No description available.

One of the largest work areas for speech and language pathologists is intervention for children with speech and language disorders. The purpose of the present study was to describe and analyze the clinical management of language impairment in children by studying and comparing medical records and literature from the years 2000 and 2009. The present study is a sequel to two previously published papers by Christina Samuelsson (1997; 1999), in which medical records and literature from the 1920-, 60- and 70’s were studied and a paper by Helén Sämfors (2001), in which the years 1985 and 1995 were studied. The medical records used in the present study came from a medical ward for speech and language pathology at a university hospital in Sweden.   The results showed that significantly more children were referred to the clinic for speech and language problems in 2009 than in 2000, and more children were treated for their impairments. Also, the speech and language pathologists were more detailed when documenting anamnesis, status and therapy, and they devoted more time for investigating the children’s impairments in 2009.  In terms of literature, a development is observable concerning bilingualism, prosody, pragmatics and Swedish research regarding intervention for children with language impairments.

No description available.

It has long been the quest of developmental theorists to understand the mechanisms behind cognitive functioning and the acquisition of language. Studies have identified that there is an interdependent, dialectical relationship between cognitive development and language acquisition. The development of language, in typical populations, is therefore dependent on a baseline cognitive skill, which, once acquired, capacitates the further development of cognition. However, very little is known about this process within atypical populations, particularly those with speech and language impairment. This study examined the relationship between cognitive functioning and early predictive factors in an atypical population of pre-school children with speech and language impairment using three measures of cognitive functioning (as measured by the WPPSI (Wechsler Pre-School and Primary Intelligence Scale), the Griffiths and the JSAIS (Junior South African Individual Scale)) and a range of demographic, diagnostic and early developmental childhood factors. Results identify factors such as parental levels of education, family structure, gender and pregnancy and early childhood health as the main influences of cognitive performance. They also highlight the pervasive influence of speech and language impairment on non-verbal and processing speed abilities. The presence of genetic conditions as well as multiple diagnoses was frequently found to have significant associations with poor cognitive performance. The study also highlighted two things of unexpected interest. The first refers to the role of handedness (particularly undifferentiated handedness) in identifying cognitive difficulty which is related to hemispheric lateralisation, and its relationship to the various diagnostic groups represented within the sample. The second considers the high proportion of diagnostic co-morbidity and the common cognitive profiling patterns across diagnostic categories in abilities outside of the verbal range to highlight potential directions for future research. The implications of these overlaps are considered within existing research on brain laterality, hemispheric dominance and neurological immaturity.

BACKGROUND: Oral communication impairments (OCIs) are a common childhood problem with often long-term negative outcomes for both the child and society. Despite the growing body of knowledge about the epidemiology of this problem, the shift from traditional treatment approaches to population based approaches to management has been slow. One suggested reason for this is a lack of community based population data on such problems with which to plan services more broadly. AIM: The aim of this thesis is to contribute to the population knowledge of children with OCIs by developing and trialing a data collection method at a community level. LITERATURE REVIEW: One of the major issues in understanding OCIs from a population perspective is the disparate and often incongruent nature of epidemiological data reported in the literature. Five areas of epidemiological research were reviewed in order to critically evaluate the existing evidence base and identify gaps for further research. The five areas reviewed were: Prevalence (Regardless of the methodology used to collect prevalence data, OCIs have been described as a common childhood problem), Life Course (Children with OCIs often have ongoing communication problems and are at risk for poorer life outcomes in social, educational and occupational domains), Comorbidities (OCIs rarely occur in isolation and most children will have other developmental or health issues), Risk factors (There is no one easily definable cause of OCIs, however, genetic and environmental factors appear to increase the risk of OCI in the general population), and Service use (Only around half of children with recognised OCIs will access specialist intervention services).The review concluded that local community data measuring the 'burden', or impact, of the problem, comorbidities and service use in children with and without OCIs would assist in service planning. Therefore a methodology would need to be developed which addressed these issues.A further review of the literature considered this methodology development with specific reference to the issues of study design, sampling and identification of OCIs. The review concluded that a cross-sectional survey design of a community sample could provide the necessary data. Parent and teacher report was suggested as a method for identifying OCIs in surveys, however, a tool needed to be developed and trialed to ensure this method was effective, valid and reliable. PILOT STUDY: A survey tool for parents was designed which included the Child Health Questionnaire (PF - 28), questions relating to socio-demographic features, health and development conditions, service use and specifically developed questions regarding OCIs. The survey methodology was trialed in one school and one childcare centre. The results of the study were reviewed and suggestions made for methodological changes before a community trial was carried out. The reliability and validity of the questions designed to identify OCIs was assessed in a number of ways. Test-retest reliability of parent completed questionnaires proved to be good. Interrater reliability was examined by comparing parent and teacher responses. Parents and teachers agreed on identification of OCI in over 75% of cases for each of the OCIs studied. Criterion validity was assessed by comparing parent report to speech pathologist evaluation in a clinical sample and by comparing parent and teacher report to screening assessments of communication skills in a school sample. Both parents and teachers tended to over-identify children, however, when parent and teacher reports were considered together the validity approached that of the 'gold standard'. Construct validity was assessed by comparing reported OCIs with reports of other developmental conditions known to be commonly comorbid with OCIs. Once again using both parent and teacher report proved to be the most valid method of identifying OCIs using the developed tool. COMMUNITY STUDY: A targeted community survey of 3 to 7 year old children was conducted in a regional centre in Queensland, Australia. Children were sampled through schools and childcare centres. Information letters were distributed to the parents of 898 eligible children. Completed questionnaires were received for 397 children. Teachers completed questionnaires on 375 children which was 42% of the population sampled. Parents and teachers identified OCIs in 16% of the children. However, only 3% of the population were rated by parents or teachers as having severe problems. Over 70% of parents and teachers of children with a reported OCI rated the problem as having an impact on the child's life. Ratings of impact were not related to parent/teacher ratings of severity. Children with OCIs were reported to have significantly more health, developmental and behaviour problems than their peers. Children with OCIs were rated lower by their parents on most aspects of the Child Health Questionnaire (PF-28). In particular, parents reported impacts on their own time and family activities due to the child's problems. No significant differences were found between children with and without reported OCIs on any of the socio-demographic variables studied. Children with reported OCIs used more health and educational services than their peers. Around 60% of children with reported OCIs had seen a speech pathologist, but many parents had also sought advice from a range of other health and educational professionals. Those with two or more OCI conditions were more likely to have seen a professional, however socio-demographic variables did not generally predict service use. Parents reported that the type of service they chose was most commonly influenced by advice from a doctor or teacher. The limitations of this methodology for collecting this type of data are discussed. However despite these limitations data were collected which has major implications for the provision of population based services for children with OCI. CONCLUSION: This thesis has contributed to the understanding of children with OCIs by researching the development of a methodology to study this problem in a defined community sample. The information gained from the literature review and the community study were considered within two models of service provision. The models encompass service delivery from individualised to more population based approaches to the management of OCIs in children. From these models, specific suggestions for the community involved in the study were discussed. This thesis, therefore, provided a survey methodology that is resource efficient in the collection of community data useful in suggesting improved services for children with oral communication impairments.