Children with pragmatic language impairment (CwPLI) are characterized by difficulties with the interpersonal use of language in social contexts and they possess a range of language difficulties that affect their educational attainment. Since literacy skills are central to this attainment, one way of identifying appropriate support needs for CwPLI would be to profile their reading and writing skills as a group.
To investigate the word reading, non-word reading, reading comprehension, and written expression skills of CwPLI and a comparison group of children with specific language impairment (CwSLI). CwSLI were recruited in order to examine any overlaps in literacy impairments for the two groups.
Primary school-aged CwPLI (n= 59) and CwSLI (n= 12) were recruited from speech and language therapists. Children completed standardized assessments of literacy skills. The level of impairment for each component literacy skill was examined for CwPLI and CwSLI.
For the CwPLI, group mean scores on each of the literacy skills were at the lower end of the normal range compared with population norms. The range of individual scores was large, with some children scoring near floor level and others scoring up to 2 SDs (standard deviations) above the mean, illustrating the heterogeneity of literacy skills within the group. For the CwSLI, group mean scores on each of the literacy skills were between 1 SD and 2 SDs below the population mean. CwSLI were significantly more impaired on all of the literacy measures compared with CwPLI. This difference remained even when receptive language ability and non-verbal intelligence were controlled for.
The results demonstrate that there is a high level of literacy impairment within CwPLI and CwSLI, providing evidence that individualized literacy skill intervention is important for the long-term academic outcome of these children.
[Show abstract][Hide abstract] ABSTRACT: Chronic heart failure (CHF) is highly prevalent and constitutes an important public health problem around the world. In spite of a large number of pharmacological agents that successfully decrease mortality in CHF, the effects on exercise tolerance and quality of life are modest. Renal dysfunction is extremely common in patients with CHF and it is strongly related not only to increased mortality and morbidity but to a significant decrease in exercise tolerance, as well. The aim of our study was to investigate the prevalence and influence of the renal dysfunction on functional capacity in the elderly CHF patients.
We included 127 patients aged over 65 years in a stable phase of CHF. The diagnosis of heart failure was based on the latest diagnostic principles of the European Society of Cardiology. The estimated glomerular filtration rate (eGRF) was determined by the abbreviated modification of diet in renal disease (MDRD2) formula, and patients were categorized using the kidney disease outcomes quality initiative (K/DOQI) classification system. Functional capacity was determined by the 6 minute walking test (6MWT).
Among 127 patients, 90 were men. The average age was 72.5 +/- 4.99 years and left ventricular ejection fraction (LVEF) was 40.22 +/- 9.89%. The average duration of CHF was 3.79 +/- 4.84 years. Ninty three (73.2%) patients were in New York Heart Association (NYHA) class II and 34 (26.8%) in NYHA class III. Normal renal function (eGFR > or = 90 mL/min) had 8.9% of participants, 57.8% had eGFR between 60-89 mL/min (stage 2 or mild reduction in GFR according to K/DOQI classification), 32.2% had eGFR between 30-59 mL/min (stage 3 or moderate reduction in GFR) and 1.1% had eGFR between 15-29 mL/min (stage 4 or severe reduction in GFR). We found statistically significant correlation between eGFR and 6 minute walking distance (6MWD) (r = 0.390, p < 0.001), LVEF (r = 0.268, p < 0.05), NYHA class (p = -0.269, p < 0.05) and age (r = 0.214, p < 0.05). In multiple regression analysis only patients' age was a predictor of decreased 6MWD < 300 m (OR = 0.8736, CI = 0.7804 - 0.9781, p < 0.05).
Renal dysfunction is highly prevalent in the elderly CHF patients. It is associated with decreased functional capacity and therefore with poor prognosis. This study corroborates the use of eGFR not only as a powerful predictor of mortality in CHF, but also as an indicator of the functional capacity of cardiopulmonary system. However, clinicians underestimate a serial measurement of eGFR while it should be the part of a routine evaluation performed in every patient with CHF, particularly in the elderly population.
[Show abstract][Hide abstract] ABSTRACT: Young children are often required to carry out writing tasks in an educational context. However, little is known about the patterns of writing skills that children with specific language impairment (CwSLI) have relative to their typically developing peers.
To assess the written language skills of CwSLI and compare these with typically developing peers. It also aimed to assess the relative contributions of reading and spelling skills to written language skills.
Forty-five children took part in the study: 15 were CwSLI, 15 were a chronological age match and 15 were a spelling age match. The children took part in a range of tasks that assessed writing, reading and spelling abilities.
In their written language and compared with typical age-matched peers, CwSLI used a significantly less diverse range of words, had lower quality written compositions overall, and lower levels of organization, unity and coherence. They also had a higher proportion of spelling errors. Overall, writing skills were strongly associated with reading skills.
The findings demonstrate the challenges CwSLI have in producing good-quality written text and that these challenges are likely to be related to the linguistic skills profile shown by these children.
International Journal of Language & Communication Disorders 03/2013; 48(2):160-71. DOI:10.1111/1460-6984.12010 · 1.47 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Background:
Developmental disorders of language and communication present considerable diagnostic challenges due to overlapping of symptomatology and uncertain aetiology. We aimed to further elucidate the behavioural and linguistic profile associated with impairments of social communication occurring outside of an autism diagnosis.
Six to eleven year olds diagnosed with pragmatic language impairment (PLI), high functioning autism (HFA) or specific language impairment (SLI) were compared on measures of social interaction with peers (PI), restricted and repetitive behaviours/interests (RRBIs) and language ability. Odds ratios (OR) from a multinomial logistic regression were used to determine the importance of each measure to diagnostic grouping. MANOVA was used to investigate differences in subscale scores for the PI measure.
Greater degrees of PI difficulties (OR = 1.22, 95% CI = 1.05-1.41), RRBI (OR = 1.23, 95% CI = 1.06-1.42) and expressive language ability (OR = 1.16, 95% CI = 1.03-1.30) discriminated HFA from PLI. PLI was differentiated from SLI by elevated PI difficulties (OR = 0.82, 95% CI = 0.70-0.96) and higher expressive language ability (OR = 0.88, 95% CI = 0.77-0.98), but indistinguishable from SLI using RRBI (OR = 1.01, 95% CI=0.94-1.09). A significant effect of group on PI subscales was observed (θ = 1.38, F(4, 56) = 19.26, p < .01) and PLI and HFA groups shared a similar PI subscale profile.
Results provide empirical support for a conceptualisation of PLI as a developmental impairment distinguishable from HFA by absence of RRBIs and by the presence of expressive language difficulties. PI difficulties appear elevated in PLI compared with SLI, but may be less pervasive than in HFA. Findings are discussed with reference to the proposed new category of 'social communication disorder' in DSM-5.
Journal of Child Psychology and Psychiatry 05/2013; 54(11). DOI:10.1111/jcpp.12079 · 6.46 Impact Factor
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