Language assessment of children with severe liver disease in a public service in Brazil.

OBJECTIVE:: The aim of this research was to compare language development (expressive and receptive skills) in children awaiting liver transplantation with that of children who have already undergone the surgical procedure. METHODS:: An observational, descriptive, cross-sectional study was conducted with 76 children divided into groups, as follows: 31 children who were candidates for liver transplantation (Group 1; G1), 45 children who had already undergone liver transplantation (Group 2; G2), and a control group (CG) of 60 healthy, normally developing children. Health status information was gathered, and the Test of Early Language Development (TELD)-3 was used to assess language skills. Family household monthly income data were also gathered using a specific questionnaire. RESULTS:: G1 had poorer language performance compared with G2 and the CG. G2 had lower language performance when compared with the CG. However, when considering the TELD-3 standard scores, G2 had scores within normal limits. The regression analysis indicated age as a risk factor for language deficits in Group 1 and family income as a risk factor for language deficits in G2. CONCLUSIONS:: The results suggested that children with chronic liver disease have delays in language development. Transplanted children have linguistic performance within normal limits, but their scores tended to be lower than the CG.

Language assessment of children with severe liver disease in a public service in Brazil

OBJECTIVE: The aim of this research was to compare language development (expressive and receptive skills) in children awaiting liver transplantation with that of children who have already undergone the surgical procedure. METHODS: An observational, descriptive, cross-sectional study was conducted with 76 children divided into groups, as follows: 31 children who were candidates for liver transplantation (Group 1; G1), 45 children who had already undergone liver transplantation (Group 2; G2), and a control group (CG) of 60 healthy, normally developing children. Health status information was gathered, and the Test of Early Language Development (TELD)-3 was used to assess language skills. Family household monthly income data were also gathered using a specific questionnaire. RESULTS: G1 had poorer language performance compared with G2 and the CG. G2 had lower language performance when compared with the CG. However, when considering the TELD-3 standard scores, G2 had scores within normal limits. The regression analysis indicated age as a risk factor for language deficits in Group 1 and family income as a risk factor for language deficits in G2. CONCLUSIONS: The results suggested that children with chronic liver disease have delays in language development. Transplanted children have linguistic performance within normal limits, but their scores tended to be lower than the CG.

Clinicians' management of young children with co-occurring stuttering and speech sound disorder.

Speech sound disorders reportedly co-occur in young children who stutter at a substantial rate. Despite this, there is a paucity of scientific research available to support a treatment approach when these disorders co-exist. Similarly, little is known about how clinicians are currently working with this caseload given that best practice for the treatment of both disorders in isolation has evolved in recent years. This study used a qualitative approach to explore current clinical management and rationales when working with children who have co-occurring stuttering and speech sound disorder. Thirteen participant SLPs engaged in semi-structured telephone interviews. Interview data were analysed based on principles derived from grounded theory. Several themes were identified including multi-faceted assessment, workplace challenges, weighing-up the evidence, and direct intervention. The core theme, clinical reasoning, highlighted the participants' main concern, that not enough is known about this caseload on which to base decisions about intervention. There was consensus that little is available in the research literature to guide decisions relating to service delivery. These findings highlight the need for further research to provide evidence-based guidelines for clinical practice with this caseload.

Working memory and specific language impairment: an update on the relation and perspectives on assessment and treatment.

PURPOSE: Children with specific language impairment (SLI) demonstrate significant language impairments despite normal-range hearing and nonverbal IQ. Many of these children also show marked deficits in working memory (WM) abilities. However, the theoretical and clinical characterization of the association between WM and language limitations in SLI is still sparse. Our understanding of this association would benefit greatly from an updated and thorough review of the literature. METHOD: We review the newest developments in these areas from both a theoretical and clinical perspective. Our intent is to provide researchers and practicing clinicians (a) a conceptual framework within which the association between WM and language limitations of children with SLI can be understood and (b) potentially helpful suggestions for assessing and treating the memory-language difficulties of children with SLI. CONCLUSIONS: In the past 10 years, important new theoretical insights into the range and nature of WM deficits and relation between these limitations and the language difficulties in SLI have occurred. New, robust diagnostic assessment tools and computerized treatment methods designed to enhance children's WM functioning have also been developed. The assessment, diagnosis, and treatment of the language difficulties in SLI should consider the potential influence of WM.

Verb comprehension and naming in frontotemporal degeneration: the role of the static depiction of actions.

We report the case study of a patient JB with the frontal variant of frontotemporal dementia (fv-FTD), who was disproportionately impaired in naming and comprehending verbs in comparison with nouns. We examined to what extent the patient's verb disproportionate deficit was dependent on the type of stimuli used to assess verb processing, that is, static depictions of actions, videotaped actions, or verbal stimuli. We found that the verb disproportionate deficit JB presented when her naming or comprehension was assessed from static depictions of actions (i.e., photographs) disappeared when naming or comprehension was assessed from videotaped actions or verbal stimuli. These results indicated that JB did not present disproportionate difficulties with verb processing per se (i.e., with retrieving the lexical and semantic features of verbs). Instead, the seemingly disproportionate verb deficit found in JB -- and possibly also in other previously reported patients with executive resource limitation -- was likely due to the picture stimuli used to probe verb versus noun naming and comprehension not being equal in executive resource demands. The finding of this study thus underscores the need of considering carefully the specific effects of task and type of stimuli in the patients' performance with action pictures before making theoretical claims about the noun versus verb or object versus action lexical and semantic representation in the brain.

Training, current practices and resources of a group of South African hospital-based speech-language therapists and audiologists working with patients living with HIV/AIDS.

The present study employed a cross-sectional survey research design to investigate the training, current practices, and resources of a sample of South African hospital-based speech-language therapists and audiologists (SLTs & As) working with persons living with HIV/AIDS. Questionnaires were mailed to 50 SLTs & As working in the major provincial hospitals in Gauteng, Kwa Zulu Natal, Free State and Western Cape, and responses were obtained from 40 therapists. Data from the questionnaire were analyzed using descriptive statistics. The findings indicated that persons with HIV/AIDS were becoming an increasing part of the caseloads of the SLTs & As who were surveyed. Investigation of participants' training, knowledge, skills and confidence in the area of HIV/AIDS suggested that the group of SLTs & As surveyed did not perceive themselves to be adequately equipped to manage persons with HIV/AIDS. These findings highlight the need for improved undergraduate training of SLT & A students in the area of HIV/AIDS; more continuing professional development workshops on HIV/AIDS for qualified practitioners; better access to resources for SLTs & As working in the area; the formulation of a position statement on HIV/AIDS by SASLHA; and further research in this area.

[The Global Deterioration Scale (GDS) and Functional Assessment Staging (FAST) in the diagnosis of Alzheimer type dementia]. / Skale GDS i FAST w rozpoznawaniu otepienia typu Alzheimera.

Described are two scales for the diagnosis of dementia of the Alzheimer type and for identifying its following stages solely on the basis of social functioning and on daily activity level of the patient. The authors of the scale, Resiberg et al. based their findings on the conclusion that dementia of the Alzheimer type is a rare clinical syndrome with a characteristic onset and development which are identical in over 90% of patients. The GDS (Global Deterioration Scale) separates the course of dementia into 6 stages. The FAST (Functional Assessment Scale) separates deterioration into 16 stages. Both scales, especially allow for the systematic tracking of course of the uncomplicated Alzheimer's case. They also show the appearance of any additional somatic and psychopathological factors which cause the state of the patient to appear worst than could result from the current stage the patient is in. They ease the differentiation between dementia of the Alzheimer type and dementia of other aetiology. Apart from these scales, especially the FAST, allow to the estimation with significant accuracy how long the current stage, as well as the whole illness will last in a given patient. Similarly, predictions may be made as to the time and in what order particular life functions will be diminishing in specific patients until the terminal state.

Thought, language, and communication disorders. I. Clinical assessment, definition of terms, and evaluation of their reliability.

Bleulerian psychiatry has considered thought disorder to be a pathognomonic symptom of schizophrenia. Evaluation of the Bleulerian perspective has been severely handicapped by the lack of any standard and widely agreed-on definition of thought disorder. Consequently, the conceptualization of thought disorder has tended to be quite diverse, and evaluation of thought disorder has tended to be quite unreliable. This report presents a set of definitions of linguistic and cognitive behaviors frequently observed in patients. These definitions derive from clinical experience, use an empirical approach, and avoid making inferences about underlying processes of thought. They attempt to define the broad range of language, thought, and communication behaviors observed in patients and are not limited to those considered characteristic of schizophrenia. The reliability of these definitions has been assessed using both tape-recorded and live interviews with patients, and it has been found to be quite good for most of the terms defined.