Literacy Profile of Children with Language Impairment: Evidence from an Alphasyllabary.

BACKGROUND: Most of the evidence explaining the language-literacy link is derived from children learning to read and write alphabetic orthography. AIM: This study investigated the literacy deficits in children learning to read Kannada, a Dravidian language that employs an alphasyllabary. METHODS: A group of 15 children with language impairment (CwLI) was compared with two groups of control (age- and language-matched) participants on a range of literacy measures. RESULTS: The results showed that, compared to the age-matched group, the CwLI group performed significantly poorer on reading (words and nonwords) and written spelling tasks. However, the performance on akshara (the written symbol in the alphasyllabary) recognition task was comparable between groups. Similarly, comparison of the CwLI group with the language-matched control group revealed poorer performance in the former group on most literacy measures but not the akshara recognition task. Akshara recognition emerged as the most significant predictor of literacy performance in children learning to read and write the Kannada alphasyllabary. Detailed analyses of the written spelling errors unveiled several unique error types in the language-impaired group. CONCLUSION: The findings of our study revealed both orthography-independent and orthography-dependent deficits in the literacy skills of CwLI mastering the Kannada alphasyllabary.

From Aphasia and Allied disorders to Autism Spectrum Disorders - A Mutualistic Symbiotic Relationship. (A Five Decade Long Journey in Neuro-Communication Disorders).

The study of aphasia and the range of allied disorders, that accompany it has provided a rich source of clinical information providing insights in to the complexities of the human brain and how it affects the functioning of the individual, as well as how it influences his experiencing of the world; subsequently verified by more rigorous scientific research. An attempt is made here to document similar clinical insights in to the experiences of children with autism spectrum disorders (ASD), now known to have atypical neuro development; on the basis of clinical observations and self-reports of these children, vetted by the author's long standing experience of working with those with neurogenic communication disorders, both adult and child. As with the aphasias, these clinical documentations and insights could lead to more carefully controlled research, paving the way for better understanding and interventional support for those with ASD.

Expert Group Meeting on Aphasia: A Report.

A multidisciplinary team of experts took stock of the current state of affairs about many aspects of aphasia in India, including community burden, diagnostic assessment, therapy, rehabilitation, research, education, and advocacy. The broad spectrum of aphasiology was matched by the types of participants ranging from neurologists, speech-language pathologists, clinical psychologists, linguists, to experts in neuroimaging and computer sciences. Threadbare discussion in 16 sessions over 3 days leads to the identification of pressing problems and possible solutions. Many action plans have been envisaged and recommendations made. A few examples with high priority are community-based and hospital-based study incidence and prevalence of aphasia, development of test batteries for the assessment of many components of speech and communication in Indian languages which are validated on rigorous psychometric, and linguistic criteria, national registry for aphasia, educational modules about aphasia for different target groups, resources for advocacy and its training, a bank of research questions and outlines of research protocols for young professionals to pursue. The expert group will continue to oversee execution of some of the actionable plans in short and long term.

Specific language impairment in a morphologically complex agglutinative Indian language-Kannada.

Specific Language Impairment (SLI) remains an underinvestigated disorder in morphologically complex agglutinative languages such as Kannada. Currently, only a few case reports are available on SLI in Dravidian languages. The morphological complexity inherent to Dravidian languages such as Kannada provides a potential avenue to verify one of the two prevailing accounts of SLI: the morphological richness theory and CGC (Computational Grammatical Complexity) hypothesis. While the previous theory predicts the relatively spared performance of children with SLI (CwSLI) on syntactic morphology in morphologically complex languages, the latter predicts a diametrically opposite performance. Data from a group of 15 Kannada-speaking CwSLI supported the morphological richness theory, and further revealed five distinct profiles of SLI. The results of this study reflected that CwSLI learning the agglutinative language (Kannada) as compared with language-matched children without SLI, displayed some shared deficits (e.g., in phonological processing on a non-word repetition task) with CwSLI learning English. However, CwSLI learning the morphosyntactically rich language Kannada differed remarkably from English-learning CwSLI by not showing deficits in syntactic morphology relative to language-matched peers (e.g., PNG, verb, tense, case, and pronoun).

Oral motor deficits in speech-impaired children with autism.

Absence of communicative speech in autism has been presumed to reflect a fundamental deficit in the use of language, but at least in a subpopulation may instead stem from motor and oral motor issues. Clinical reports of disparity between receptive vs. expressive speech/language abilities reinforce this hypothesis. Our early-intervention clinic develops skills prerequisite to learning and communication, including sitting, attending, and pointing or reference, in children below 6 years of age. In a cohort of 31 children, gross and fine motor skills and activities of daily living as well as receptive and expressive speech were assessed at intake and after 6 and 10 months of intervention. Oral motor skills were evaluated separately within the first 5 months of the child's enrolment in the intervention programme and again at 10 months of intervention. Assessment used a clinician-rated structured report, normed against samples of 360 (for motor and speech skills) and 90 (for oral motor skills) typically developing children matched for age, cultural environment and socio-economic status. In the full sample, oral and other motor skills correlated with receptive and expressive language both in terms of pre-intervention measures and in terms of learning rates during the intervention. A motor-impaired group comprising a third of the sample was discriminated by an uneven profile of skills with oral motor and expressive language deficits out of proportion to the receptive language deficit. This group learnt language more slowly, and ended intervention lagging in oral motor skills. In individuals incapable of the degree of motor sequencing and timing necessary for speech movements, receptive language may outstrip expressive speech. Our data suggest that autistic motor difficulties could range from more basic skills such as pointing to more refined skills such as articulation, and need to be assessed and addressed across this entire range in each individual.

Impact of early intervention on children with autism spectrum disorders as measured by inclusion and retention in mainstream schools.

OBJECTIVES: To follow up the school/educational status of children with a primary diagnosis of Autism Spectrum Disorders (ASD), who had been enrolled in an Early Intervention (EI) program for 1-3 y, before the age of 6. METHODS: Data was collected through a questionnaire covering three specific areas-the families' success in following the recommendation given on completion of the EI program, issues in schooling and feedback on the EI program. The contact modes included email, post, telephonic interviews and face-to-face interviews. RESULTS: One hundred and two of the 296 children responded to the questionnaire. The responses were analyzed to identify, the number of families who had completed the program and were able to follow through with the recommendation given on completion of the EI program, difficulties faced if any, family feedback on the program and the additional help that they would have liked to receive. The reasons for failure to comply with the recommendations were analyzed. Of the 102 children who responded seven had dropped out midway through the program and 10 had discontinued after one year. Of the remaining 85 who completed the program, 71 were advised mainstreaming (83.5 %) and 14 were advised special school (16.5 %). Sixty-five of the 71 children, who were advised to enroll their child in the mainstream, were in regular school. 76.5 % of the children who completed the EI program were integrated in regular schools, 2 to 7 y after having completed the program. CONCLUSIONS: EI helps in enrolment and retention of substantial numbers of children with ASD in mainstream schools.

Efficacy of communication DEALL--an indigenous early intervention program for children with autism spectrum disorders.

OBJECTIVE: To establish the efficacy of Communication DEALL, an indigenous early intervention program; in the management of children with autism spectrum disorders (ASD). METHODS: ABA design of pre intervention assessment, intervention and post intervention assessment was utilized, across an 8 month period. The first set of measures covered the assessment of developmental skills in the eight areas of gross motor skills, fine motor skills, activities of daily life skills, receptive language, and expressive language, cognitive, social and emotional skills. The second independent measure was the rating of each child on the Childhood Autism Rating Scale. Parental observations and parental estimation of the child's progress were also recorded. The study was conducted in the Com DEALL units in Bangalore, including thirty subjects diagnosed with ASD. Main Outcome Measures were developmental skill gains and decrease in behavioral issues. RESULTS: Statistically significant increase in all eight developmental domains and statistically significant decrease in behavioral symptoms as measured by the CARS, were seen. CONCLUSIONS: Thus, the Communication DEALL program shows promise as an effective early intervention program. It also indicates a need to further enhance the stabilization of the pre linguistic skills such as maintenance of eye contact, attention, sitting tolerance and compliance, in the program.

Four decades of speech-language pathology in India: changing perspectives and challenges of the future.

The paper traces the evolution and current status of speech-language pathology in India in its clinical and training aspects.