Analysis of topic as illustrated in a head-injured and a normal adult.

The purpose of this study was to develop a reliable multidimensional topic analysis that would be sensitive to patterns and problems in topic management. Six conversation and four monologue language samples of a closed-head-injured adult and a matched normal adult were compared. High interjudge reliability was found for all frequently occurring parameters of the analysis. Differences between the two subjects were obtained on a number of the topic introduction and maintenance parameters. The results illustrate the potential of the analysis to reliably identify, quantify, and describe differences between subjects in discourse topic management. The potential of the analysis to provide detailed profiles of topic management and describe the influence of such variables as genre and topic complexity on discourse topic was demonstrated.

A young meningitically deaf child with a cochlear implant: a case study.

This study describes the development of the auditory, cognitive, linguistic, and social domains of a child deafened by meningitis at 20 months of age. He received a 3M/House cochlear implant at 27 months and is believed to be the youngest child to receive a cochlear implant. He was seen for intervention emphasizing audiometric conditioning and testing and language (speech and sign) stimulation for a period of 2:9 years (6 months pre-implant to 2:3 years post-implant). Videotapes of intervention; interviews with parents, teachers, and clinicians; test results; and medical and clinical reports were documented from pre-implant to two years post-implantation. The child regressed in all areas evaluated following his illness and subsequent deafness and cochlear implantation. At about one year after implantation, his social and cognitive skills began to improve. By two years after implantation (chronological age (CA) = 4:6), his abilities in all areas except auditory reception and speech had progressed to about the 4:0 age level. He communicates primarily through signs and seems to derive environmental sound and speech duration cues from the implant. Although it is difficult to separate the effects of the implant from maturational factors, he now willingly uses the implant simultaneously with his hearing aid on the non-implanted ear every day and seems to be functioning well with them. He responds inconsistently to his name when called, and consistently provides appropriate signed responses to questions. His imitative skills are improving; he can discriminate one- vs two-syllable words; and produces limited spontaneous speech. His cognitive and social abilities are at least age-appropriate and he signs 3- and 4-word combinations.

Degeneration of speech, language, and hearing in a patient with mucopolysaccharidosis VII.

Mucopolysaccharidosis VII (MPS-VII) is probably the rarest of the mucopolysaccharidoses; literature reveals only 20 cases. We have had the opportunity to study and treat such a child in our clinic, and this paper documents his speech, language, and hearing. Results demonstrated a delay with respect to his chronological age in all cognitive, linguistic, and social domains. He had a mixed hearing loss which could have contributed to his diminishing speech and language abilities; he had chronic otitis media. After 59 h of speech and language intervention (over a period of 19 months), primarily for language treatment, standardized tests revealed that his scores had decreased over time. During this period, both his speech production and his hearing got poorer. At about the time of his 8th birthday, he underwent a permanent tracheostomy, altering further therapy. Although MPS-VII is a very rare disorder, what has been learned here may apply to other MPSs and even to other multiply handicapped patients. We hope that the presentation of our findings may assist others when confronted with complex, degenerative disorders.

A clinical appraisal of the pragmatic aspects of language.

A descriptive taxonomy, the pragmatic protocol, was developed for this study. The protocol consists of 30 pragmatic parameters of language. The purpose of the study was to test the utility of the tool to evaluate a range of pragmatic aspects of language in a sample of conversational speech from subjects in six groups. Among the disordered subjects, four distinct profiles emerged that separated the diagnostic groups. Individual differences in the way pragmatic deficits were distributed within a diagnostic category were also identified. The authors stress that the assessment of pragmatics should encompass a range of parameters that includes aspects of linguistic structure as well as those aspects of communication that have to do with principles governing language use. We offer our data as an early look at the way in which pragmatic deficits stratify across disordered populations.

Cohesion in the discourse of normal and head-injured adults.

Cohesion strategies used by 3 normal and 3 head-injured adults were examined in both conversational and narrative conditions. Two major findings emerged. First, the head-injured subjects used different cohesion patterns from the normal adults in both conditions. Second, both groups used different cohesion patterns in the conversational and narrative conditions. The study highlights the importance of viewing the language of head-injured adults within the context of discourse. Testing the language system through narrative as well as conversational discourse is important since both conditions are characterized by their own distinctive internal structure and organization.

Profiles of communicative and cognitive-social abilities in autistic children.

The purpose of this study was to examine profiles of communicative and cognitive-social abilities in a small group of autistic children functioning in the prelinguistic and early stages of language development and to compare them with those of normal children functioning at similar stages of language development. The results of measures in the cognitive-social areas of communicative intent, tool use, imitation, and play and in language comprehension demonstrated uneven development for the autistic subjects. A functional analysis of communicative behaviors indicated that, despite a wide variation in communicative means, the autistic subjects displayed a relatively homogeneous profile of communicative functions that was both quantitatively and qualitatively different from the normal profile. Explanations for the heterochrony in communicative and cognitive-social development of these autistic children are discussed.

Pragmatic and semantic development in young children with impaired hearing.

The purpose of the study was to characterize the early pragmatic-semantic communicative development of young hearing-impaired children learning spoken English as a first language. Twelve children with impaired hearing, ranging in age from 22 months to 60 months, were videotaped. Approximately 13 hours of videotaped data from four different communicative settings were analyzed. The pragmatic and semantic categories used by these children varied across age groups. Results are discussed with regard to age, expressive modality, mean length of utterance (MLU), and hearing loss. There was much variation among these parameters in communicative development across children.

Process /prá/,ses/n: the action of moving forward progressively from one point to another on the way to completion.

A rationale for the application of a stage process model for the language-disordered child is presented. The major behaviors of the communicative system (pragmatic-semantic-syntactic-phonological) are summarized and organized in stages from prelinguistic to the adult level. The article provides clinicians with guidelines, based on complexity, for the content and sequencing of communicative behaviors to be used in planning remedial programs.

Testing for a specific syntactic structure.

Nine language delayed children who had failed the "is interrogative" test item on the Programmed Conditioning for Language Test served as subjects. A comparison was made of subjects' syntactic performance on six language tasks designed by the investigators to elicit the "is interrogative" structure. These tasks ranged along an imitative-to-spontaneous continuum demonstrating varying degrees of communicative intention, presence or absence of contextual referents, and varying levels of task structure. Analyses indicated all nine subjects produced complete grammatical "is interrogative" utterances on one or more of the language tasks. The most effective tasks for eliciting the specific structure were those that required communicative intention, included specific contextual referents, and provided a relatively structured situation. The direct imitative task was less effective, although it elicited more correct productions than the spontaneous language sampling task. However, the relative eliciting potential of each task was not the same for each child. Theoretical and clinical implications of these findings are discussed.

Clinician-child discourse: some preliminary questions.

Various pragmatic procedures were used to analyze clinician-child discourse in a language remediation setting. Communicative acts, responses to prior requests, and discourse topics were described in the interaction between clinician and child. Three major trends were derived from the data. First, consistent patterns were found among clinicians and children for the relative frequency of communicative acts as well as the general and specific types of communicative acts. Second, patterns were not found for the responses to prior requests for either clinicians or children. Last, consistent patterns were found across data on groups of clinicians and children for the introduction, continuation, and reintroduction of discourse topics. Preliminary questions are raised regarding the variables associated with clinician-child discourse to begin to understand the nature of this interaction.

Communicative performance of mentally retarded adults in four conversational settings.

A sociolinguistic analysis of the communicative performances and social interactions of four mentally retarded adults was conducted. Role relationships were examined along dimensions of dominance-submission and control in various conversational settings. Audiotape recordings were made of each adult's conversation while engaged in discourse with his speech-language pathologist, peers, parents, and with a normal young child. Relational communication coding schemes involving the analysis of questions and subsequent responses were applied to the data. Results indicated that the retarded adults, though not always able to hold a dominant position in a conversation, were capable of expressing the same types of control as normal adults. The types of control expressed by each subject varied as a function of the conversational setting. Furthermore, differences existed in the types and frequencies of control expressed across subjects. These findings suggest that a sociolinguistic approach provides important information regarding the mentally retarded adult's communicative performance.

Imitation: a closer look.

This paper explores the effectiveness of elicited imitation in clinical assessment and remediation procedures. A critical review of the literature dealing with the role of elicited imitation in language acquisition as well as the use of elicited imitation clinically is presented. Conclusions drawn from the review indicated that the effectiveness of employing elicited imitation for assessment and remediation purposes is not clearly defined.

The expressive portion of the NSST compared to a spontaneous language sample.

This study was undertaken to determine the relationship between syntactic structures produced on the expressive portion of the NSST and those produced in a spontaneous language sample. The NSST was administered to 12 children previously diagnosed as delayed in language. In addition, spontaneous language samples were collected by a speech clinician and by the child's mother. The children ranged in age from four years one month to five years 11 months. We found that 30 percent of those syntactic structures incorrectly produced on the NSST were correctly produced spontaneously in the language sample. Furthermore, the sample obtained by the clinician was significantly richer in terms of number of structures produced correctly than the sample collected by the mother. Overall results indicate that an item analysis of the expressive portion of the NSST does not present an accurate representation of the child's language performance and therefore cannot be interpreted beyond its stated purpose, namely that of a screening instrument.