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Evaluation of screening for speech/language and non-speech language

Lopend onderzoek in het kader van de onderzoekslijn Kind, Taal & Ontwikkeling. Deze onderzoekslijn maakt deel uit van het Lectoraat Transparante Zorgverleningen en het Lectoraat Integraal Jeugdbeleid. Language problems have impact on school succes (Beichtman et al., 1996, Nelson et al., 2006), behavior (Coster et al., 1999), and quality of life (Van Agt, 2011). Also the comorbidity with other developmental disorders like dyslexia, ADHD and ASS is high (Gerrits, 2011). Psychological wellbeing depends on the interaction with others (Steenbeek & Geert, 2007), in which speech and language are important tools. Identification of children at risk for speech and language delays and related problems may lead to appropriate follow-up and interventions at a young age, when chances for improvement are best (Nelson, 2006). Therefore, it is of great importance to monitor the speech and language development and its consequences during early childhood. In the Netherlands, several protocols exist to detect children with speech and language delay and to guide them to appropriate care. Though, the balance between health benefits, costs, scope and adverse results of these protocols are not evaluated. In 2009, the RIVM and the NCJ formulated a practice based guideline for the screening of children with speech and language delays in Child Health Care (CHC). This position statement is based on consensus in the field. The goal of this study is to collect evidence for the scientific underpinnings of the current practice-based guidelines of the NCJ. We want to evaluate the improvements of speech and language outcomes as well as non speech and language outcomes a year after CHC-screening 2-year-old children.

Overall intelligibility, articulation, resonance, voice and language in a child with Nager syndrome.

OBJECTIVE: The purpose of this study was to provide a description of the language and speech (intelligibility, voice, resonance, articulation) in a 7-year-old Dutch speaking boy with Nager syndrome. To reveal these features comparison was made with an age and gender related child with a similar palatal or hearing problem. METHODS: Language was tested with an age appropriate language test namely the Dutch version of the Clinical Evaluation of Language Fundamentals. Regarding articulation a phonetic inventory, phonetic analysis and phonological process analysis was performed. A nominal scale with four categories was used to judge the overall speech intelligibility. A voice and resonance assessment included a videolaryngostroboscopy, a perceptual evaluation, acoustic analysis and nasometry. RESULTS: The most striking communication problems in this child were expressive and receptive language delay, moderately impaired speech intelligibility, the presence of phonetic and phonological disorders, resonance disorders and a high-pitched voice. The explanation for this pattern of communication is not completely straightforward. The language and the phonological impairment, only present in the child with the Nager syndrome, are not part of a more general developmental delay. The resonance disorders can be related to the cleft palate, but were not present in the child with the isolated cleft palate. One might assume that the cul-de-sac resonance and the much decreased mandibular movement and the restricted tongue lifting are caused by the restricted jaw mobility and micrognathia. To what extent the suggested mandibular distraction osteogenesis in early childhood allows increased mandibular movement and better speech outcome with increased oral resonance is subject for further research. CONCLUSION: According to the results of this study the speech and language management must be focused on receptive and expressive language skills and linguistic conceptualization, correct phonetic placement and the modification of hypernasality and nasal emission.

“So, I told him to look for friends!” Barriers and protecting factors that may facilitate inclusion for children with Language Disorder in everyday social settings: Cross-cultural qualitative interviews with parents

Purpose Although researchers have explored parental perspectives on childhood speech and language disorders, this work has mostly been conducted in English-speaking countries. Little is known about parental experiences across countries. Participation in the COST Action IS1406 ‘Enhancing children’s oral language skills across Europe and beyond’ provided an opportunity to conduct cross-cultural qualitative interviews. The aims were to explore how parents construe inclusion and/or exclusion of their child and how parents involve themselves in order to facilitate inclusion. Method Parents from nine countries and with a child who had received services for speech-language disorder participated in semi-structured qualitative interviews. We used thematic analysis to analyze the data. Results Two overarching themes were identified: ‘Language disabilities led to social exclusion’ and ‘Promoting pathways to social inclusion’. Two subthemes were identified Interpersonal relationships are important and Deliberate proactiveness as stepping stones for social inclusion. Conclusions Across countries, parents report that their children’s hidden disability causes misunderstandings that can lead to social exclusion and that they are important advocates for their children. It is important that the voices and experiences of parents of children with developmental disabilities are understood and acknowledged. Parents’ recommendations about how to support social inclusion need to be addressed at all levels of society.

Measurement of speech parameters in casual speech of dementia patients

From the article: "Individuals with dementia often experience a decline in their ability to use language. Language problems have been reported in individuals with dementia caused by Alzheimer’s disease, Parkinson’s disease or degeneration of the fronto-temporal area. Acoustic properties are relatively easy to measure with software, which promises a cost-effective way to analyze larger discourses. We study the usefulness of acoustic features to distinguish the speech of German-speaking controls and patients with dementia caused by (a) Alzheimer’s disease, (b) Parkinson’s disease or (c) PPA/FTD. Previous studies have shown that each of these types affects speech parameters such as prosody, voice quality and fluency (Schulz 2002; Ma, Whitehill, and Cheung 2010; Rusz et al. 2016; Kato et al. 2013; Peintner et al. 2008). Prior work on the characteristics of the speech of individuals with dementia is usually based on samples from clinical tests, such as the Western Aphasia Battery or the Wechsler Logical Memory task. Spontaneous day-to-day speech may be different, because participants may show less of their vocal abilities in casual speech than in specifically designed test scenarios. It is unclear to what extent the previously reported speech characteristics are still detectable in casual conversations by software. The research question in this study is: how useful for classification are acoustic properties measured in spontaneous speech."

Cluttering identified: differential diagnostics between cluttering, stuttering and speech impairment related to learning difficulties

An adolescent confronted with cluttering

Purpose: This case study is presented to inform the reader of potential speech, language, cognitive, and emotional characteristics in preadolescent cluttering. Method: This case study describes a 10-year-old boy who started to clutter during preadolescence. The case illustrates that, in some adolescents, cluttering can co-occur with temporary stuttering-like behavior. In this case, signs of disturbances in speech-language production associated with behavioral impulsiveness as a young child were noted. Speech, language, cognitive, and emotional results of the case are reported in detail. Results: The changes in fluency development are reported and discussed within the context of changes in the adolescent brain as well as adolescent cognitive and emotional development. While being unaware of their speech condition before adolescence, during preadolescence, the changes in brain organization lead to an increase in rate and a decrease in speech control. Given that the client had limited understanding of what was occurring, they were at risk of developing negative communication attitudes. Speech-language therapists are strongly advised to monitor children with cluttering signals in the early years of their adolescence.