills in children.

A speech and language assessment procedure was developed to study different aspects of speech and language skills in children 6.5 years old who had needed intensive care in the neonatal period. It was required that the procedure could be carried out at one examination session and that it should characterize a broad spectrum of language skills and permit detection of deviations in language development. The assessment comprises three parts. Part A is an evaluation of the child's spontaneous speech during a 10- to 15-minute conversation between the child and the assessor. Eight different variables are assessed, and an overview of the child's conversational behaviour is obtained. Part B is an assessment of speech and language skills. A set procedure is used to assess auditory discrimination, interaction between auditory and speech motor capacity, different comprehension functions, vocabulary and word fluency. Some motor tasks are included to elucidate the relationship between speech and non-linguistic fine motor activity. Part C is an interview with the parents. A control group of 40 children was tested. The assessment protocol is now being applied for follow-up examination of children who have needed neonatal intensive care at Uppsala University Hospital, Sweden.