Parent based language intervention for 2-year-old children with specific expressive language delay: a randomised controlled trial.

OBJECTIVE: The aim of this randomised controlled trial was to evaluate the effectiveness of a short, highly structured parent based language intervention group programme for 2-year-old children with specific expressive language delay (SELD, without deficits in receptive language). METHODS: 61 children with SELD (mean age 24.7 months, SD 0.9) were selected between October 2003 and February 2006 during routine developmental check-ups in general paediatric practices, using a German parent-report screening questionnaire (adapted from the MacArthur Communicative Development Inventories). Standardised instruments were used to assess the language and non-verbal cognitive abilities of these children and of 36 other children with normal language development (reference group; mean age 24.6 months, SD 0.8). 58 children with SELD were sequentially randomly assigned to an intervention group (n = 29) or a 12-month waiting group (n = 29). In the intervention group, mothers participated in the 3-month Heidelberg Parent-based Language Intervention (HPLI). All children were reassessed 6 and 12 months after pretest. Assessors were blind to allocation and previous results. RESULTS: 47 children were included in the analysis. At the age of 3 years, 75% of the children in the intervention group showed normal expressive language abilities in contrast to 44% in the waiting group. Only 8% of the children in the intervention group versus 26% in the waiting group met the criteria for specific language impairment (t score < or =35). CONCLUSIONS: By applying the short, highly structured HPLI in children with SELD, the rate of treatment for language impairment at the age of 3 years can be significantly reduced.

[CA-50 in serum of patients with carcinoma. Clinical experiences with a new tumor marker]. / CA-50 im Serum von Karzinom-Patienten. Klinische Erfahrungen mit einem neuen Tumormarker.

Quantitative radioimmunological demonstration of carbohydrate antigen CA-50 in serum achieved a sensitivity of 62.3% for colorectal carcinoma (n = 53), of 64.7% for gastric carcinoma (n = 34), of 33.9% for lung carcinoma (n = 56), and 19.8% for lymphoproliferative diseases (n = 91). The positive results for the latter probably correspond to the immunohistological demonstration of the antigen in dendritic reticulum cells. Occasionally an increased CA-50 level in inflammatory disease presents difficulties in differential diagnosis, but it returns to normal when the inflammatory process has subsided. Methodological scatter of the CA-50 system is satisfactory, with a coefficient of variation of +/- 11%, but unsatisfactory at low values (less than or equal to 10 U/ml) and high ones (greater than or equal to 50 U/ml) with a coefficient of variation of +/- 19%. Further development with the IMRA technique may significantly reduce methodological scatter (coefficient of variation +/- 5%).