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Diagnóstico diferencial precoz entre el trastorno del lenguaje y el retraso del lenguaje a partir de los procesos de simplificación fonológica

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Abstract

El principal objetivo de este trabajo es identificar los errores fonológicos que permiten una diferenciación precoz entre el trastorno del lenguaje (TL) y el retraso del lenguaje (RL). La muestra está formada por 20 niños que pertenecen a cuatro grupos diferentes: 5 niños con TL, 5 con RL, 5 controles de edad y 5 controles de LMEp. Se identificaron los procesos de simplificación fonológica en estos grupos y se usaron como variables en la realización de un análisis discriminante por pasos. Los resultados mostraron que la variable que tenía mayor capacidad para discriminar entre el grupo TL y los otros grupos (RL, controles de edad y controles de LMEp) fue la omisión de sílabas átonas y la variable que distinguía mejor entre los grupos TL, RL y controles de LMEp respecto a los controles de edad fue la omisión de consonantes en posición codal. Sin embargo, este análisis discriminante no pudo reclasificar a los sujetos en cuatro grupos (70 %) porque todas las variables identificadas tenían un valor bajo para discriminar entre los sujetos con RL y el grupo de controles de LMEp. Con la intención de comprobar la hipótesis de que los niños con RL y los controles de LMEp presentan un perfil de procesos fonológicos similar, se llevó a cabo otro análisis discriminante pero predefiniendo sólo tres grupos (TL [5 niños], RL + controles de LMEp [10 niños] y controles de edad [5 niños]). Los resultados de este análisis mostraron que, identificando las mismas variables (omisión de sílabas átonas y omisión de codas), ahora se reclasificaban el 90 % de los sujetos. Estos resultados parecen indicar que los niños con RL y controles de LMEp están adquiriendo la fonología de manera similar, mientras que los niños con TL no siguen el mismo curso. Estos resultados son explicados a partir de la hipótesis de Superficie de L. Leonard

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... 35, n", junio 2004, pp. 177-202 ganización fonológica; se explicm'an asi 10s resultados de Aguilar (2002), quien relaciona 10s procesos que afectan a la posición de coda con aspectos madurativos que no permiten discriminar la naturaleza de las alteraciones fonológicas. ...
... En este sentido, la validez del análisis de 10s procesos fonológicos y de la evaluación logopédica que del mismo resulte dependerá de que las pruebas correspondientes sean capaces de captar la complejidad de 10s mecanismos implicados en las alteraciones fonológicas. Procedimientos exhaustivos como el que han desarrollado Aguilar y Serra (2003) y estudios que permitan explicar 10s procesos fonológicos en relación con el desarrollo normal y alterado, e interpretar la relación entre la presencia de determinados procesos y el curso de la adquisición fonológica, como el de Aguilar (2002) o el que aquí presentamos, pueden contribuir a entender mejor la naturaleza de 10s problemas. En muchos casos de alteración, la naturaleza de 10s procesos es idéntica a la que se observa en el desarrollo normal (Chin y Dinnsen, 1992;Diez-Itza et al., 2001b, 2003bMartinez, Miranda y Diez-Itza, 2001) De hecho, 10s procesos fonológicos incorporan en su propia concepción original 10s principios explicativos de 10s cambios fonemáticos y fonotácticos. ...
... La principal novedad de esta prueba es la inserción de tres niveles de análisis, un análisis a nivel segmental, un análisis a nivel silábico y un tercero a nivel de palabra, que lo convirtieron en la primera prueba en español en incorporar un enfoque no lineal. La prueba está sólidamente fundamentada en proyectos de investigación del desarrollo del lenguaje típico y en poblaciones clínicas (Aguilar-Mediavilla, 2002;Aguilar-Mediavilla et al., 2002;Bosch y Serra, 1997;Sanz-Torrent et al., 2001;Serrat, 1997;Serra et al., 2000). ...
... Con el doble objetivo de esclarecer estos puntos e intentar diagnosticar el TEL de manera precoz con el fin de realizar intervenciones tempranas, llevamos a cabo una investigación longitudinal (Aguilar, 2002;Serra, Aguilar, y Sanz, 2002;Sanz, 2002). En este proyecto longitudinal de comparación entre Desarrollo normal, Retraso del Lenguaje y Trastorno Específico del Lenguaje nos planteamos preguntas acerca de las semejanzas y, los marcadores diferenciales entre el RL y el TEL para las distintas edades: 3, 4 y 5 años. ...
... Complementarily, the sentence repetition task has been shown as a SLI linguistic marker: a research by Hincapié-Henao et al. (2008) has replicated with Spanish-speaking children similar results obtained by Botting and Conti-Ramsden (2003) and Conti-Ramsden and Botting (2001) by with English-speaking children. Within a limitation in general processing capacity, it has been pointed to justify the "surface hypothesis" ( Leonard, 1998) a delay in segmental element acquisition and syllabic omissions in spontaneous speech ( Aguilar-Mediavilla, 2002). In addition, syllabic omissions have been demonstrated in Spanish-Catalan bilingual children with SLI ( Aguilar-Mediavilla, Sanz-Torrent, & Serra-Raventós, 2007). ...
Article
Background: The diagnosis of Specific Language Impairment (SLI) is very complex, given the variety of clinical pictures described in this disorder. Knowledge about the linguistic markers of SLI can facilitate its differentiation from the normal profile of language development. These markers can also be used as tools that may improve diagnostic. Aims: To determine which psycholinguistic markers best discriminate Spanish-speaking children with SLI from children with typical language development. Method and procedure: The performance of 31 Spanish-speaking children with SLI was analysed using a battery of 13 psycholinguistic tasks organized into two areas: phonology and morphosyntax. The performance of the SLI group was compared to that of two subgroups of controls: aged matched (CA) and linguistically matched (CL). Outcomes and results: The data show that the SLI group performed worse than the CA subgroup on all 13 verbal tasks. However, the performance of the SLI group did not significantly differ from that of the CL subgroup on most (11/13) of the tasks. Stepwise discriminant analysis established the canonical function of three tasks (morphologic integration, sentence understanding and diadochokinesis) which significantly discriminated SLI from CA, with sensitivity 84% and specificity 90%. Conclusions and implications: These results contribute to determining the psycholinguistic and clinical characteristics of SLI in Spanish-speaking children and provide some methods for screening assessment.
... en Vihman et al. 2013. En español existe una gran abundancia de investigaciones sobre el proceso de desarrollo fonológico, tanto en desarrollo típico (Albalá, Marrero y Cappelli, 1996;Bosch, 2003;Díez-Itza y Martínez, 2004), como en retraso del habla (Acosta y Ramos, 1998;Aguilar, 2002;Aguilar y Serra, 2003;Pérez y Serra, 1998). Sin embargo, estos trabajos se han dirigido principalmente a describir el desarrollo fonológico en términos de hitos de adquisición, y no tanto al estudio de mecanismos de aprendizaje y de procesamiento, ni a su relación con otras áreas del desarrollo (como el léxico). ...
... En este sentido, la validez del análisis de los procesos fonológicos y de la evaluación logopédica que del mismo resulte dependerá de que las pruebas correspondientes sean capaces de captar la complejidad de los mecanismos implicados en las alteraciones fonológicas. Procedimientos exhaustivos como el que han desarrollado Aguilar y Serra 34 (2003) y estudios que permitan explicar los procesos fonológicos en relación con el desarrollo normal y alterado e interpretar la relación entre la presencia de determinados procesos y el curso de la adquisición fonológica, como el de Aguilar (2002) o el que aquí presentamos, pueden contribuir a entender mejor la naturaleza de los problemas. En muchos casos de alteración, la naturaleza de los procesos es idéntica a la que se observa en el desarrollo normal (Diez-Itza et al., 2001b, 2003bChin y Dinnsen, 1992;Martínez, Miranda y Diez-Itza, 2001). ...
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Research on child phonology tends to adopt formal models from linguistics, and to concentrate on the early stages. The present study is an attempt to establish the later stages in the development of phonology, and to explain them from a psychological and pragmatic perspective based on the paradigm of phonological processes. We considered both phonematic and phonotactic processes, but we focused on consonant cluster reduction as the process that is most representative of late phonology. Spontaneous speech samples were recorded from 240 Spanish-speaking children (120 girls/120 boys) divided into six age groups ranging from 3;0 to 5;11 years. We obtained a large corpus of errors and codified them in terms of the corresponding processes. The results show a significant age-related decrease in the frequency of the processes. Three stages can be observed in the acquisition of phonology during the period studied: expansion, stabilization and resolution. Age four is a decisive milestone in the acquisition of phonology, as previous research in several languages has repeatedly pointed out. Our data strongly support universal trends in the acquisition of phonology, although it is accomplished through different individual paths. Analysis of the mechanisms underlying phonological processes provides a tentative explanation of phonological development in the context of emergent knowledge. Implications for articulation versus knowledge based intervention in speech disorders are also discussed.
... Con el doble objetivo de esclarecer estos puntos e intentar diagnosticar el TEL de manera precoz con el fin de realizar intervenciones tempranas, llevamos a cabo una investigación longitudinal (Aguilar, 2002;Serra, Aguilar, y Sanz, 2002;Sanz, 2002). En este proyecto longitudinal de comparación entre Desarrollo normal, Retraso del Lenguaje y Trastorno Específico del Lenguaje nos planteamos preguntas acerca de las semejanzas y, los marcadores diferenciales entre el RL y el TEL para las distintas edades: 3, 4 y 5 años. ...
... Esta coocurrencia es mucho más compleja que la mostrada inicialmente por diferentes estudios, pues Stothard, Snowling, Bishop, Chipchase y Kaplan (1998)Scarborough, 1990) y que los problemas de lenguaje oral (y escrito) pueden volver a emerger en niños que ya habían superado sus problemas. Diferentes estudios ponen de manifiesto diferencias considerables respecto al grado de afectación del lenguaje oral y describen diversas diferencias entre las categorías diagnósticas de retraso del lenguaje y de trastorno específico del lenguaje (TEL) (Aguilar, 2002; Leonard, 1998; Stothard, Snowling, Bishop, Chipchase y Kaplan, 1998). En la figura 1 vemos de forma clara el transcurso del desarrollo en la adquisición del lenguaje (extraído y adaptado de Leonard, 1998) que presentan tanto los niños con desarrollo típico de lenguaje, los que presentan retraso del lenguaje, los niños con TEL y los hablantes tardíos o late-talkers. ...
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This study explores how the delay in oral language development and specific language impairment affects the reading development in 11-year-old children. For this reason, we assessed the reading of eight 11 years-old children that all of them had initially been diagnosed as language delay (at 3 years-old) and at 5 years-old were classified according to their level of language, between children with language delay (4 children) and children with specific language impairment (4 children). These children were applied two tests to analyze reader profile. The results indicate no differences between the groups, but both groups (children with a history of SLI as with LD) show difficulties in reading processes: seven of the eight (87.5%) children studied, have a level below their expected level in relation their age. In addition, the SLI group presents, in all cases, significant challenges both processes in lexical and semantic and syntactic processes involved in the reading process.
... Con el doble objetivo de esclarecer estos puntos e intentar diagnosticar el TEL de manera precoz con el fin de realizar intervenciones tempranas, llevamos a cabo una investigación longitudinal (Aguilar, 2002;Serra, Aguilar, y Sanz, 2002;Sanz, 2002). En este proyecto longitudinal de comparación entre Desarrollo normal, Retraso del Lenguaje y Trastorno Específico del Lenguaje nos planteamos preguntas acerca de las semejanzas y, los marcadores diferenciales entre el RL y el TEL para las distintas edades: 3, 4 y 5 años. ...
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El objetivo de este trabajo es analizar las diferencias que desde un punto de vista clínico tienen los conceptos de Retraso de Lenguaje (RL) y Trastorno Específico del Lenguaje (TEL). Para tal fin se seleccionó una muestra de 6 sujetos con RL y otros 6 con TEL, a través del uso de instrumentos tanto estandarizados como en forma de tareas. Mientras que los niños con RL no recibieron tratamiento alguno, los TEL fueron sometidos a un programa de intervención que perseguía, por un lado, favorecer el desarrollo de la comprensión y la producción lingüística, y, por otro, estimular el progreso de habilidades básicas para la iniciación a la lectura, especialmente el desarrollo narrativo y el procesamiento fonológico. Los contenidos del programa se han secuenciado en orden creciente de complejidad cognitiva. Con el fin de comprobar las semejanzas o diferencias de los sujetos en su desarrollo lingüístico, atendiendo a su grupo de pertenencia, se utilizó la U de Mann-Whitney. Los resultados obtenidos muestran diferencias estadísticamente significativas entre ambos grupos. Así, se destaca una evolución siempre favorable de los sujetos con RL, sin que sean sometidos a intervención alguna, todo lo contrario de lo que ocurre con los niños con TEL. En consecuencia nuestros datos apuntan a que no tiene porqué haber un recorrido desde el RL hasta el TEL, tratándose de categorías diagnósticas diferenciadas
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Children with specific language impairment (SLI) often show more limited use of grammatical morphology than younger, normally developing children matched according to mean length of utterance (MLU). However, within groups of children with SLI, individual differences are seen in grammatical morpheme use. In this study, we examined the role of weak syllable use in explaining some of these differences. Employing two different languages – English and Italian - children with SLI were placed into pairs. The children in each pair showed similar MLUs; however, one member of the pair showed a greater use of particular function words. In each of the pairs examined in both languages, the children with the greater use of function words also showed a greater use of weak syllables that did not immediately follow strong syllables. The weak syllable productions of children showing a more limited use of function words in each pair seemed to be dependent on a strong syllable-weak syllable production sequence. This sequence appeared to be operative across several prosodic levels, as defined within the framework of prosodic phonology. Because weak syllables that follow strong syllables usually have longer durations than those that precede strong syllables, the findings might have a perceptual basis. However, the results raise the possibility that limitations in prosody can restrict the degree of grammatical morpheme use by children with SLI.
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This paper provides a characterization of the phonological system of a family of specifically language-impaired (SLI) individuals. Morphological and syntactic data from these same subjects have previously been presented in Gopnik and Crago (1991) and Guilfoyle (1991). Data were collected from eight subjects, all family members, ranging from 7 to 46 years of age. Language samples were obtained at two sessions, 17 months apart, and analysed according to a revised version of the phonological assessment procedures outlined in Ingram (1981, 1989). Results indicated that these SLI subjects acquired the phonological inventory of English following the normal developmental sequence, but at an extremely delayed rate. In contrast, these subjects never achieved adult competency in reproducing the complex syllable patterns of English, as evidenced by the fact that consonants in syllable-final position and clusters were particularly susceptible to deletion or substitution errors. It is argued that these data are consistent with a linguistically based account of this impairment, which is manifested in the phonological component by the inability to construct learned, language-specific rules.
Article
Various aspects of the phonological behavior of three normal-speaking and three language disordered children, matched on the basis of mean utterance length, sex, and cognitive development, were compared. The children's spontaneous speech was analyzed to reveal selection constraints inferred from characteristics of the adult form of the words attempted by the child, production constraints inferred from characteristics of the children's productions, phonological processes, and five dimensions of phonological variability. While some individual variation was noted, no substantial group differences were revealed. The phonologies of the normal-speaking and language disordered children were strikingly similar. The implications of these similarities are discussed in terms of a synergistic view of linguistic disorders and remediation.
Article
A speech processing algorithm was developed to create more salient versions of the rapidly changing elements in the acoustic waveform of speech that have been shown to be deficiently processed by language-learning impaired (LLI) children. LLI children received extensive daily training, over a 4-week period, with listening exercises in which all speech was translated into this synthetic form. They also received daily training with computer “games” designed to adaptively drive improvements in temporal processing thresholds. Significant improvements in speech discrimination and language comprehension abilities were demonstrated in two independent groups of LLI children.
Análisis fonético-fonoló-gico en el retraso de adquisición del lenguaje: estudio de un caso. Póster presentado en el II Encuentro Internacional sobre Adquisición de las Lenguas del Estado. Barcelona, 2-4 de septiembre de 1998. Baddeley A. Memoria humana: teoría y práctica
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