Lorian Baker’s research while affiliated with Neuropsychiatric Research Institute and other places

This paper reports on the prevalence of affective disorders in a sample of children presenting to a community clinic for speech or language evaluation. It was found that, among 600 children studied, 4% had some type of affective disorder, according to DSM-HJ diagnostic criteria. The children with affective disorders were generally not typical of the children presenting for speech and language evaluation: they tended to be older on the average, to have more psychiatric disorders, and to have more learning disorders than the “typical” child presenting for speech/language evaluation. The relationships between affective disorders, learning disorders, and speech/language disorders are discussed.

This paper compares attention deficit disorder (ADD) with hyperactivity (ADDH) and without hyperactivity (ADDWO). The literature is outlined, revealing the areas of possible differences to be not only the core symptoms, but also associated conduct and emotional symptoms, social relations functioning, learning, medical disorders, family history, and course and outcome of the disorder. Empirical data are presented comparing age and sex matched groups of children from a speech/language clinic sample with ADDH (N = 40) and ADDWO (N = 40). Although the methods of the present study are different from those of previous studies, they nonetheless support a number of previous findings, and, further, give support to the external validity of the ADDWO diagnostic category.

Examined the concurrence of speech/language (SL) disorders in 65 children (aged 6–15.3 yrs) with attention deficit disorder (ADD). 78% had speech articulation impairments; 58% had expressive language impairments; 34% had receptive language impairments; and 69% had language-processing (auditory memory, discrimination, or association) impairments. 40 Ss had concurrent disorders of both speech and language. 11 Ss had pure language disorders and 14 had pure speech disorders. Results suggest that the various subtypes of disorders found in children with ADD may be related to other factors such as age, sex, and psychiatric diagnosis. The assessment of a child with ADD should include assessment of SL functioning. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

This paper discusses the manifestations and correlates of depressive affect disorders in adolescents. It begins with some definitions and a discussion of the concept (from adult psychiatry) of depression and depressive disorders. The clinical picture of depressive disorders in adults is described, and the interrelationship is considered between them and the depressive disorders of adolescents and prepubertal children. Data are discussed regarding the external validity of adolescent depressive disorders (including their familial and biological correlates, their course and treatment outcome). Finally, the relevance of these data is summarized with regard to the process of establishing a diagnosis of a depressive disorder in adolescents.

This article discusses the relationship between attention deficit-hyperactivity disorder (ADHD) and learning disability (LD). The relevant literature is outlined, and empirical data are presented from a prospective follow-up study of 600 speech/language-impaired children. The data show an increased prevalence of both LD and ADHD among children with early speech/language impairments. Furthermore, LD was strongly associated with ADHD in both the initial and follow-up samples. Also, the children with LD had increased rates of other psychiatric disorders (e.g., behavior disorders, mood disorders, anxiety disorders). The implications of these data are discussed with regard to the possible etiology of the ADHD-LD association, treatment for children with LD and ADHD, and promising hypotheses for future research.

Follow-up or natural history outcome data for various DSM-III child and adolescent psychiatric diagnoses are presented. The data are relevant not only to our understanding of the specific disorders but also to the validity of the DSM-III diagnostic categories. "Semi-blind" psychiatric evaluations of 151 children were made as they presented to a community speech/language clinic and again approximately 4 years later. The follow-up data revealed high stability for only three diagnoses: infantile autism, attention deficit disorder with hyperactivity, and oppositional disorder. The data revealed that several of the DSM-III subcategories lacked predictive validity. This was true for the distinctions between attention deficit disorder with versus without hyperactivity; and between avoidant, separation anxiety, and overanxious disorders. Surprisingly low stability was found for conduct disorder diagnoses as were surprisingly poor prognoses for parent-child problems and adjustment disorders.

An interim follow-up study of a group of "higher functioning" boys with infantile autism and control group of boys with severe (receptive) developmental language disorder (or dysphasia) is reported. The boys were compared both initially and at follow-up for overall functioning in the areas of language, peer relationships, stereotyped behaviors, and disruptive public behaviors, as well as for the presence of a number of specific symptoms. In some respects, the behaviors that differentiated the groups initially did so also at follow-up, although there were important differences. Very few of the autistic boys had good language skills at follow-up, whereas nearly half of the dysphasic group were communicating well, a difference that is striking in view of the initial general similarity between the groups in terms of poor language functioning. However, some of the dysphasic children had developed greater difficulties in peer relationships. The implications for concepts of the nature of the deficit in severe receptive developmental language disorders are considered.

Most professionals who work with children acknowledge the existence of a class of disorders of development that are characterized by: (1) the inadequate development of particular skills (involving language and/or academic learning) and (2) the absence of any demonstrable etiology of physical disorder, neurological disorder, global mental retardation, or severe environmental deprivation. This group of disorders has been labeled “minimal brain dysfunction syndrome” by the National Easter Seal Society for Crippled Children and Adults (Clements, 1966a) and the National Institute of Neurological Diseases and Blindness (Clements, 1968b); “special learning disabilities” by the National Advisory Committee on Handicapped Children (1968); “specific learning disabilities” by the National Institute of Neurological Diseases and Stroke (Chalfant & Scheffelin, 1969), the U.S. Office of Education (1977), and the Council for Exceptional Children (U.S. Public Law 94–142; 1975); “developmental disorders” by the World Health Organization (WHO, 1978, 1986); “specific developmental disorders” by the American Psychiatric Association (APA, 1980, 1987); and “learning disabilities” by the National Joint Committee for Learning Disabilities (Hammill, Leigh, McNutt, & Larsen, 1981).

The validity of DSM-III anxiety disorder diagnoses was examined in a sample of languistically-impaired children. Children were divided into three groups based on concurrent psychiatric disorders: (a) anxiety disorder, (b) behavior disorder, (c) no psychiatric disorder. The three groups then were compared for demographic characteristics, developmental factors, Axis II diagnoses, psychosocial stressors, and speech/language variables, as well as treatment history. In addition, diagnoses obtained at a four-year follow-up are presented for children with anxiety disorders, in order to examine the stability of the diagnoses over time. Analysis of differences between the three groups generally support the validity of anxiety disorders as an overall diagnostic class. However, data from the follow-up indicate that specific anxiety disorder diagnoses are not very stable over time. These data suggest that the DSM-III classification of subtypes of anxiety disorders may draw distinctions that are too fine to be of value in predicting outcome.