Language Profiles in ASD, SLI, and ADHD

from the Journal of Autism and Developmental Disorders

Abstract Developmental disorders might differ in their language profiles when using parent reports. The first study indicated that school aged children with ASD have similar language profiles as children with ADHD. Both groups had relatively more difficulties with pragmatics than with structural language aspects. The second study indicated that both preschoolers with ASD and those with SLI show the opposite pattern, thus having relatively more difficulties with structural language aspects than with pragmatics. Finally, an increase in the presence of ADHD characteristics of impulsivity in these preschoolers is associated with an increase in language difficulties, while there is no such relation with inattention. It seems useful to evaluate the communication abilities of children regularly in the course of development and take ADHD characteristics into account. Finally recommendations on clinical use of the Children’s Communication Checklist-2 (CCC-2, Bishop 2003) are discussed.

The merest Logomachy: The 1868 Norwich discussion of aphasia by Hughlings Jackson and Broca

from Brain

This article reconsiders the events that took place at the 1868 meeting of the British Association for the Advancement of Science (BA) in Norwich. Paul Broca and John Hughlings Jackson were invited to speak on the new and controversial subject of aphasia. Over the ensuing decades, there have been repeated references made to a debate between Broca and Jackson. This meeting has been identified as a turning point in favour of Broca’s position on the cerebral localization of language. A return to original sources from key witnesses reveals that the opinion of the British practitioners was generally against Broca’s views. Close examination of contemporaneous materials suggests that no public debate between Jackson and Broca occurred. However, the public discussion after Broca’s presentation records notable concerns over both theoretical issues of localization of function and the status of exceptional clinical cases. A significant stage in the development of current views on the organization of language in the brain is revealed in the accounts of the BA meeting in August 1868 and successive responses to these events in the British press over a period of years.

Cochrane review: Corticosteroids for acute bacterial meningitis

from Evidence-Based Child Health

Abstract

Background
In experimental studies, the clinical outcome of acute bacterial meningitis has been related to the severity of the inflammatory process in the subarachnoidal space. Treatment with corticosteroids can reduce this inflammatory response and thereby may improve outcome. We conducted a meta-analysis of randomised controlled trials (RCTs) of adjuvant corticosteroids in the treatment of acute bacterial meningitis.

Objectives
We conducted a systematic review examining the efficacy and safety of adjuvant corticosteroid therapy in acute bacterial meningitis.

Search strategy
In this updated review, we searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 2, 2006); MEDLINE (1966 to July 2006); EMBASE (1974 to June 2006); Current Contents (2001 to June 2006); and reference lists of all articles. We also contacted manufacturers and researchers in the field.

Selection criteria
Eligible published and non-published RCTs on corticosteroids as adjuvant therapy in acute bacterial meningitis. Patients of any age and in any clinical condition, treated with antibacterial agents and randomised to corticosteroid therapy (or placebo) of any type, could be included. At least case fatality rate or hearing loss had to be recorded for inclusion.

Data collection and analysis
Two review authors independently assessed trial quality and extracted data. Adverse effects were collected from the trials. Additional analyses were performed for children and adults, causative organisms, and low-income and developed countries.

Main results
Eighteen studies involving 2750 people were included. Overall, adjuvant corticosteroids were associated with lower case fatality (relative risk (RR) 0.83, 95% CI 0.71 to 0.99), lower rates of severe hearing loss (RR 0.65, 95% CI 0.47 to 0.91) and long-term neurological sequelae (RR 0.67, 95% CI 0.45 to 1.00). In children, corticosteroids reduced severe hearing loss (RR 0.61, 95% CI 0.44 to 0.86). In adults, corticosteroids gave significant protection against death (RR 0.57, 95% CI 0.40 to 0.81) and short-term neurological sequelae (RR 0.42, 95% CI 0.22 to 0.87). Subgroup analysis for causative organisms showed that corticosteroids reduced mortality in patients with meningitis due to Streptococcus pneumoniae (RR 0.59, 95% CI 0.45 to 0.77) and reduced severe hearing loss in children with meningitis due to Haemophilus influenzae (RR 0.37, 95% CI 0.20 to 0.68); subgroup analysis for patients with meningococcal showed a nonsignificant favourable trend in mortality (RR 0.71, 95% CI 0.31 to 1.62). Sub analyses for high-income and low-income countries of the effect of corticosteroids on mortality showed RRs of 0.83 (95% CI 0.52 to 1.05) and 0.87 (95% CI 0.72 to 1.05), respectively. Corticosteroids were protective against short-term neurological sequelae in patients with bacterial meningitis high-income countries (RR 0.56, 95% CI 0.3 to 0.84); in low-income countries this RR was 1.09 (95% CI 0.83 to 1.45). For children with bacterial meningitis admitted in high-income countries, corticosteroids showed a protective effect of on severe hearing loss (RR 0.61, 95% CI 0.41 to 0.90) and favourable point estimates for severe hearing loss associated with non-Haemophilus influenzae meningitis (RR 0.51, 95% CI 0.23 to 1.13) and short-term neurological sequelae (RR 0.72, 95% CI 0.39 to 1.33). For children in low-income countries, the use of corticosteroids was neither associated with benefit nor with harmful effects. Overall, adverse events were not increased significantly with the use of corticosteroids.

Authors’ conclusions
Overall, corticosteroids significantly reduced rates of mortality, severe hearing loss and neurological sequelae. In adults with community-acquired bacterial meningitis, corticosteroid therapy should be administered in conjunction with the first antibiotic dose. In children, data support the use of adjunctive corticosteroids in children in high-income countries. We found no beneficial effect of corticosteroids for children in low-income countries.

Plain language summary
The corticosteroid dexamethasone can reduce hearing loss and death after meningitis for both children and adults
Acute bacterial meningitis is an infection of the membrane lining the brain that often causes hearing loss and is frequently fatal. It is usually caused by bacteria spreading from an ear or throat infection. Corticosteroids are drugs that can reduce inflammation caused by infection. Research on the use of corticosteroids for meningitis has had conflicting results. This review of trials found that the corticosteroid dexamethasone leads to a major reduction in hearing loss and death in both children and adults, without major adverse effects.

Effects of voice training and voice hygiene education on acoustic and perceptual speech parameters and self-reported vocal well-being in female teachers

from Logopedics Phoniatrics Vocology

Voice education programs may help in optimizing teachers’ voice use. This study compared effects of voice training (VT) and voice hygiene lecture (VHL) in 60 randomly assigned female teachers. All 60 attended the lecture, and 30 completed a short training course in addition. Text reading was recorded in working environments and analyzed for fundamental frequency (F0), equivalent sound level (Leq), alpha ratio, jitter, shimmer, and perceptual quality. Self-reports of vocal well-being were registered. In the VHL group, increased F0 and difficulty of phonation and in the VT group decreased perturbation, increased alpha ratio, easier phonation, and improved perceptual and self-reported voice quality were found. Both groups equally self-reported increase of voice care knowledge. Results seem to indicate improved vocal well-being after training.

Syntactic-semantic relationships in the mental lexicon of aphasic patients

from Clinical Linguistics and Phonetics

This paper examines the relative values of syntactic-semantic relationships in the mental lexicon of aphasic patients, which were tested within syntagmatic and paradigmatic networks of lexical relations. Semantic relations, such as synonymy, antonomy, and hyperonymy, as well as collocational and coordinational syntactic-semantic relations, were examined simultaneously. Twenty-five subjects diagnosed with nominal aphasia were tested, as well as a control group of 20 healthy subjects. The control group was matched with the aphasic group in terms of dominant hemisphere, age, sex, and job. A naming test based on semantic context was used in this research. The test was presented orally to subjects. After the examiner had read a sentence, subjects were supposed to finish it with a target word (the word which was, through context, in a syntactic-semantic relationship with the rest of the sentence). Sentences were composed of highly frequently occurring words. The categories used in the test were randomly patterned. The resultant data were analysed according to adequate semantic relations of the answers in the given context, and according to the type of the semantic-syntactic relation in ‘wrong’ answers. Results of this analysis are interpreted according to current psycholinguistic theories.

Acoustic quantification of /i/-/I/ overlap in children 21 to 33 months

from the International Journal of Speech-Language Pathology

This longitudinal investigation examined the temporal and spectral characteristics of the high front vowels /i/ and /I/ as produced by nine monolingual US English children from 21-33 months. Vowel overlap was quantified in two-dimensional (F1, F2) and three-dimensional (F1, F2, duration) space using Spectral Overlap Assessment Measure (SOAM). These findings were compared with the results from Support Vector Machine (SVM) vowel classification, vowel duration ratios, and measures of effect size, to determine whether a spectral/temporal trading effect existed in the early vowel productions of young children. Children between the ages of 21 and 33 months are highly variable in the way they use spectral and temporal parameters to distinguish between these two adjacent vowels. However, findings pointed to the existence of a spectral/temporal trading effect when spectral overlap values are relatively high (>60%) at 21 and 24 months of age.

Why do some individuals with objectively verified hearing loss reject hearing aids?

from Audiological Medicine

We investigated, in new hearing aid candidates, whether or not the use of coping strategies and the life situation, in terms of activity limitation, participation restriction and psychological well-being, were associated with the outcome of audiological counselling, i.e. the patients’ acceptance or rejection of a hearing aid (HA). The study included 173 consecutive adult patients (104 men and 69 women) with a need for audiological rehabilitation including HA-fitting. Use of communication strategies (Communication Strategies Scale, CSS), experience of activity limitation and participation restriction (Hearing Disability and Handicap Scale, HDHS), and general psychological well-being (Psychological General Well-being scale, PGWB) were assessed by self-report inventories. The hospital records, reviewed 1.5years after the first consultation, showed that 39 patients (25 men and 14 women, 23%) had not accepted a hearing aid. In crude and adjusted logistic regression analyses a low report (high scores) of maladaptive behaviour in communication was associated with a three-times higher odds for rejecting a hearing aid, while a highly perceived activity limitation and participation restriction were related to lower odds for rejection. Patients who felt they had few problems with their hearing or overlooked or repressed their shortcomings, rejected HAs more often.

Conference On Advances In Neurotechnology

from Medical News Today.com

Imagine being paralyzed, unable to move your arms or to walk again. An estimated four to five million Americans suffer from this debilitating situation. Or imagine being mostly blind, or mostly deaf. Conservatively, tens of millions of Americans are affected by these infirmities.

Etiologic and Audiologic Evaluations After Universal Neonatal Hearing Screening: Analysis of 170 Referred Neonates

from Pediatrics

OBJECTIVE. The goal was to clarify the audiologic aspects and causes of congenital hearing loss in children who failed universal neonatal hearing screening.

METHODS. A prospective analysis of 170 consecutive records of neonates referred to a tertiary center after universal neonatal hearing screening failure, between 1998 and 2006, was performed. The data presented here represent the equivalent of 87000 screened newborns. The screening results were validated with a clinical ear, nose, and throat examination and electrophysiological testing, including diagnostic auditory brainstem response, automated steady state response, and/or behavioral testing. A diagnostic evaluation protocol for identification of the cause of the hearing loss was also implemented, in collaboration with the departments of genetics and pediatrics.

RESULTS. Permanent hearing loss was confirmed in 116 children (68.2%). Bilateral hearing loss was diagnosed in 68 infants (58.6%) and unilateral hearing loss in 48 infants (41.4%). Median thresholds for the neonates with confirmed hearing loss were severe in both unilateral and bilateral cases, at 70 dB nHL and 80 dB nHL, respectively. In 55.8% of those cases, no risk factors for hearing loss were found. In 60.4%, the initial automated auditory brainstem response diagnosis was totally in agreement with the audiologic evaluation results. In 8.3% of the cases, however, a unilateral refer result was finally classified as bilateral hearing loss. An etiologic factor could be identified in 55.2% of the cases. Of the causes identified, a genetic mechanism was present in 60.4% of the cases, peripartal problems in 20.8%, and congenital cytomegalovirus infection in 18.8%.

CONCLUSIONS. An etiologic factor could be identified for nearly one half of the children with confirmed congenital hearing loss referred through a universal hearing screening program.

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Prescribing Assistive-Technology Systems: Focus on Children With Impaired Communication

from Pediatrics

This clinical report defines common terms of use and provides information on current practice, research, and limitations of assistive technology that can be used in systems for communication. The assessment process to determine the best devices for use with a particular child (ie, the best fit of a device) is also reviewed. The primary care pediatrician, as part of the medical home, plays an important role in the interdisciplinary effort to provide appropriate assistive technology and may be asked to make a referral for assessment or prescribe a particular device. This report provides resources to assist pediatricians in this role and reviews the interdisciplinary team functional evaluation using standardized assessments; the multiple funding opportunities available for obtaining devices and ways in which pediatricians can assist families with obtaining them; the training necessary to use these systems once the devices are procured; the follow-up evaluation to ensure that the systems are meeting their goals; and the leadership skills needed to advocate for this technology. The American Academy of Pediatrics acknowledges the need for key resources to be identified in the community and recognizes that these resources are a shared medical, educational, therapeutic, and family responsibility. Although this report primarily deals with assistive technology specific for communication impairments, many of the details in this report also can aid in the acquisition and use of other types of assistive technology.

Identification of novel dyslexia candidate genes through the analysis of a chromosomal deletion

from the American Journal of Medical Genetics Part B: Neuropsychiatric Genetics

Abstract
Dyslexia is the most common childhood learning disorder and it is a significantly heritable trait. At least nine chromosomal loci have been linked to dyslexia, and additional susceptibility loci on other chromosomes have been suggested. Within two of these loci, DYX1C1 (15q21) and ROBO1 (3p12) have recently been proposed as dyslexia candidate genes through the molecular analysis of translocation breakpoints in dyslexic individuals carrying balanced chromosomal translocations. Moreover, genetic association studies have indicated a cluster of five dyslexia candidate genes in another linkage region on chromosome 6p22, although there is currently no consensus about which of these five genes contributes to the genetic susceptibility for dyslexia. In this article, we report the identification of four new dyslexia candidate genes (PCNT, DIP2A, S100B, and PRMT2) on chromosome region 21q22.3 by FISH and SNP microarray analyses of a very small deletion in this region, which cosegregates with dyslexia in a father and his three sons. © 2008 Wiley-Liss, Inc.

Comparison of the acoustic and neural distortion product at 2f1-f2 in normal-hearing adults

from the International Journal of Audiology

Input/output functions of the simultaneously recorded acoustic distortion product otoacoustic emissions (DPOAE) and neural frequency following-response distortion products (FFR-DP) at 2f1-f2 were evaluated to determine if these two representations of cochlear nonlinearity exhibit similar response behavior, which would suggest shared cochlear generators. Responses were recorded from normal-hearing adults for a tone burst stimulus pair (F1: 500 Hz; F2: 612 Hz) at 40-70 dB nHL. DPOAE responses were recorded from the ear canal, and FFR responses were recorded differentially from scalp electrodes, representing a vertical configuration. The input/output function for FFR-DP revealed a compressive saturating nonlinearity, whereas the DPOAE input/output function exhibited a linear growth at higher intensities following a compressive behavior at moderate levels. Results appear to suggest that cochlear generators may be contributing differentially to the acoustic and the neural distortion products. Also, FFR-DP responses appeared more identifiable and less variable, particularly at lower stimulus levels, than the corresponding DPOAE. These findings may point to a potential benefit of applying FFR testing to complement DPOAE in evaluating cochlear function at low frequencies.

Development of the Canadian French Hearing in Noise Test

from the International Journal of Audiology

No abstract available.

Tracheoesophageal Puncture & Prosthesis for Post-Laryngectomy Voice Restoration Course

from the National Library for Health

For further information contact:

Event Tel: Tel: +1 317 926 1056
Event Fax: Fax: +1 317 579 0476

Where:Carmel, USA
When:06 Dec 2008 10:00 – 07 Dec 2008 16:30

Auditory language comprehension of temporally reversed speech signals in native and non-native speakers

from Acta neurobiologiae experimentalis

Neuropsychological studies in brain-injured patients with aphasia and children with specific language-learning deficits have shown the dependence of language comprehension on auditory processing abilities, i.e. the detection of temporal order. An impairment of temporal-order perception can be simulated by time reversing segments of the speech signal. In our study, we investigated how different lengths of time-reversed segments in speech influenced comprehension in ten native German speakers and ten participants who had acquired German as a second language. Results show that native speakers were still able to understand the distorted speech at segment lengths of 50 ms, whereas non-native speakers only could identify sentences with reversed intervals of 32 ms duration. These differences in performance can be interpreted by different levels of semantic and lexical proficiency. Our method of temporally-distorted speech offers a new approach to assess language skills that indirectly taps into lexical and semantic competence of non-native speakers.