Academic abilities and glycaemic control in children and young people with Type 1 diabetes mellitus.

AIMS: To determine if children and young people aged < 23 years with Type 1 diabetes differ in academic ability from age-matched control subjects without Type 1 diabetes and whether academic scores are related to glycaemic control. METHODS: Using a cross-sectional study design, we administered cognitive and academic tests (Woodcock-Johnson III Spatial Relations, General Information, Letter-Word Recognition, Calculation and Spelling tests) to young people with Type 1 diabetes (n=61) and control subjects (n=26) aged 9-22 years. The groups did not differ in age or gender. Participants with Type 1 diabetes had a disease duration of 5-17.7 years. History of glycaemic control (HbA1c , diabetic ketoacidosis and severe hypoglycaemic episodes) was obtained via medical records and interviews. RESULTS: The participants with Type 1 diabetes had a lower mean estimated verbal intelligence (IQ) level compared with those in the control group (P=0.04). Greater exposure to hyperglycaemia over time was associated with lower spelling abilities within the group with Type 1 diabetes (P=0.048), even after controlling for age, gender, socio-economic status, blood glucose level at time of testing and verbal IQ (P=0.01). History of severe hypoglycaemia or ketoacidosis was not associated with differences in academic abilities. CONCLUSIONS: In children and young people, Type 1 diabetes was associated with a lower verbal IQ. Moreover, increased exposure to hyperglycaemia was associated with lower spelling performance. These results imply that hyperglycaemia can affect cognitive function and/or learning processes that may affect academic achievement.

Use of technology in phonological intervention.

Microcomputers can support phonological intervention in a variety of ways. Software and hardware can assist clinicians in identifying errors and establishing appropriate treatment targets. Technology can also help to determine the nature of errors so that optimal intervention methods are used. Specific technology tools for addressing phonological errors due to problems with articulation, phonemic identification, and phonetic mapping are discussed. The use of technology to document and analyze treatment performance is also addressed.

Use of technology to facilitate language skills in school-age children.

Technology offers numerous possibilities for facilitating language and literacy skills in school-age children and adolescents. Narrative skills can be addressed by the use of specialized programs as well as generic word processing software. Writing skills can be targeted due to the variety of possibilities for input as well as options for supporting spelling and syntax. Reading skills might be improved by the use of programs that focus on decoding, as well as hypertext tools that highlight the use of text patterns or signals.

Use of technology in phonological assessment: evaluation of early meaningful speech and prelinguistic vocalizations.

Technologies that assist in the assessment of phonological abilities in early meaningful speech and prelinguistic vocalizations are discussed. Computerized assessment of phonological abilities (CAP) software offers significant time savings for basic analyses and makes possible the completion of more detailed analyses. The programs discussed in this article allow flexibility in determining not only the most appropriate analyses for an individual client, but also the design of the optimal symbol system for representing the client's productions. Case studies are included to illustrate the clinical benefits of CAP technology.

The performance of children with language-learning disabilities on two types of cognitive tasks.

The performance of children with language-learning disabilities on two types of cognitive tasks was compared to that of two groups without language-learning disabilities, one matched for mental age and the other for language (vocabulary) age. The first task, Concept Formation, measured one's ability to identify and state the rule for a concept about a set of colored geometric figures when shown instances and noninstances of the concept. The second task, Analysis Synthesis, required the identification and use of a solution key to solve an incomplete logic puzzle. Both tasks involved increases in complexity as additional items were administered. Results indicate that the children with language-learning disabilities performed at a level commensurate with the language-matched group on the Concept Formation task, and at a level commensurate with the mental-age matched group on the Analysis-Synthesis task. The implications of these findings for the nature of language-learning disabilities are discussed.

Verbal analogical reasoning in children with language-learning disabilities.

This study was designed to explore the influences of both cognitive and linguistic abilities on verbal analogy completion. School-age children classified as language-learning disabled were administered five types of verbal analogies: synonyms, antonyms, linear order, category membership, and functional relationship. The performance of the children with language-learning disabilities was compared with one group of normally developing children matched for mental age and another group matched for language age. Results indicated that the group matched for mental age performed better than the other two groups on all types of analogies. Although they had significantly higher mental ages, the children with language-learning disabilities did no better than the language-matched group on any analogy type except antonyms.

Linguistic trade-offs in school-age children with and without language disorders.

Factors influencing the occurrence of trade-off effects among linguistic components were examined. Several linguistic measures were used to represent syntactic and phonological production in order to determine whether interrelationship patterns would vary across measures. Linguistic interactions present in imitated speech were compared to those from spontaneous speech. Group effects were explored by comparing data from children with language-learning disabilities, children with reading disabilities, and normally developing children. Results indicated trade-offs between some linguistic measures and positive relationships among others. More trade-offs were present in imitated speech than in spontaneous utterances. In general, interrelationship patterns were similar across groups. Interpretation of these results in reference to current models of sentence production is offered.

The effects of sampling conditions on sentence production in normal, reading-disabled, and language-learning-disabled children.

This study explored the effects of contextual support, discourse genre, and the listener's knowledge of information on syntactic and phonologic production and fluency. Subjects were language-learning-disabled, reading-disabled, and normal primary school children. Clause structure complexity, fluency, and grammatical and phonemic accuracy tended to be highest when children were discussing absent referents, providing explanations and stories, and giving unshared information. These effects were generally the same across all groups, although some effects were significant for only the language-learning-disabled children. Several explanations for these findings are considered.