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Language Disorders and Prognosis for Reading Disabilities in Developmental Age
Abstract
2 groups of language-disordered children were studied regarding the reading levels reached at the end of the first year of school. The first group was composed by children with language retardation mainly on phonological level, the second group was composed by children with retardation also on semantic-syntactic level. The results confirmed the strong association between reading disability and language disorders and yielded significant differences between the two groups: the reading achievement seemed to be associated mainly to semantic and syntactic competences.
... Research has demonstrated that many children diagnosed in the preschool years as being language impaired continue to demonstrate language disorders into their school years (Aram, Ekelman, and Nation, 1984;Hall and Tombl in, 1978;Levi et al., 1982;McGrady, 1964;Strominger, 1983). On standardized reading tests, language-impaired children have more difficulty than age-peers in the standardization sample (Aram et al., 1984;Strominger, 1983) or controls (Hall and Tomblin, 1978;Levi et aI., 1982;McGrady, 1964). ...
... Consistent with findings of previous studies (Hall and Tomblin, 1978;levi et al., 1982;~1cGrady, 1964;Strominger, 1983), these language-impaired subjects showed difficulty in reading. On the WRAT, 29 50% scored at or below the 25%i le. ...
... Summary. Although limited in number, all of the studies reviewed found that language-impaired children, when considered as a group, demonstrated significant reading delays (Aram et al., 1984;Hall and Tomb 1 in, 1978;Levi et al. ,1982;McGrady, 1964;Strominger, 1983). Moreover, some research results indicated that different types of language impairments may be associated with type and seve~lty of reading delay. ...
... Several studies have sought to identify preschool predictors of later language, reading, and spelling skills. Preschool language status has been consistently identified as a predictor of later academic outcomes (Bishop & Adams, 1990;Hall & Tomblin, 1978;Levi, Capozzi, Fabrizi, & Sechi, 1982). In general, preschool children with isolated phonology disorders tend to have better outcomes than do children whose phonology disorders are accompanied by additional language problems (Hall & Tomblin, 1978). ...
... The results of this study are consistent with previous findings showing that school-age children with histories of preschool speech and language disorders are at high risk for reading, spelling, and language problems (Aram & Hall, 1989;Bishop & Adams, 1990;Catts, 1991;1993;Larrivee, & Catts, 1999;Menyuk et al., 1991;Stothard et al., 1998;Tallal, Ross, & Curtiss, 1989). Previous studies have suggested that preschool syntactic/semantic impairments are more predictive of later academic problems than are preschool speechsound disorders (Bishop & Adams, 1990;Catts, 1991;1993;Hall & Tomblin, 1978;Levi et al., 1982;Shriberg & Kwiatkowski, 1988). Consistent with these findings, preschool deficits in language skills as measured on the TOLD-P:2 predicted later language and reading disorders. ...
Tests of phonology, semantics, and syntax were administered to 52 preschool children (19 girls and 33 boys, age 4-6 years) with moderate to severe speech sound disorders. The children's performance on these tests was used to predict language, reading, and spelling abilities at school age (age 8-11 years). Language impairment at school age was related to poor performance on preschool tests of syntax and nonsense word repetition, while reading impairment was predicted by poor performance in all preschool test domains (phonology, semantics, and syntax). In contrast, spelling impairment was predicted by deficits in preschool tests of phonological processing as measured by the Word Discrimination subtest of the Test of Language Development - Primary 2. Family history for speech and language disorders did not predict language, reading, or spelling impairment at school age. However, family history for reading disorders was a good predictor of school-age spelling difficulties.
... Le risque de trouble de lecture est considérablement accru, lorsqu'un TSLO est associé à un TSSP, plutôt qu'en cas de TSSP isolé (Bishop & Adams, 1990 ;Hall & Tomblin, 1978 ;Johnson et al., 1999 ;Levi, Capozzi, Fabrizi, & Sechi, 1982;Lewis & Freebairn, 1992 ;Lewis, Freebairn, & Taylor, 2000Nathan et al., 2004 ;Raitano, Pennington, Tunick, Boada, & Shriberg, 2004;Sices, Taylor, Freebairn, Hansen, & Lewis, 2007). À ce propos, Bishop et Adams (1990) proposent l'hypothèse de la synergie, selon laquelle l'association du TSLO et du TSSP aurait un impact délétère sur la lecture beaucoup plus prononcé que celui prédit par l'un ou l'autre de ces troubles pris isolément. ...
Résumé Les enfants avec un trouble spécifique d’articulation, de parole et/ou de langage oral résorbé ou persistant, présentent, à des degrés divers, des risques de difficultés d’apprentissage de la lecture. Cette revue critique de la littérature présente les caractéristiques des capacités de lecture de ces enfants, pour ce qui concerne la reconnaissance de mots écrits et la compréhension en lecture. Cette analyse qui insiste sur les liens entre les habiletés orales et écrites de ces enfants, est réalisée en référence aux différents modèles sur les liens entre les troubles du langage oral et les troubles de lecture.
... Le risque de trouble de lecture est considérablement plus élevé, en cas de TSLO associé au trouble phonologique, plutôt qu'en cas de trouble phonologique isolé Hall & Tomblin, 1978;Johnson et al., 1999;Levi, Capozzi, Fabrizi, & Sechi, 1982;Lewis, Freebairn, & Taylor, 2000Lewis & Freebairn, 1992;Nathan et al., 2004;Raitano, Pennington, Tunick, Boada, & Shriberg, 2004;Sices, Taylor, Freebairn, Hansen, & Lewis, 2007). À ce propos, proposent l'hypothèse de la synergie, selon laquelle l'association du TSLO et des troubles phonologiques aurait un impact délétère sur la lecture beaucoup plus prononcé que celui prédit par l'un ou l'autre de ces troubles pris isolément. ...
Cette thèse porte sur les capacités de lecture des enfants souffrant de troubles spécifiques du langage oral (TSLO). Elle tente de préciser les processus à l’oeuvre lors de la lecture de mots isolés chez ces enfants, en analysant leurs compétences langagières écrites en lien avec leurs compétences orales. Dans un premier temps, nous présentons les principaux acquis de la littérature à ce propos. Puis nous exposons quatre études expérimentales réalisées auprès d’enfants avec un TSLO ainsi qu’auprès d’enfants au développement typique, sur les sujets suivants : (1) la reconnaissance de mots écrits isolés en lecture à voix haute, (2) la reconnaissance de mots écrits isolés en lecture silencieuse, (3) la compréhension de mots écrits, (4) et les facteurs prédictifs de la lecture. Les résultats les plus marquants indiquent qu’en reconnaissance de mots écrits, les enfants avec un TSLO présentent un retard d’un peu plus de trois ans, en lecture à voix haute comme en lecture silencieuse. En tant que groupe, leur procédure de lecture phonologique apparaît moins efficiente que leur procédure orthographique. L’hétérogénéité interindividuelle demeure toutefois importante. Les enfants qui souffrent des troubles phonologiques expressifs les plus sévères sont ceux dont la procédure phonologique est la plus altérée. Quant à la compréhension de mots écrits isolés, elle apparaît coûteuse en termes de ressources de traitement. Enfin, les facteurs prédictifs de la lecture des enfants avec un TSLO sont identiques à ceux des enfants au développement typique, à l’exception d’un facteur original : chez les enfants avec un TSLO, l’instabilité phonologique est prédictive des capacités de lecture, contrairement aux enfants contrôles. Ce facteur mériterait de plus amples recherches.
... Such investigations have revealed complex relationships between children's speech, language, and literacy achievement. Regarding language skills, research has consistently shown that children with language difficulties are more likely to develop reading disorders than their typically developing peers (Levi et al., 1982;Bishop & Adams, 1990;Catts, 1993), with the majority of children who experience reading difficulties in school having a history of language deficits even earlier . Regarding speech skills, whereas some have documented similar literacy outcomes in children with and without SSD (Shriberg & Kwiatkowski, 1988;Bishop & Adams, 1990;Catts, 1993), others have documented lower literacy outcomes in children with SSD (Lewis & Freebairn, 1992;Bird et al., 1995;Leitao & Fletcher, 2004). ...
Objective
The purpose of this study was to examine experiences and practices related to supporting literacy development and preventing reading difficulties in children with cleft lip and/or palate (CL/P).
Methods
Via online surveys, 67 respondents including 35 parents/guardians of children with CL/P and 32 speech-language pathologists (SLPs) answered questions about home literacy practices, clinical practices, and perceptions of SLPs’ role in literacy.
Results
The variability in responses highlights both the positive contributions of parents/guardians and SLPs in supporting literacy development and preventing reading disabilities in children with cleft and the need for increased education and efforts to meet their literacy needs.
... Le risque de trouble de lecture est considérablement accru, lorsqu'un TSLO est associé à un TSSP, plutôt qu'en cas de TSSP isolé (Bishop & Adams, 1990 ;Hall & Tomblin, 1978 ;Johnson et al., 1999 ;Levi, Capozzi, Fabrizi, & Sechi, 1982;Lewis & Freebairn, 1992 ;Lewis, Freebairn, & Taylor, 2000Nathan et al., 2004 ;Raitano, Pennington, Tunick, Boada, & Shriberg, 2004;Sices, Taylor, Freebairn, Hansen, & Lewis, 2007). À ce propos, Bishop et Adams (1990) proposent l'hypothèse de la synergie, selon laquelle l'association du TSLO et du TSSP aurait un impact délétère sur la lecture beaucoup plus prononcé que celui prédit par l'un ou l'autre de ces troubles pris isolément. ...
Du fait des liens linguistiques étroits entre le langage oral et le langage écrit (Zesiger, Brun, & Nanchen, 2004), les enfants souffrant ou ayant souffert de troubles d’articulation, de parole et/ou de langage oral présentent, à des degrés divers, des risques d’apprentissage du langage écrit, notamment au niveau de la lecture (McArthur, Hogben, Edwards, Heath, & Mengler, 2000; Zesiger et al., 2004). Dans cette revue critique de littérature, nous nous intéresserons aux capacités de lecture de certains de ces enfants, ceux dont ces troubles sont dits spécifiques, c’est-à-dire ne pouvant s’expliquer par aucune cause connue, qu’il s’agisse d’une pathologie neurologique avérée (ex. syndrome épileptique), d’un déficit intellectuel, ou d’une déficience sensorielle (ex. surdité).2La compréhension des capacités de lecture de ces enfants nécessite la connaissance préalable de travaux de recherche dans plusieurs domaines : la lecture et ses liens avec le langage oral ; les troubles spécifiques d’articulation, de parole et/ou de langage oral. Après avoir abordé ces thématiques, nous nous intéresserons aux modèles théoriques concernant les liens entre ces troubles et les troubles de lecture. Par la suite, nous discuterons de la validité de ces modèles, en les confrontant aux résultats des études décrivant les aptitudes en lecture de ces enfants.
... Le risque de trouble de lecture est considérablement accru, lorsqu'un TSLO est associé à un TSSP, plutôt qu'en cas de TSSP isolé (Bishop & Adams, 1990 ;Hall & Tomblin, 1978 ;Johnson et al., 1999 ;Levi, Capozzi, Fabrizi, & Sechi, 1982;Lewis & Freebairn, 1992 ;Lewis, Freebairn, & Taylor, 2000Nathan et al., 2004 ;Raitano, Pennington, Tunick, Boada, & Shriberg, 2004;Sices, Taylor, Freebairn, Hansen, & Lewis, 2007). À ce propos, Bishop et Adams (1990) proposent l'hypothèse de la synergie, selon laquelle l'association du TSLO et du TSSP aurait un impact délétère sur la lecture beaucoup plus prononcé que celui prédit par l'un ou l'autre de ces troubles pris isolément. ...
... Stark et al. (1984) reported that of the six children in their study who appeared to have recovered from early language impairment, only two were reading appropriately for their age. However, likelihood of reading problems in a language-impaired child does appear to depend on the type of impairment, so that children with isolated phonological disorders are far less likely to have reading problems than those with semantic and syntactic difficulties (Debray-Rit_zen, Mattlinger, & Chapuis, 1976;Levi, Capozzi, Fabrizi, & Sechi, 1982). We aim to study our sample further to discover if reading problems develop even in children who have apparently recovered from early language delay by the time they start school or in those who have only residual phonological problems. ...
In a prospective, longitudinal study, 87 language-impaired children were assessed at the ages of 4, 4½, and 5½ years on a battery of language measures. In 37% of children, who were termed the "good outcome group," the language disorder had resolved by the age of 5½ years so that children were indistinguishable from a control group. If one restricted consideration only to those 68 children whose nonverbal ability was within normal limits, the figure rose to 44%. Outcome for individual children (good or poor) could be predicted with 90% accuracy on the basis of test measures obtained at 4 years. The best predictor was ability to tell back a simple story to pictures. The one language measure that did not relate to outcome was phonological competence.
... 6,7 Moreover, difficulty with reading and/or literacy acquisition represent/s only one/two of the various symptoms of this complex disorder, which involves the visual, auditory, and motor domains. [8][9][10][11] Other symptoms include minor neurological signs, 12 sleep complaints, 13 motor impairment, 14 social difficulties, 15 and internalizing problems. 1 Moreover, individuals affected by DD tend to have difficulty in accessing the phonological word forms after receiving normal access to the corresponding abstract lexical representation. ...
The objective of the study reported here was to assess the orthodontic features in children affected by developmental dyslexia (DD).
A total of 28 children affected by DD (22 boys, six girls; mean age: 9.78 ± 1.69 years) were compared with 51 healthy children (38 boys, 13 girls; mean age 9.41 ± 1.48; range 7-10 years). Reading and writing skills were evaluated along with orthodontic features.
The DD and control groups were not significantly different in terms of total intelligence quotient (P = 0.441) and writing skills (P = 0.805 and P = 0.240, respectively), whereas significant differences were observed between the DD group and control group in both word reading (2.018 ± 1.714 vs 0.917 ± 0.563; P = 0.000) and non-word reading (2.537 ± 1.543 vs 0.862 ± 0.244; P = 0.000). Moreover, for many orthodontic features, there was no significant difference between the two groups; only in prevalence of diastemas (57.14%, P = 0.006), midline diastemas (46.42%, P = 0.007), overbite > 4 mm (71.42%, P = 0.006) and overjet > 4 mm (53.57%, P = 0.001), was there a statistically significant difference. According to univariate logistic regression analysis, the presence of diastemas (odds ratio [OR] 4.33; 95% confidence interval [CI] 1.61-11.65), midline diastemas (OR 4.68; 95% CI 1.61-13.43), an overbite >4 mm (OR 1.75; 95% CI 0.64-4.71), or an overjet >4 mm (OR 2.76; 95% CI 1.06-7.20) seems to play a role in the relationship between occlusal abnormalities and DD in children.
Children with DD tend to present with altered dental features, particularly in the area of the incisors, suggesting that a persistently different tongue kinematic profile may thus affect both the developmental variability of the tongue and lip and the occlusion.
... Longitudinal and retrospective research has indicated that many children with language disorders are at risk for reading difficulties (e.g., Aram, Ekelman, & Nation, 1984;Aram & Nation, 1980;Bishop & Adams, 1990;Gillam & Carlile, 1997;Korngold, Menyuk, Liebergott, & Chesnick, 1988;Menyuk & Chesnick, 1997). For children with speech impairments, the picture is less consistent, with several studies showing no relationship between speech impairments and reading disabilities (Bishop & Adams, 1990;Catts, 1993;Hall & Tomblin, 1978;King, Jones, & Lasky, 1982;Levi, Capozzi, Fabrizi, & Sechi, 1982;Lewis & Freebairn, 1992) and others finding a relationship between specific types of speech impairments and reading disabilities (Catts, 1986(Catts, , 1989Magnusson & Naucler, 1990). Bird, Bishop, and Freeman (1995) found that children with persistent speech impairments (from ages 5;10 to 7;7) scored significantly below controls on literacy measures. ...
Sixteen preschool children with speech and/ or language disorders received phonological awareness training for a period of 9 months. Eight children attended a preschool classroom, and 8 children attended a pre-kindergarten classroom. The classrooms were located in a private school for children with speech and language disorders. A group of older children with speech and/or language disorders served as a nontreatment comparison group. Children in the treatment groups received 15 minutes of small-group lessons twice each week for two semesters. Classroom-based treatment focused on rhyming the first semester and on phoneme awareness the second semester. Rhyming and phoneme awareness activities were adapted from the literature on the development of phonological awareness in typically-achieving children. Results revealed that preschool children with speech and/or language disorders made significant improvement in rhyming and phoneme awareness. Comparisons with the non-treatment group indicated that gains in phoneme awareness were likely a result of the treatment rather than maturation or other aspects of the curriculum. We recommend the inclusion of some form of phonological awareness training, particularly phoneme awareness training, in intervention programs for preschoolers.
... Children who continue to have language impairments when they enter school may experience further learning problems. There is still uncertainty as to the number of children who will go on to have literacy difficulties (see Levi et al., 1982). Unfortunately, much of the work investigating the problems has been retrospective, with all the inherent problems of such an approach. ...
The wider educational needs of children with specific speech and language difficulties are of major concern to practitioners. Yet few studies have documented the literacy skills of these children across a range of different types of educational provision. The present study was designed to address this gap by profiling the language and literacy skills of 59 year 3 children in two local education authorities and 10 children attending specialist residential provision. Children completed standardized measures of language, literacy, numeracy and non-verbal ability. Children’s language and literacy scores were significantly delayed, with an average delay of two years. The implications of these difficulties for practice are discussed.
... The findings of this study support previous research that suggests that children with early speech sound disorders are at risk for later spelling difficulties (Bird, Bishop & Freeman 1995; Clark-Klein & Hodson 1995; Webster, Plante & Couvillion 1997). Further, our results are in agreement with studies that have shown that children with speech sound disorders accompanied by additional language problems have poorer spelling outcomes than children with isolated speech sound disorders (Bishop & Adams 1990; Bishop, Bishop, Bright, James, Delaney & Tallal 1999; Catts 1993; Levi, Capozzi, Fabrizi & Sechi 1982; Hall & Tomblin 1978; Menyuk, Chesnick, Liebergott, Korngold, D'Agostino & Belanger 1991; Shriberg & Kwiatkowski 1988). Previous reports concluded that children with isolated speech sound disorders are not at risk for academic difficulties. ...
The correlates of spelling impairment wereexamined in children with histories of earlyspeech sound disorders. The spelling errors of52 children with histories of speech sounddisorders were analyzed to predict theassociation between weaknesses in expressivelanguage skills in early childhood andschool-age spelling abilities. Resultsrevealed that children with preschool speechsound and language problems became poorerspellers at school age than did children withpreschool speech sound disorders only. However, even children with isolated speechsound disorders demonstrated a weakness inspelling skills relative to their reading andlanguage abilities and Weschler Performance IQ.Measures of phonological awareness were highlycorrelated with spelling skills, suggestingthat phonological processing abilities arerelated to the ability to spell phoneticallypredictable words. Analysis of spelling errorsbased on level of phonological awareness skillrevealed that children with preschool speechsound disorders utilize phonetic strategies inspelling phonetically predictable words. Familial aggregation of spelling disorderssuggests a possible genetic component that ismodified by gender.
... There are several studies that have shown that children with SSD are at greater risk for a reading disorder (see, for instance, Bishop & Adams, 1990;Larivee & Catts, 1999;Lewis & Freebairn, 1992;Snowling, Bishop, & Stothard, 2000) than children with typical speech development. There are also other studies that suggest that children with SSD are either at no or very low risk for poor reading outcomes during the school years ( Beitchman et al., 1996;Bishop & Adams, 1990;Catts, 1993;Hall & Tomblin, 1978;Levi, Capozzi, Fabrizi, & Sechi, 1982). The research on preliteracy skills involving phonological awareness, letter identification, and rapid serial naming in children with SSD shows rather consistent results, indicating that these children have poorer preliteracy skills than children with typical speech sound development (see, for instance, Carroll & Snowling, 2004;Hesketh, Adams, Nightingale, & Hall, 2000;Nathan, Stackhouse, Goulandris, & Snowling, 2004;Raitano et al., 2004;Rvachew & Grawburg, 2006). ...
This article describes a database that was created in the process of conducting a large-scale epidemiologic study of specific language impairment (SLI). As such, this database will be referred to as the EpiSLI database. Children with SLI have unexpected and unexplained difficulties learning and using spoken language. Although there is no uniform standard for the diagnosis of SLI, the construct encompasses a language deficit occurring in the presence of grossly normal sensory and nonverbal cognitive abilities (H. Tager-Flusberg & J. Cooper, 1999). Although these language difficulties are most apparent during the preschool and early school years, evidence now exists that these problems are usually present well into adulthood and are probably present throughout a person's life (see, for instance, C. J. Johnson et al., 1999; S. E. Stothard, M. J. Snowling, D. V. M. Bishop, B. B. Chipchase, & C. A. Kaplan, 1998; J. B. Tomblin, 2008).
Much of what we know of these children has come from research on children who have been clinically identified and served. Certainly, by studying those who are being served, our research base is most likely to be relevant to clinical services. However, there is a danger in this research strategy. It is quite possible that not all children with SLI are clinically identified and served within our service delivery systems. In such circumstances, there is the potential for systematic factors to influence which children do or do not find their way to clinical service.
If our research questions are concerned with the characteristics of the actual population of children with SLI that exists in our communities and not just those who are being served, then we need to turn to methods of epidemiology to aid our research.
... However, the children they studied had exceptionally severe and unusual phonological problems, with inconsistent articulatory errors persisting to 8 years or over. Other studies, however, have reported that children with isolated phonological problems are less likely to have reading difficulties than those with other types of language impairment (Debray-Ritzen, Mattlinger & Chapuis, 1976; Levi, Capozzi, Fabrizi & Sechi, 1982). Of course, the phonological disorders seen in our language-delayed children were very different from the deficits in phonological processing studied by Bradley and Bryant. ...
Language and literacy skills were assessed in 83 8 1/2-year olds whose language development had been impaired at 4 years of age. Provided that language problems had resolved by age 5 1/2 years, literacy development was normal, but many of the children who still had verbal deficits at 5 1/2 years of age did have reading difficulties and persisting oral language impairments later on. In these children, reading comprehension tended to be poor relative to reading accuracy. Syntactic competence in the preschool period accounted for a substantial proportion of the variance in literacy attainments, after allowing for the effects of non-verbal ability. There were only weak links between expressive phonological disorders and later ability to read either meaningful text or non-words.
... Stark et al. (1984) reported that of the six children in their study who appeared to have recovered from early language impairment, only two were reading appropriately for their age. However, likelihood of reading problems in a language-impaired child does appear to depend on the type of impairment, so that children with isolated phonological disorders are far less likely to have reading problems than those with semantic and syntactic difficulties (Debray-Rit_zen, Mattlinger, & Chapuis, 1976;Levi, Capozzi, Fabrizi, & Sechi, 1982). We aim to study our sample further to discover if reading problems develop even in children who have apparently recovered from early language delay by the time they start school or in those who have only residual phonological problems. ...
In a prospective, longitudinal study, 87 language-impaired children were assessed at the ages of 4, 4 1/2, and 5 1/2 years on a battery of language measures. In 37% of children, who were termed the "good outcome group," the language disorder had resolved by the age of 5 1/2 years so that children were indistinguishable from a control group. If one restricted consideration only to those 68 children whose nonverbal ability was within normal limits, the figure rose to 44%. Outcome for individual children (good or poor) could be predicted with 90% accuracy on the basis of test measures obtained at 4 years. The best predictor was ability to tell back a simple story to pictures. The one language measure that did not relate to outcome was phonological competence.
... In addition, children with articulation impairments alone (i.e., Al subgroup) generally performed at or above the level of the normal group in reading achievement. These findings are consistent with other studies that have failed to observe a relationship between articulation impairments and reading disabilities (Bishop & Adams, 1990;Hall & Tomblin, 1978;King, Jones, & Lasky, 1982;Lewis & Freebairn, 1992;Levi et al., 1982). Naucler (1987, 1990), on the other hand, have proposed that a subgroup of children with articulation impairments may have a high incidence of reading disabilities. ...
A group of children with speech-language impairments was identified in kindergarten and given a battery of speech-language tests and measures of phonological awareness and rapid automatized naming. Subjects were followed in first and second grades and administered tests of written word recognition and reading comprehension. The children with speech-language impairments were found to perform less well on reading tests than a nonimpaired comparison group. Subjects' performance on standardized measures of language ability in kindergarten was observed to be closely related to reading outcome, especially reading comprehension. Measures of phonological awareness and rapid automatized naming, on the other hand, were found to be the best predictors of written word recognition. The implications of these findings for the early identification and remediation of reading disabilities are discussed.
... Longitudinal studies on educational outcome have found early isolated phonological impairment does not leave a child significantly at risk for later academic difficulties (Hall & Tomblin, 1978). A number of large studies have also concluded that speech impairment alone is unrelated to reading achievement (Levi, Capozzi, Fabrizi & Sechi, 1982;Bishop & Adams, 1990;Catts, 1993). On the other hand, researchers such as Hodson, Nonomura and Zappia (1989) hypothesise that children with a phonological performance problem (i.e. ...
Phonological processing has been shown by many researchers to be strongly related to the acquisition of reading and spelling skills. Children with speech and language impairment appear to be at increased risk for phonological processing problems and hence literary difficulties. However, not all children with speech and language impairment experience difficulties: the literature is not clear as to which groups of speech and language impaired children are most severely affected nor which aspects of phonological processing are most likely to be impaired. Rigorous subject selection was employed to compare the performance of four groups of 20 children, aged approximately 6 years: speech-impaired (Speech); language-impaired (Language); speech and language impaired (Mixed); and children with normally developing language (Normal), by use of a battery of phonological processing tasks. The results supported the research that has shown speech and language impaired children to have weaker phonological processing skills than the general population. All the subjects in this sample appeared to be at risk: the Mixed children demonstrated the most difficulty, followed by the Language group, with the Normal group performing the best. Whilst the Speech group as a whole performed significantly more poorly than the Normal group, it consisted of two levels of performance which, on post hoc analysis were shown to relate to the pattern of speech impairment exhibited by the child.
... In contrast, children with speech and additional language impairments showed significantly worse performance. Similar findings were reported by Levi, Capozzi, Fabrizi, and Sechi (1982) and Nathan, Stackhouse, Goulandris, and Snowling (in press). Both of these studies compared the reading skills of speech-impaired children with and without additional language problems. ...
Dyslexia is now generally acknowledged to involve difficulties in phonological processing. However, the links between reading difficulties and speech difficulties remain unclear.
In the present study, 17 children with speech difficulties between the ages of four and six were compared to children with a family history of dyslexia and normally developing controls on phonological processing, phonological learning, phonological awareness and literacy tasks.
The two groups of children at risk of reading difficulties showed very similar patterns of impairment, with average vocabulary but poor input and output speech processing, phonological learning, phonological awareness and reading development.
It is concluded that the antecedents of reading difficulty are similar in these two groups of children, with both groups showing deficits in the development of phonological representations.
... Preschool language status is consistently identified as a predictor of later academic skills (Bishop & Adams, 1990; Hall & Tomblin, 1978; Levi, Capozzi, Fabrizi, & Sechi, 1982 ). In general, preschool children with isolated speechsound disorders have better achievement outcomes than do children whose speech-sound disorders are accompanied by additional language problems (Hall & Tomblin, 1978; Lewis, Freebairn, & Taylor, 2000). ...
The primary aim of this study was to examine differences in speech/language and written language skills between children with suspected childhood apraxia of speech (CAS) and children with other speech-sound disorders at school age.
Ten children (7 males and 3 females) who were clinically diagnosed with CAS (CAS group) were followed from the preschool years (ages 4-6) to school age (ages 8-10) and were compared with children with isolated speech-sound disorders (S group; n = 15) and combined speech-sound and language disorders (SL group; n = 14). Assessments included measures of articulation, diadochokinetic rates, language, reading, and spelling.
At follow-up, 8 of the children with CAS demonstrated improvement in articulation scores, but all 10 continued to have difficulties in syllable sequencing, nonsense word repetition, and language abilities. The children also exhibited comorbid disorders of reading and spelling. Group comparisons revealed that the CAS group was similar to the SL group, but not the S group during the preschool years. By school age, however, the SL group made more positive changes in language skills than the CAS group.
These findings suggest that the phenotype for CAS changes with age. Language disorders persist in these children despite partial resolution of articulation problems. Children with CAS are also at risk for reading and spelling problems.
... Apart from the work of Dodd et al. (1989), research has tended to include a composite group of speech-impaired subjects whose group performance may mask that of existing subgroups. The presence of subgroups may go some way towards explaining the inconsistent findings in the literature regarding the relationship between speech impairment and literacy outcomes (Hall and Tomblin 1978, Levi et al. 1982, Snowling and Stackhouse 1983, Hodson et al. 1989, Bishop and Adams 1990, Catts 1993, Larrivee and Catts 1999. ...
Theoretical and empirical support now exists for the finding that many children with expressive phonological impairment experience problems in acquiring phonological awareness and early literacy skills. Few studies, however, have examined the long-term academic and literacy outcomes for this population, in particular as the students leave the final stages of primary school.
The reported study forms the final stage of a longitudinal research project that tracked the phonological processing and literacy skills of a group of children with specific speech impairment from their first year at school (aged 5-6 years). The earlier data provided evidence of a relationship between speech impairment characterized by the presence of non-developmental error processes and weaker phonological awareness and literacy skills in the first 2-3 years at school. It was hypothesized that the effect of this relationship would continue to be apparent as the students completed the final stages of primary school.
Fourteen of the original set of 36 students were available for reassessment of their phonological processing, reading and spelling skills at age 12-13 years.
Those children with an original classification of non-developmental speech errors performed significantly more poorly than those with an original classification of developmental errors on phonological awareness and reading comprehension measures. Reading accuracy and spelling scores also showing a similar trend.
These findings provide further evidence for the long-term impact of speech impairment. The follow-up data demonstrated ongoing difficulties for students who entered school with expressive speech impairment, particularly those whose speech errors were characterized by non-developmental error processes. The impact was apparent on tasks measuring phonological awareness, reading accuracy and spelling (skills that depend on good phonological processing skills and clear underlying phonological representations). Weaknesses in reading comprehension were also found. These findings have implications for the early identification of those at risk. In addition, intervention approaches for young children with expressive speech difficulties demonstrating these patterns of error should address weak underlying phonological representations and develop phonological awareness skills.
... Hence, in a sample of children who meet PD criteria close to the age of 6 and beyond one is likely to find a high rate of concomitant language impairment. Children who exhibit mild articulation errors in preschool do not later have associated reading difficulties, even when their articulation difficulties extend into the school years [Catts, 1993;Levi et al., 1982]. These children stand no greater risk for literacy difficulties than the general population. ...
Children with developmental speech/language impairments are at higher risk for reading disability than typical peers with no history of speech/language impairment. This article reviews the literacy outcomes of children with speech/language impairments, clarifying the differential risk for three groups of children: speech production impairments alone, oral language impairments alone, and speech production and oral language impairments. Children at greatest risk for reading and writing disabilities are children with language impairments alone and children with comorbid speech impairments and language impairments. For children with speech impairments alone, there is limited risk for literacy difficulties. However, even when reading skills are within the average range, children with speech impairments may have difficulties in spelling. Children with language impairments are likely to display reading deficits in word decoding and reading comprehension. It is not clear what role early literacy interventions play in the amelioration of reading difficulties in these populations.
La psichiatria dell’età evolutiva, in passato detta psichiatria infantile, è una disciplina medica che si occupa dei disturbi psichici del bambino e dell’adolescente, in presenza o meno di altre patologie o deficit; il suo campo d’azione è perciò l’età evolutiva, che va per convenzione dalla nascita ai 18 anni. In Italia la psichiatria dell’età evolutiva viene esercitata dal neuropsichiatra infantile.
Sia la prima visita sia i colloqui successivi hanno in ultima analisi l’obiettivo di rilevare informazioni e dati utili al fine ultimo della consultazione ambulatoriale, cioè formulare un orientamento diagnostico che permetta di dare indicazioni mirate sulla successiva presa in carico. Tali informazioni e dati si rilevano: 1) partendo da ciò che viene detto spontaneamente in visita e dalle risposte a domande fatte dal medico; e 2) dall’osservazione di segni indicativi, i quali possono emergere spontaneamente o venire ricercati mediante stimolazioni specifiche. Queste stimolazioni, quando sono organizzate secondo un principio direttivo, possono essere chiamate prove o tecniche; mentre in generale il fatto di saper osservare e rilevare (eventualmente tramite prove o tecniche) i segni di una situazione di disturbo o di patologia si definisce semeiotica, in questo caso semeiotica in psichiatria dello sviluppo.
Treatment approaches in speech-language therapy are sometimes selected and justified on the basis of a clinician's experience that "it works." Moreover, it has been argued (e.g., Kamhi, 1999) that such clinical judgment is, in principle, sound and should be endorsed. Contrary to this view, five extraneous effects are presented as confounding influences that invalidate clinical judgment as the sole basis for adopting a therapy approach. Clinicians should always question whether observed changes in their patients are due to their interventions or to extraneous effects. Possible controls for these effects are double-blind and single subject repeated measures. Research design suggestions are presented, with descriptions of the five extraneous effects.
The present study examined the acquisition of sight reading vocabulary learned incidentally during articulation training. A multiple probe design across behaviors with reinforced probe conditions was used to evaluate the effectiveness of an articulation training program that included incidental information to teach basic sight word reading. Specifically, beginning readers with sound production errors received articulation therapy paired with a procedure in which (a) words were printed below the stimulus pictures and (b) the experimenter drew an imaginary line under the word while saying, "Yes, (word). Look, (word)." as part of feedback for articulatory performance. Results indicated that the subjects learned to read sight words incidentally during articulation training, and this learning generalized beyond printed words on cards to printed words on a list.
The primary purpose of this study was to compare the phonological awareness ability of children with persistent phonological impairment to that of phonologically normal children. We also studied the impact of speech intelligibility on beginning reading skills. Eleven moderate to severely unintelligible children and 11 phonologically normal children between the ages of 6:5 (years:months) and 8:6 were administered four measures of phonological awareness and one measure of word recognition (reading) ability. Phonologically normal children scored significantly higher on three of the four phonological awareness measures. There were no significant differences for word recognition. Multiple regression analysis yielded speech intelligibility as a highly significant predictor of performance on three of the four phonological awareness tasks. We concluded that phonological awareness is closely associated with productive phonological ability independent of mental age, chronological age, and educational experience.
A group of speech-language impaired children was administered a battery of standardized language tests and measures of phonological processing in kindergarten. Performance on these language measures was then compared to reading ability in first grade. Results indicated that children with semantic-syntactic language deficits had more difficulties in reading than did children with primarily speech articulation impairments. In addition, phonological processing measures were found to be good predictors of reading achievement. Results are discussed in terms of their implications for the early identification of developmental dyslexia.
Natural recovery from stuttering is well documented for preschool-age children. If natural recovery from developmental language disorders is equally possible, speech-language pathologists could develop predictive measures for language disorders to save treatment time and money and alleviate parental concern. This article reviews the research literature on recovery from developmental language disorders with particular attention to specific language impairment (SLI). Additional attention is directed to the research describing late talkers and the probability of their recovery. Results of the literature review indicate that recovery is unlikely and that, even with treatment, preschool children with identified language disorders are likely to present with reading and writing disorders during the school-age and adolescent years.
The purpose of this study was to investigate the story writing skills of adults with a history of oral language impairment.
It was hypothesized that writing text would pose difficulty for adults with a history of language impairment (LI), and that
this difficulty would manifest itself as reduced grammatical complexity and increased errors in spelling, grammar and punctuation.
The story writing of 10 adults with a history of LI was compared to a group of 51 unimpaired individuals. Participants were
asked to write the story of Cinderella. Stories were analysed for length, grammatical complexity and accuracy of grammar,
punctuation and spelling. Data were analysed to determine group trends as well as individual profiles. As a group, the adults
with LI showed no difference from the comparison group in the length of their stories as measured by total number of words.
The LI group did, however, show reduced grammatical complexity in their writing, as measured by mean length of t-unit. The
LI group made more errors in grammar, spelling and punctuation than the comparison group. Individual analyses indicated substantial
variability within the LI group. It is concluded that LI in childhood is associated with writing difficulties in adulthood.
Thesis (Ph. D.) - Macquarie University, 1996. Bibliography: leaves 264-279. http://minerva.mq.edu.au:8080/vital/access/manager/Repository/mq:33163
In this study, the authors evaluated literacy outcome in children with histories of speech sound disorder (SSD) who were characterized along 2 dimensions: broader language function and persistence of SSD. In previous studies, authors have demonstrated that each dimension relates to literacy but have not disentangled their effects. Methods Two groups of children (86 SSD and 37 controls) were recruited at ages 5-6 and were followed longitudinally. The authors report the literacy of children with SSD at ages 7-9, compared with controls and national norms, and relative to language skill and SSD persistence (both measured at age 5-6).
The SSD group demonstrated elevated rates of reading disability. Language skill but not SSD persistence predicted later literacy. However, SSD persistence was associated with phonological awareness impairments. Phonological awareness alone predicted literacy outcome less well than a model that also included syntax and nonverbal IQ.
Results support previous literature findings that SSD history predicts literacy difficulties and that the association is strongest for SSD + language impairment (LI). Magnitude of phonological impairment alone did not determine literacy outcome, as predicted by the core phonological deficit hypothesis. Instead, consistent with a multiple deficit approach, phonological deficits appeared to interact with other cognitive factors in literacy development.
Four children with early language delays (ELD) were compared to a control group of 12 children with respect to their preschool language abilities from age 2 1/2 to 5 years and their verbal skills at the end of Grade 2. The language-delayed children each initially showed severe and broad impairments in syntactic, phonological, and lexical production. Over time, their deficits became milder and more selective, such that normal or nearly normal speech and language proficiency was exhibited by age 60 months. Nevertheless, when followed up 3 years later, three of the four cases were severely reading disabled. These findings are discussed with respect to prior findings and hypotheses about the sequelae of early language delay and the relationship of language development to reading achievement.
Three groups of children: 18 dyslexic children; 18 children with reading retardation: 18 normal children (mean age = 9 years), were given an oral storytelling test. The results point out a clear--cut differentiation between the three groups in their overall performance and the presence of atypical linguistic strategies in dyslexic children. The data are discussed in relation to linguistic difficulties in dyslexic children.
This study investigated the link between expressive phonological impairments, phonological awareness, and literacy. Previous investigations of literacy skills in children with speech impairments have given mixed results; here we considered whether presence of additional language impairments or severity of the speech impairment was an important prognostic factor. Thirty-one children with expressive phonological impairments were compared with control children matched on age and nonverbal ability on three occasions, at mean ages of 70, 79, and 91 months. On each occasion they were given three tests of phonological awareness: one involved rime-matching and two involved onset-matching. At assessments 2 and 3 literacy skills were assessed. Children with phonological impairments scored well below their controls on phonological awareness and literacy, independent of whether or not they had other language problems. Although many of them knew letter sounds, they were poor at reading and writing nonwords as well as real words. It is suggested that both the speech impairment and the literacy problems arise from a failure to analyze syllables into smaller phonological units. The severity of the phonological problems in relation to age is an important determinant of literacy outcome; children who have severe expressive phonological impairments at the time they start school are at particular risk for reading and spelling problems.
This study examined the effects of overt phonologic impairment (disordered speech) on phonological awareness, verbal working memory, and letter knowledge. Forty-five children--29 with moderate to severe productive phonologic impairment at the inception of the project and 16 without impairment--were followed from mean age 3-6 to age 6-0. Fifteen participants with impairment were matched on gender and mental age to 15 without impairment for certain aspects of the analysis. The children with phonologic impairment performed significantly worse than their controls on tasks of verbal working memory, phoneme segmentation, and letter identification. In addition, a path analysis revealed working memory to be a potentially important mediating variable. The investigators also measured productive syntax, which, although associated with productive phonology and working memory, was not associated with letter identification.
Background: This report concerns the identification and treatment of children with primary speech and language delays, that is delays which cannot be attributed to other conditions such as hearing loss or other more general developmental disabilities. Such delays are important because they cause concern to parents, because they are commonly associated with behavioural and other difficulties in the pre-school period and because they constitute a risk factor for subsequent poor school performance, and for a wide range of personal and social difficulties for the individuals concerned. It is unclear, given the current state of knowledge, whether such delays represent varying levels of a single condition or a number of different conditions with diverse aetiologies. Currently the identification and treatment of speech and language delays fall within the remit of the health services in the early years of life and most health trusts have in place informal procedures for identifying such delays. The educational services and those responsible for providing nursery and child-care services also have a considerable role to play in the process of identification and management of these children. This review aims to provide the information needed to help decide whether universal screening for speech and language delays should be implemented within the NHS. Objectives: Four domains (prevalence, natural history, intervention and screening) were identified as being key to a review of screening issues, with the following objectives being stated: to undertake a systematic review of research into the value of screening and intervention for speech and language delays in children up to the age of 7 years; to identify priority areas in need of further investigation; to provide evidence-based direction for the future provision of services. Methods: The review was carried out using structured guidelines for systematic reviews. These are described in detail in the full report. Results: Prevalence: The number of potential cases of primary speech and language delay is high, with a median figure of 5.95% reported for delays in either speech or language. There has been little attempt to tie this evidence into prediction of subsequent case status, and there is little published evidence to support the perception that either the total number of children with language delay declines in real terms across the age range, or that prevalence has been rising over recent years. Natural history: The natural history data indicate that a substantial proportion of children identified on the basis of expressive delay alone are likely to have difficulties which resolve spontaneously in the pre-school period. However, the data do not, at this stage, make it possible to predict at the time of identification, which of the children with expressive delay are likely to have persistent problems. A poorer prognosis has been consistently identified for children with expressive/receptive delays. The picture for older children is clouded by the lack of evidence from samples that have received no additional educational or therapeutic support. Nonetheless it is clear from follow-up studies of treated samples that children identified as having language difficulties in the first year of primary school are likely to have difficulties which persist through to secondary school. Intervention: Results from randomised controlled trials (RCTs) and quasi-experimental designs reveal positive and statistically significant effects of intervention relative to untreated controls in all areas of speech and language skills. Comparable results for direct (clinician-administered) and indirect treatment were observed in the case of expressive language. In contrast, direct intervention was more effective in the case of speech, whereas indirect intervention was more effective in the case of receptive language. Data from the single-subject experimental designs were synthesised and provide confirmatory evidence for the positive effects of intervention. The data in particular provide evidence for the generalisation of treatment effects. However, the data reviewed do not provide information about long-term outcomes of intervention, nor of the likelihood of intervention reducing prevalence in a given population. Similarly, it is not possible to draw conclusions about the effects of subject variables such as socio-economic status or age upon the relative value of interventions. Screening: The screening evidence indicates that, although a considerable number of assessments have been shown to perform adequately in terms of their productivity, few studies compare the performance of two or more screening tests when applied to one population, nor do they compare single screening measures across different populations. It is difficult, therefore, to make judgements about the relative value of different procedures. In general, specificity is higher than sensitivity, suggesting that it is easier to determine who is not a case than to establish who is. Parent-focused measures appear to be as useful as specific tests of child behaviour. Interpretation is further complicated by the considerable variation in the cut-offs adopted on the range of reference 'gold-standard' measures, suggesting that there remains considerable disagreement as to what proportion of the population should be considered cases. There have been no explicit attempts to benchmark the target population in terms of prevalence estimates, the prediction of case status or the impact of the intervention. Conclusions: It is clear that early speech and language delay should be a cause for concern to those involved with child health surveillance because of the problems for the individual child, because it may indicate other co- morbid conditions such as hearing loss, developmental and behavioural difficulties, and because of the implications it may have for literacy and socialisation in school. The fact that there is not sufficient evidence to merit the introduction of universal screening does not imply that speech and language delay should not be identified, for example, by less formal methods. Implications for policy: The review suggests that more attention might be shown to the role of parents in identifying children with speech and language delay. Primary-care workers (health visitors, general practitioners, school nurses and nursery staff) should be involved in eliciting parental concerns and in making appropriate observations of children's communication behaviours. This would require formal training in delayed speech and language development and risk factors pertaining to it. Appropriate information would also have to be made available to parents to allow them to play an active role in judging need. Given the reported value of indirect approaches to intervention there is a case for widening the range of professionals able to promote good interactive practice in parents of young children. Speech and language therapists as a professional group are in a good position to play an active role in disseminating this information and coordinating such services. Children who do not respond to such primary prevention could then be given access to speech and language therapy services and appropriately structured nursery input. Recommendations for research: There are many gaps in the literature, and the review identified a number of research priorities. The impact of speech and language delay needs to be examined, both as an explanatory and a response variable across time in prospective cohort studies. RCTs need to be designed to examine the medium- and long-term effects of well described models of intervention. These should include an appropriate range of outcome measures including, where possible, economic analysis. There is a need for the development of a screening measure that combines data on risk factors with parental report and professional observation, and for the examination of its value in different sections of the population. The predictive ability of different models of early identification and intervention needs to be examined. Further details of conclusions and recommendations are given in the full report.
Evaluation of school attainments in children with congenital hypothyroidism (CH) detected by neonatal screening and treated early in life.
Text comprehension, mathematics, reading, writing and verbal and spatial memory, as indices of school learning, were evaluated in nineteen 5- to 10-year-old children with CH attending nursery or elementary school. l-Thyroxine substitution (starting dose 8-10 microg/kg body weight per day) was initiated at a mean age of 30+/-10 days of life. The control group included 298 unaffected children matched with the CH children for age and school grade. Thirty per cent of controls were classmates of CH children. Intelligence quotients (IQ), language performances and motor development were evaluated in CH children at age 5 years, and were related to their school attainments. School performances of CH children were also compared with their neonatal serum thyroxine (T4) concentration, and with the social-cultural level of the family.
Four out of 19 (21%) children with CH, 3 in the nursery and 1 in the elementary school, displayed a generalized learning disorder. Symbol copy, geometric copy, phrase repetition, dictation writing and spontaneous writing were particularly defective in nursery school CH children, while orthographic error recognition was defective in elementary school CH children. School learning disorders in CH children were significantly correlated with a borderline-low IQ, poor language performances and a low social-cultural level of the family, but not with motor skills or neonatal T4 concentration.
School attainments of early treated CH children were within the normal range in most affected cases. However, about 20% of CH children, most of them attending nursery school, showed a generalized learning disorder. Low IQ scores and poor language performances at age 5 years were associated with defective learning, mainly in CH children living in a poor social-cultural environment. In this subset of CH children, prompt initiation of speech and psychomotor rehabilitation therapy is recommended in order to prevent subsequent school learning disorders.
Screening programs for congenital hypothyroidism (CH) dramatically improved the neuropsychological prognosis in affected children. However, mild impairments in cognitive performances, poorer motor skills, defective language abilities, and learning problems have been reported in some studies of early-treated CH children. The occurrence of these defects makes neuropsychological follow-up mandatory. The aim of the present study was to identify those neuropsychological functions that are more frequently affected in early-treated CH children and that might require prompt rehabilitation treatment to prevent permanent defects. The study group involved 24 CH children. Levothyroxine (LT4) treatment (initial dose 8-10 microg/kg per day) was started at mean age of 28 days (range 15-45) and was then adjusted with the goal to keep thyrotropin (TSH) and free thyroid hormone levels in the normal range. Cognitive evaluation was performed at 3, 5, and 7 years of age and did not significantly differ from that of controls. Mean neurological scores were lower in children 5 years of age than in controls. Children with severe neonatal hypothyroidism (serum thyroxine [T4] < 2 microg/dL) had significantly lower neurological scores compared to less affected CH children and normal controls. The most affected functions were balance, extremity coordination, fine motricity, quality of movements, associated movements, and head movements. Language disorders were observed in half of CH children at 3 and 5 years of age, but moderately severe defects were restricted to those with severe neonatal hypothyroidism. In conclusion, a problem-oriented, simplified neuropsychological follow-up of early-treated children with CH should not systematically include the frequent repetition of time-consuming and expensive psychometric tests because individual IQ scores are in the normal range of tests in almost all CH children and can be differentiated from those of normal controls only on a population-statistic basis. Selected tests of motor proficiency are indicated at 3 and 5 years of age to detect those defects in motor skills that appear to be more specifically affected in CH children. Language performances are at particular risk in CH children, and should be always checked at 3 and 5 years of age. Children with even mild language disorders or delayed language achievements should be regularly reevaluated at 6-month intervals and, if no spontaneous improvement is observed, they should receive specific rehabilitation treatment. No further motor and language evaluation is warranted in CH children with normal tests at age 5 years.
Previous work has suggested that, because writing is a late-acquired and complex skill, it may be a particularly sensitive index of language difficulties in children. Evidence in support of this view was obtained in a study contrasting 161 normally-developing control children aged from 7.5 to 13 years with 75 twin children of the same age who either had specific speech-language impairments, or were co-twins of affected children. Written narratives were elicited from children using a sequence of five photographs depicting a simple story, and were analysed for grammatical complexity and accuracy, intelligibility, and semantic content. Only 42 of the twins could spell well enough to attempt the narrative task. Some co-twins of affected children had deficits in written language, despite normal performance on oral language tests. Most children with language impairments were poor at writing, with particularly marked deficits on a measure of spelling and punctuation. Children with language impairments made a relatively high proportion of phonologically inaccurate spelling errors when compared with younger children at a similar vocabulary level. Those who did poorly on a nonword repetition test were especially likely to have poor written language. However, four children with pure speech difficulties produced age-appropriate written narratives.
The existing literature has conflicting findings about the literacy outcome of children with speech sound disorders (SSD), which may be due to the heterogeneity within SSD. Previous studies have documented that two important dimensions of heterogeneity are the presence of a comorbid language impairment (LI) and the persistence of SSD, but these factors have not been examined separately.
The current study used a 2 x 2 MANOVA design (with follow-up MANCOVAs) to examine how a comorbid language impairment (LI) and the persistence of SSD relate to pre-literacy skills in a sample of 5- to 6-year-old children with SSD.
Significant main effects for persistent SSD and LI were obtained, such that each factor was associated with worse performance on pre-literacy tasks, particularly those assessing phonological awareness (even with nonverbal IQ covaried). In addition, even SSD children with normalized speech without LI were found to have deficits on phonological awareness tasks relative to control participants.
These results suggest that a history of SSD and comorbid LI are strong correlates of pre-literacy deficits.
Fifty-two children identified at age 4 to 6 years as demonstrating a moderate to severe expressive phonology disorder were followed to the third and fourth grades. Children were classified into two groups based on the presence of an early phonology disorder in isolation (P) or the presence of a phonology disorder with other language problems (PL). At follow-up, articulation measures failed to differentiate the groups; however, the PL group performed more poorly than the P group on measures of phoneme awareness, language, reading decoding, reading comprehension, and spelling. The P group demonstrated poor spelling skills relative to their reading and language abilities, suggesting residual spelling weaknesses in these children. The PL group reported more nuclear family members with speech-language disorders and with reading disorders than the P group. Findings support previous research linking early language disorders with later reading difficulties.
In an attempt to delineate causal factors in dyslexia, 113 children and young adults (age‐range eight to 18 years) were divided into three groups: those with brain damage who could read (n = 31), those with brain damage who were dyslexic (n = 53), and those without brain damage who were dyslexic (n = 29). A battery of neuropsychological tests was presented to each participant.
No significant differences were found between the two dyslexic groups. Three syndromes ‐language disorder, articulation and graphomotor dysco‐ordination, and visuo‐perceptual disorder—were found among the great majority of those with dyslexia. The results support a model of dyslexia as being caused by multiple independent defects in higher cortical functioning, as opposed to the theory of a single causal defect. A clinical description of each syndrome is given and models of dyslexia are discussed. The authors stress the desirability of including brain‐damaged readers as a control group in any future study on causal factors in dyslexia.
RÉSUMÉ
Dyslexie chez les enfants et les adolescents: trois syndromes neuropsychologiques indépendants
Dans le but de déterminer les facteurs en cause dans la dyslexie, 113 enfants et adolescents (ágés de 8 à 18 ans) ont été divises en trois groupes: ceux qui pouvaient lire malgré une lésion cérébrale (n = 31), ceux qui présentaient une lésion cérébrale et une dyslexie (n = 53) et ceux qui sans lésion cérébrale avaient une dyslexie (n 29). Une batterie de tests neuropsychologiques ont été proposes a chaque sujet.
Aucune différence significative n'a été trouvée entre les deux groupes dyslexiques. Trois syndromes: troubles du langage, incoordination de l'articulation et de la graphomotricité, et troubles visuo‐perceptif ont été notés chez la grande majorité des dyslexiques. Ces résultats sont en faveur d'une conception de la dyslexie causée par de multiples facteurs indépendants dans le fonctionnement cortical haut et non d'une conception d'une cause unique. Une description clinique de chaque syndrome est donnée et des modèles de dyslexie sont discutés. Les auteurs insistent sur la nécessité d'inclure des lecteurs atteints de troubles cérébraux comme groupe contrôle dans toute étude ultérieure sur les facteurs en cause dans la dyslexie.
ZUSAMMENFASSUNG
Leseschwäche bei Kindern und Heraimachsenden: drei unabhängige neuropsychologische Syndrome
Um die Kausalfaktoren der Dyslexie zu beschreiben, wurden 113 Kinder und Heran‐wachsende (Alter 8–18 Jahre) in der Untersuchung in drei Gruppen geteilt: solche mit Hirnschaden, die aber lesen konnten (n = 31), solche mit Hirnschaden und Dyslexie (n = 53) und solche ohne Hirnschaden mit Dyslexie (n = 29). Jeder Versuchsteilnehmer wurde einer Reihe neuropsychologischer Tests unterzogen.
Zwischen den leseschwachen Gruppen fand sich keine signifikante Differenz. Bei der großen Mehrheit derer mit Dyslexie fanden sich drei Symtome—Sprachstörungen, Artikulations‐ und graphomotorische Dyskoordination und visuell‐perzeptive Störungen. Die Ergebnisse unterstützen eine Modellvorstellung der Dyslexie, die sie durch multiple voneinander unabhängige Defekte höherer corticaler Funktionen verursacht ansieht, im Gegensatz zu der Theorie eines einzelnen kausalen Defekts. Es wird eine klinische Beschreibung eines jeden Syndroms gegeben und Modelle der Dyslexie werden diskutiert. Die Autoren betonen, daß es wünschenswert ist bei jeder weiteren Studie über Kausalfaktoren der Dyslexie Hirngeschädigte, die lesen können, als eine Kontrollgruppe mit einzubeziehen.
RESUMEN
Dislexia en ninos y jóvenes adultos: Tres sindromes neuropsicológicos independientes
En un intento de delinear los factores causales en la dislexia, 113 niños y adultos jóvenes (de edad entre 8 y 18 años) fueron divididos en tres grupos: Unos con lesión cerebral y que podian leer (n = 31), otros con lesión cerebral pero que eran disléxicos (n = 53) y otros sin lesión cerebral y que eran disléxicos (n = 29). A cada participante se le presentó una bateria de tests neuropsicológicos.
No se halló ninguna diferencia significativa entre los dos grupos disléxicos. Tres sindromes (alteración en el lenguaje, discoordinación de la articulacion y grafomotora y alteracion visuo‐perceptiva) fueron hallados en la gran mayoria de los que padecian dislexia. Los resultados apoyan la idea de que la dislexia está causada por mûltiples defectos independientes de las funciones corticales superiores, en oposición a la teoría de un único defecto causal. Se da una descripción clinica de cada sindrome y se discuten los modelos de dislexia. Los autores subrayan el deseo de incluir a los lectores con lesión cerebral como un grupo control en estudios futuros que se hagan sobre los factores causales de la dislexia.
Poor and normal reader performance in oral phonemic synthesis test and in writing and reading tests are compared. Substantial correlation between oral phonemic synthesis test and writing and reading tests suggest that poor readers evidence a specific linguistic disability, even in exclusively oral performance. Poor readers are to be considered as children who are incapable of re-utilizing oral language and of translating it into written language.
Developmental dyslexia may be associated with (i) bi-hemisphere representation of spatial functions, in contrast to the right-hemisphere
specialization observed in normal children, and (ii) typical left-hemisphere representation of linguistic functions, as is
observed in normal children. The bilateral neural involvement in spatial processing may interfere with the left hemisphere's
processing of its own specialized functions and result in deficient linguistic, sequential cognitive processing and in overuse
of the spatial, holistic cognitive mode. This pattern of cognitive deficits and biases may lead dyslexics to read predominantly
with a spatial-holistic cognitive strategy and neglect the phonetic-sequential strategy. Such an approach in learning to read
phonetically coded languages, such as English, many be inefficient and limited.
Using the data from five epidemiological studies of the total child population, the traditional distinction between general reading backwardness (i.e. reading below average for age, regardless of I.Q.) and specific reading retardation (i.e. a disability in reading relative to the child's age and general intellectual level) is put to the test. The concept and measurement of underachievement are discussed and it is shown that severe degrees of specific reading retardation occur at a rate above that predicted on a statistical basis, suggesting a “hump” at the lower end of the distribution. Reading retardation is shown to differ significantly from reading backwardness in terms of sex ratio, neurological disorder, pattern of neuro-developmental deficits and educational prognosis. It is concluded that the concept of specific reading retardation is valid, but evidence is discussed which shows that this does not support the view of a genetically distinct syndrome of dyslexia.