Speech Defects in Children Aged 7 Years: A National Study

A series of screening procedures applied on a national scale by doctors, teachers, and health visitors showed that between 10% and 13% of British 7-year-old children born in one week in 1958 were reported as having an appreciable degree of speech impairment. Between 1% and 2% had a marked speech defect though hearing normally. This latter group of speech-defective children were more often male and of poor family background, and more were born towards the end of a long family. They were often at a disadvantage educationally and had more clumsiness and defects of vision and visuomotor co-ordination than the rest of the sample. The methods used for screening provided a reliable guide in the selection of children who require further investigation.     

Uvular transposition: a new method of cleft palate repair

This prospective study was done to determine whether a new cleft palate repair utilizing uvular transposition improved speech outcome as measured objectively by a speech pathologist. In the uvular transposition procedure, the palate was lengthened with tissue from the uvula by a double-opposing Z-plasty; an intravelar veloplasty was performed, and two-thirds of the mass of the uvula was transposed to the nasal surface of the soft palate. This procedure facilitates velopharyngeal closure by significantly lengthening the palate, anatomically reconstructing the muscles of the palate, and decreasing the palatal excursion necessary to achieve closure. Sixty-two children with a cleft palate were treated with this procedure performed by the senior surgeon between the years of 1988 and 1995. These children were then enrolled in cleft lip and palate clinic at age 2 to 3 years and blindly evaluated yearly by a single speech pathologist who specialized in pediatric speech pathology. Postoperative clinical follow-up ranged from 36 to 112 months (mean, 56.8 months). Perceptual nasal emission was found to be normal in 59 of the 62 patients (95 percent). Nasometry was performed in all 62 of these patients, and the mean score was 15.7 percent, well within the accepted normal range of 25 or less at our institution. Only two of these children (3 percent) required a pharyngeal flap for velopharyngeal insufficiency. These findings suggest that the uvula transposition cleft palate repair may result in good normalization of speech with negligible rates of velopharyngeal insufficiency.     

血清胱抑素C、血肌酐及血尿素氮对窒息新生儿肾功能损害的临床意义

目的:探讨体外反搏联合言语训练治疗脑性瘫痪并语言发育迟缓儿童的临床疗效。方法:选择2015年12月至2017年12月在上海市儿童医院康复科普通门诊确诊的脑瘫并语言发育迟缓患儿52例,按照随机数字表法将其随机分为治疗组和对照组,每组26例。对照组仅给予言语训练治疗,治疗组给予体外反搏联合言语训练治,以4周1个疗程,两组均治疗3个疗程。治疗前后,采用中国康复研究中心汉语版儿童语言发育评定法s-s法、Gesell发育评分法评价和比较患儿言语发育商和认知发育商的变化。结果:治疗后,两组言语发育商和认知发育商均显著高于治疗前,且治疗组言语发育商和认知发育商均显著高于对照组,差异均有统计学意义(均P0.01)。结论:体外反搏联合言语训练较单纯言语训练可更有效改善脑瘫并语言发育迟缓患儿的言语发育和认知发育。     

Some etiologic factors of speech comprehension disturbances

Disturbances of speech comprehension were analyzed in a prospective study of 97 children, aged from 23 to 77 months. Pregnancy, birth and early psychomotor development were normal for all the children and no focus of neurological deficit was found. A tonal audiometer did not detect any auditory disturbances, and psychological testing with non-verbal tests showed normal mental functioning for the age. In this group of selected subjects, family and personal case histories were taken. In addition, a detailed neurological physical examination, standard EEG and auditory evoked potentials, and a psychiatric examination were performed during several appointments. The results showed that disturbances in speech comprehension were more frequent in boys, and that in 13.4% of cases it was caused by pervasive developmental disturbances and in 41.24% of cases by external stimulating factors of speech development (pedagogy, social and emotional stimulation and growing up in a multilingual community). The study emphasizes the importance of non-verbal methods for the study of speech and the use of auditory evoked potentials.     

Childhood Psychosis or Mental Retardation: A Diagnostic Dilemma: I. Psychiatric and Psychological Aspects

A relatively large percentage of children seen at a mental retardation clinic demonstrated psychotic symptoms. The entire group with psychotic manifestations, 62 in all, were reviewed in order to clarify the diagnosis of childhood psychosis or mental retardation. The 1961 British criteria for childhood psychosis were used and are advocated by the authors. Childhood psychosis was the primary diagnosis in 38 cases, and psychosis secondary to brain damage in 24 cases. Onset of the condition under the age of three years and a poor prognosis for social recovery were characteristic of the entire group.Obvious emotional disorder was present in 21 mothers and 14 fathers. There was a continuum in terms of number of psychotic symptoms, level of intelligence and presence of organic signs. It is concluded that there is an overlap between the entities of childhood psychosis and mental retardation.     

THE CHILD WHO DOES NOT TALK

The majority of normal children will have developed some speech by the age of two years. Significant delay in speech development may be the result of (1) deafness, (2) mental retardation, (3) faulty innervation of the speech organs, (4) aphasia, (5) autism, (6) a family trait, (7) hospitalism, (8) parental neurosis, or (9) some combination of these factors. Each nonspeaking child needs an individually planned study for precise diagnosis and recommendation for treatment.     

Auditory-motor learning during speech production in 9-11-year-old children

Background

Hearing ability is essential for normal speech development, however the precise mechanisms linking auditory input and the improvement of speaking ability remain poorly understood. Auditory feedback during speech production is believed to play a critical role by providing the nervous system with information about speech outcomes that is used to learn and subsequently fine-tune speech motor output. Surprisingly, few studies have directly investigated such auditory-motor learning in the speech production of typically developing children.

Methodology/Principal Findings

In the present study, we manipulated auditory feedback during speech production in a group of 9–11-year old children, as well as in adults. Following a period of speech practice under conditions of altered auditory feedback, compensatory changes in speech production and perception were examined. Consistent with prior studies, the adults exhibited compensatory changes in both their speech motor output and their perceptual representations of speech sound categories. The children exhibited compensatory changes in the motor domain, with a change in speech output that was similar in magnitude to that of the adults, however the children showed no reliable compensatory effect on their perceptual representations.

Conclusions

The results indicate that 9–11-year-old children, whose speech motor and perceptual abilities are still not fully developed, are nonetheless capable of auditory-feedback-based sensorimotor adaptation, supporting a role for such learning processes in speech motor development. Auditory feedback may play a more limited role, however, in the fine-tuning of children''s perceptual representations of speech sound categories.     

Male facial attractiveness,perceived personality,and child-directed speech

This study investigated associations between men's facial attractiveness, perceived personality, attitudes towards children, and the quality of their child-directed (CD) speech. Sixty-three males were photographed and completed a brief questionnaire concerning their family background and attitudes towards children. They then performed a task in which they gave directions to (imaginary) adults and children. Analyses of the acoustic properties of speech produced under each condition were performed in order to determine the extent to which individual men changed their speech to accommodate a child listener (i.e., exhibited CD speech). The men's faces were rated by 59 female participants, who assessed perceived prosociality, masculinity, health, and short- and long-term attractiveness. Although women's ratings of attractiveness and prosociality were related to men's self-reported liking for children, they were negatively correlated to men's use of CD speech (i.e., less attractive men used more features of CD speech when addressing an imaginary child). These findings are discussed in the context of halo effects and strategic pluralism in male mating behaviors.     

Role of the Right- and Left-Hemispheric Structures in Speech and Memory Formation in Children

The role of structures of the left and right cerebral hemispheres in formation of speech function and memory was studied on the basis of complex examination of children with developmental speech disorders. On the basis of EEG estimation of the functional state of the brain, children were classified in two groups depending on the side of localization of changes in electrical activity: those with local changes in electrical activity in the left hemisphere (group I) and those with changes in the right hemisphere (group II). The medical history suggested that the observed features of topography of local changes in electrical activity were linked with the character of prenatal and labor complications and their consequences leading to embryo- and ontogenetic disorders in development of different brain regions. Comparison of the results of neuropsychological examination of the two groups showed that different regions of the brain cortex of both the left and right hemispheres are involved in speech formation. However, a specific role of the right hemisphere in formation and actualization of automatic speech series was revealed. It was suggested that the integrity of gnostic functions of the right hemisphere and, primarily, the spatial organization of perception and movements is a necessary factor of development of auditory–speech and nominative memory.     

Speech movements do not scale by orofacial structure size.

The potential role of a size-scaling principle in orofacial movements for speech was examined by using between-group (adults vs. 5-yr-old children) as well as within-group correlational analyses. Movements of the lower lip and jaw were recorded during speech production, and anthropometric measures of orofacial structures were made. Adult women produced speech movements of equal amplitude and velocity to those of adult men. The children produced speech movement amplitudes equal to those of adults, but they had significantly lower peak velocities of orofacial movement. Thus we found no evidence supporting a size-scaling principle for orofacial speech movements. Young children have a relatively large-amplitude, low-velocity movement strategy for speech production compared with young adults. This strategy may reflect the need for more time to plan speech movement sequences and an increased reliance on sensory feedback as young children develop speech motor control processes.     

Arcuate fasciculus abnormalities and their relationship with psychotic symptoms in schizophrenia

Disruption of fronto-temporal connections involving the arcuate fasciculus (AF) may underlie language processing anomalies and psychotic features such as auditory hallucinations in schizophrenia. No study to date has specifically investigated abnormalities of white matter integrity at particular loci along the AF as well as its regional lateralization in schizophrenia. We examined white matter changes (fractional anisotropy (FA), axial diffusivity (AD), asymmetry indices) along the whole extent of the AF and their relationship with psychotic symptoms in 32 males with schizophrenia and 44 healthy males. Large deformation diffeomorphic metric mapping and Fiber Assignment Continuous Tracking were employed to characterize FA and AD along the geometric curve of the AF. Our results showed that patients with schizophrenia had lower FA in the frontal aspects of the left AF compared with healthy controls. Greater left FA and AD lateralization in the temporal segment of AF were associated with more severe positive psychotic symptoms such as delusions and hallucinations in patients with schizophrenia. Disruption of white matter integrity of the left frontal AF and accentuation of normal left greater than right asymmetry of FA/AD in the temporal AF further support the notion of aberrant fronto-temporal connectivity in schizophrenia. AF pathology can affect corollary discharge of neural signals from frontal speech/motor initiation areas to suppress activity of auditory cortex that may influence psychotic phenomena such as auditory hallucinations and facilitate elaboration of delusional content.     

Novel Evidence That Attributing Affectively Salient Signal to Random Noise Is Associated with Psychosis

We wished to replicate evidence that an experimental paradigm of speech illusions is associated with psychotic experiences. Fifty-four patients with a first episode of psychosis (FEP) and 150 healthy subjects were examined in an experimental paradigm assessing the presence of speech illusion in neutral white noise. Socio-demographic, cognitive function and family history data were collected. The Positive and Negative Syndrome Scale (PANSS) was administered in the patient group and the Structured Interview for Schizotypy-Revised (SIS-R), and the Community Assessment of Psychic Experiences (CAPE) in the control group. Patients had a much higher rate of speech illusions (33.3% versus 8.7%, OR_adjusted: 5.1, 95% CI: 2.3–11.5), which was only partly explained by differences in IQ (OR_adjusted: 3.4, 95% CI: 1.4–8.3). Differences were particularly marked for signals in random noise that were perceived as affectively salient (OR_adjusted: 9.7, 95% CI: 1.8–53.9). Speech illusion tended to be associated with positive symptoms in patients (OR_adjusted: 3.3, 95% CI: 0.9–11.6), particularly affectively salient illusions (OR_adjusted: 8.3, 95% CI: 0.7–100.3). In controls, speech illusions were not associated with positive schizotypy (OR_adjusted: 1.1, 95% CI: 0.3–3.4) or self-reported psychotic experiences (OR_adjusted: 1.4, 95% CI: 0.4–4.6). Experimental paradigms indexing the tendency to detect affectively salient signals in noise may be used to identify liability to psychosis.     

Hormones and handedness

BACKGROUND: The Wessex Growth Study has monitored the growth and psychological development of short normal (SN) and average height control subjects since they entered school in 1985/1986. During psychometric testing, we found that 25% SN compared to 9% control subjects wrote with their left hand. The short group also attained significantly lower scores on measures of IQ and attainment and displayed less internalisation of control. Laterality, however, is thought to be influenced by the intrauterine environment and has been associated with pubertal delay. At recruitment, short children had a relatively low birth weight, delayed bone age and were more likely than controls to be short for family. OBJECTIVES: To determine if birth conditions were associated with lateral preference and whether laterality could account for the differences found during the psychometric assessment or predict pubertal timing of SN children. METHODS: Subjects were classified as right- (RH) or left-handed (LH) according to the writing hand and the data were investigated examining the effect of handedness and stature. RESULTS: RH and LH SN children were no more likely to suffer birth complications than those of average height. Psychometric testing did not reveal any significant differences between RH and LH SN children and their patterns of growth appeared to be similar. However, both RH and LH SN children scored less well on tests of cognitive ability and analyses of covariance revealed significant gender/handedness effects for both the timing of puberty and final height. CONCLUSIONS: The increase in left-handedness among SN children did not appear to be related to adverse birth conditions, but it may be that the hormones responsible for growth and development also play some part in brain laterality and cognitive development.     

Schizophrenia and cognitive function

Schizophrenia is often associated with cognitive deficits, particularly within the domains of memory and language. Specific cognitive deficits have recently been linked to psychotic phenomena, including verbal hallucinations and disorganized speech. Impairments of working and semantic memory are primarily due to dysfunction of the frontal cortex, temporal cortex, and hippocampus. Cognitive skills in schizophrenia predict social functioning and may serve as outcome measures in the development of effective treatment strategies.     

Auditory-motor mapping training as an intervention to facilitate speech output in non-verbal children with autism: a proof of concept study

Although up to 25% of children with autism are non-verbal, there are very few interventions that can reliably produce significant improvements in speech output. Recently, a novel intervention called Auditory-Motor Mapping Training (AMMT) has been developed, which aims to promote speech production directly by training the association between sounds and articulatory actions using intonation and bimanual motor activities. AMMT capitalizes on the inherent musical strengths of children with autism, and offers activities that they intrinsically enjoy. It also engages and potentially stimulates a network of brain regions that may be dysfunctional in autism. Here, we report an initial efficacy study to provide 'proof of concept' for AMMT. Six non-verbal children with autism participated. Prior to treatment, the children had no intelligible words. They each received 40 individual sessions of AMMT 5 times per week, over an 8-week period. Probe assessments were conducted periodically during baseline, therapy, and follow-up sessions. After therapy, all children showed significant improvements in their ability to articulate words and phrases, with generalization to items that were not practiced during therapy sessions. Because these children had no or minimal vocal output prior to treatment, the acquisition of speech sounds and word approximations through AMMT represents a critical step in expressive language development in children with autism.     

Why Movement Is Captured by Music,but Less by Speech: Role of Temporal Regularity

Music has a pervasive tendency to rhythmically engage our body. In contrast, synchronization with speech is rare. Music’s superiority over speech in driving movement probably results from isochrony of musical beats, as opposed to irregular speech stresses. Moreover, the presence of regular patterns of embedded periodicities (i.e., meter) may be critical in making music particularly conducive to movement. We investigated these possibilities by asking participants to synchronize with isochronous auditory stimuli (target), while music and speech distractors were presented at one of various phase relationships with respect to the target. In Exp. 1, familiar musical excerpts and fragments of children poetry were used as distractors. The stimuli were manipulated in terms of beat/stress isochrony and average pitch to achieve maximum comparability. In Exp. 2, the distractors were well-known songs performed with lyrics, on a reiterated syllable, and spoken lyrics, all having the same meter. Music perturbed synchronization with the target stimuli more than speech fragments. However, music superiority over speech disappeared when distractors shared isochrony and the same meter. Music’s peculiar and regular temporal structure is likely to be the main factor fostering tight coupling between sound and movement.     

Cost and complexity: selection for speech and language

The handicap principle has been applied to a number of different traits in the last three decades, but it is difficult to characterize its record, or even its perceived relevance, when it comes to an important human attribute—spoken language. In some cases, assumptions regarding the energetic cost of speech, and the veracity of linguistically encoded messages, have failed to recognize critical aspects of human development, cognition, and social ecology. In other cases, the fact that speech contains honest (physiological) information, and tends to be used honestly with family and friends, has been overlooked. Speech and language are functionally related but they involve different resources. Individuals can increase the attractiveness of their speech, and of more stylized vocal and verbal performances, without enhancing linguistic structure or content; and they can modify their use of language without significant changes in the physical form of speech. That its production costs are normally low enables speech to be produced extravagantly in bids for status and mating relationships, and in evolution, may have allowed its content—linguistic knowledge and structure—to become complex.     

Family mealtimes: A contextual approach to understanding childhood obesity

There has been a growing interest in the role that shared family mealtimes may play in promoting the health and well-being of children. Families that regularly eat their main meal together four or more times a week are more likely to have children who do better in school, are of average weight, less likely to use drugs and alcohol at an early age, and consume more fruits and vegetables. The mere fact that families eat together does not address the process by which shared family mealtimes may protect children from unhealthy weight gain. Just as there is no simple explanation for the rising rates of obesity, the link between shared family mealtimes and childhood obesity is a complex one including socioeconomic and cultural context. In this paper, we provide an overview of how shared family mealtimes are embedded in a socio-cultural context that may either support or derail healthy eating patterns for children and youth. Evidence from an observational study of 200 family mealtimes demonstrates the complex interplay between socio-economic factors, family mealtime behaviors, and child obesity status. Families who had a child of healthy weight spent more time engaged with each other during the meal, expressed more positive communication, and considered mealtimes more important and meaningful than families who had a child who was overweight or obese. Using a cumulative risk model, it was found that the combination of family level and neighborhood risk factors predicted child overweight status. Recommendations are made for future research directions and policies directed toward families living in diverse economic circumstances.     

Childhood antecedents of schizophrenia and affective illness: social adjustment at ages 7 and 11.

OBJECTIVE--To investigate the social adjustment in childhood of people who as adults have psychiatric disorders. DESIGN--Subjects in a prospectively followed up cohort (the national child development study) who had been admitted as adults to psychiatric hospitals were compared with the rest of the cohort on ratings of social behaviour made by teachers at the ages of 7 and 11 years. SUBJECTS--40 adult patients with schizophrenic illnesses, 35 with affective psychoses, and 79 with neurotic illness who had been admitted for psychiatric reasons by the age of 28. 1914 randomly selected members of the cohort who had never been admitted for psychiatric treatment. MAIN OUTCOME MEASURES--Overall scores and scores for overreaction (externalising behaviour) and underreaction (internalising behaviour) with the Bristol social adjustment guide at ages 7 and 11. RESULTS--At the age of 7 children who developed schizophrenia were rated by their teachers as manifesting more social maladjustment than controls (overall score 4.3 (SD 2.4) v 3.1 (2.0); P < 0.01). This was more apparent in the boys (5 (2.6)) than the girls (3.4 (1.8)) and related to overreactive rather than underreactive behaviour. At both ages prepsychotic (affective) children differed little from normal controls. By the age of 11 preneurotic children, particularly the girls, had an increased rating of maladjustment (including overreactions and underreactions). CONCLUSION--Abnormalities of social adjustment are detectable in childhood in some people who develop psychotic illness. Sex and the rate of development of different components of the capacity for social interaction are important determinants of the risk of psychosis and other psychiatric disorders in adulthood.