Annika Dahlgren Sandberg

Reading and spelling, phonological awareness, and working memory in children with severe speech impairments: A longitudinal study

A longitudinal study of reading and spelling abilities was conducted with seven school-aged children with severe speech impairments (SSIs) and normal intelligence. Their reading and spelling abilities were tested on two occasions: prior to starting school and after attending school for 3 to 4 years. The aim of the study was to follow the childrens development of reading and spelling abilities and to examine more closely their phonological awareness and memory capacities, both visual and auditory, in order to identify the reasons for their documented difficulties in literacy acquisition. The childrens memory capacities were judged to be of special importance in view of their difficulties in rehearsing subvocally and creating and maintaining a sound image. Over time, the children made some progress in reading. However, after 3 to 4 years of formal education, they still performed at very low levels on all literacy indicators—despite good phonological abilities—compared to a group of normally developing children with natural speech who were matched by sex, chronological age, and mental age. An analysis of the spelling errors of the children with SSIs indicated that they did not use their phonological abilities efficiently while spelling. The results are discussed in relation to problems of rehearsal in working memory.

Phonologic awareness and literacy abilities in nonspeaking preschool children with cerebral palsy

Eight nonspeaking and eight nondisabled preschool children, 5 to 7 years of age, were studied with respect to phonologic abilities and literacy competence. The groups were matched for age and intellectual level. Both groups performed comparably on tests of phonologic awareness. The comparison group, however, scored higher than the disability group on the reading and writing tests, despite equal performance on phonologic tests. This difference between the groups fits with previous findings. On the other hand, it has been shown repeatedly among children without disabilities that phonologic awareness is highly predictive of literacy skills. This did not seem to hold for the nonspeaking children in this study. Explanations of the results were suggested including perceptual/cognitive limitations and limited interaction possibilities with the environment, resulting in limited acquaintance with print in a broad sense.

The non-specificity of theory of mind deficits: Evidence from children with communicative disabilities

The aim of the present paper was to investigate the performance on theory of mind tasks of four different clinical groups: children with deficits in attention, motor control and perception (DAMP), children with autism, children with Asperger syndrome, and non-vocal cerebral-palsied children. The children with DAMP performed on the same level as the comparison group on the first and second order theory of mind task. The children with autism and Asperger syndrome performed somewhat lower than the children with DAMP and the comparison group. However, in respect of the specifcity issue, only 6 out of 14 of the non-vocal participants successfully solved the first order theory of mind task, while 13 out of 14 children in a comparison group did. The children were matched for chronological age and IQ. The findings suggest that deficits in theory of mind are not specific to the autistic continuum, but can be found in other groups with communicative disabilities, implying that linguistic and communicative skills are important precursors in the development of theory of mind. The study also shows that severe dysfunction in attention, motor control, and perception is not associated with any theory of mind difficulties.

Language and literacy in nonvocal children with cerebral palsy

Metalinguistic and literacy abilities were studied in twenty-seven nonvocal cerebral palsied school children. The participants of the study were presented four tests of phonological awareness: rhyme recognition, sound identification, phoneme synthesis and word length analysis. Their verbal comprehension was measured using a semantic and a syntactic task. Two tests of nonverbal memory: the visual sequential task from ITPA and Corsi blocks and the Digit Span task from WISC, were also included. These measures were related to their reading and spelling ability. The nonvocal children performed on a lower level on the reading and spelling tasks than did the children of two comparison groups, one matched for mental age and one for mental and chronological age. There were no differences in phonological awareness or in verbal memory. The disabled children performed worse on the verbal comprehension task than the children in the comparison groups. Although the reading and spelling results were low in the nonvocal group there were children showing some literacy skills. A within-group analysis performed in the nonvocal group showed that the reading children performed better on all memory tests, and on the sound identification and the word length analysis tasks than the nonreading ones. They also showed better results on verbal comprehension, the semantic task and used more symbols in their communication. Synthetic speech was more often used in reading and spelling education in the reading subgroup than in the nonreading. Metalinguistic abilities and possibility of acoustic rehearsal are discussed as important factors in reading and spelling acquisition in the nonvocal population.

Reading and spelling abilities in children with severe speech impairments and cerebral palsy at 6, 9, and 12 years of age in relation to cognitive development: a longitudinal study

Development of literacy skills was studied in six children (one male, five females) with severe speech impairments and cerebral palsy (CP). These skills were related to intellectual development, phonological abilities, and short‐term memory. Three of the children were diagnosed with dystonia, and three with diplegia. They had no, or severely restricted, independent mobility (Gross Motor Function Classification System Level IV for four children and Level V for two), and severe fine motor problems, including difficulty with pointing. As they had no intelligible speech, the Bliss system was the primary communication mode. Assessments were made at approximately 6, 9, and 12 years of age. The results revealed that the children had difficulties acquiring literacy skills, although intellectual level and phonological ability predicted otherwise. Positive development during the first 3 years was followed by an arrest. A conspicuous decrease in IQ points was also found. Thus, phonological ability does not seem to have the same predictive power for literacy development in children with severe speech impairments and CP as in typically developing children. Further studies are needed to clarify the role of phonological abilities, working memory, and strategies used in literacy acquisition in these children. Such studies might also clarify the importance of articulatory abilities in early literacy acquisition.

The Rett Syndrome Complex: Communicative Functions in Relation to Developmental Level and Autistic Features

Communicative functions and their relationship with overall developmental level and autistic features were studied in eight young women with disorders in the Rett syndrome complex, three with the classical variant and five with variants with partially preserved/regained speech. The Vineland Adaptive Behaviour Scales, individual structured observation, and a specially designed structured interview covering early pre-linguistic and linguistic development, current receptive and expressive language and non-verbal communication skills, were used. Autistic features were evaluated in accordance with the DSM-IV. Low levels of communicative abilities and overall functioning were demonstrated. In most cases, the communicative abilities did not reach the level expected on the basis of overall development. Joint attention behaviours and expressions of communicative intent were rare. However, six of the eight subjects showed clear examples of social interaction abilities.‘Eye pointing’, as distinct from ‘eye communication’, was demonstrated only in a minority of the cases. The level of communicative function at developmental arrest did not predict later language ability. It is suggested that intervention should focus on developing further the joint attention behaviours, intentional communications and communicative functions spontaneously used by individuals with disorders in the Rett syndrome complex.

Children with Autistic Spectrum Disorders and Speech-Generating Devices: Communication in Different Activities at Home.

The communication of four children with autistic spectrum disorder was investigated when they were supplied with a speech‐generating device (SGD) in three different activities in their home environment: mealtime, story reading and “sharing experiences of the preschool day”. An activity based communication analysis, in which collective and individual background factors for the activities were outlined, was used as a basis for the discussion of linguistic coding data derived from video‐recordings made before and during SGD intervention. The coded communicative behaviours were engagement in activity, role in turn‐taking, communicative form, function and effectiveness. An increase in communicative effectiveness was more noticeable when the SGDs could be used to fulfil goals and roles within the activity. The instruction to the parents to use the SGDs in their communication with the child had an important influence on the activities.

Referential communication in children with autism spectrum disorder

Referential communication was studied in children with autism spectrum disorder (ASD) including children with autism and Asperger syndrome. The aim was to study alternative explanations for the childrens communicative problems in such situations. Factors studied were theory of mind, IQ, verbal ability and memory. The main results demonstrated diminished performance in children with autism spectrum disorder, mirroring performance in everyday life, in comparison to verbal IQ and mental age matched typically developing children. Among children with autism spectrum disorders, there was a positive relationship between performance in referential communication and theory of mind. Memory capacity also proved to play a role in success in the task.

Theory of mind in children with severe speech and physical impairment (SSPI): a longitudinal study

Six children with cerebral palsy and severe speech impairment took part in a two‐phase longitudinal study of development of social cognition. The children ranged in age from 5 to 7 years old at data collection time 1 and from nine to 11 years old at data collection time 2. Using a model of normal development of Theory of Mind (ToM) suggested by Gopnik and Slaughter (1991), the children were tested on a number of tasks requiring (ToM). The findings suggest that the children with speech impairment follow a normal pattern of development, but with a severe delay compared with children without disability. The results are discussed in relation to problems in early social and communicative experience for the group of children with cerebral palsy and severe speech impairment.

A comparative, descriptive study of reading and writing skills among non‐speaking children: a preliminary study

For many non-speaking. Bliss-using persons with cerebral palsy (CP), literacy skills seem hard to achieve, although their cognitive functioning and verbal reception skills would predict good reading and writing. The aim of this study was to describe literacy skills in relation to intellectual level and to level of phonological awareness, which are both considered important predictors of literacy in the speaking population. Seven disabled adolescents participated in the study. In a comparison group there were seven children matched for results on a non-verbal intelligence test and a test of phonological awareness. The subjects in the disability group performed on a lower level on reading and spelling variables than the subjects in the comparison group. The results also indicated that the spelling skills of the subjects in the disability group were more developed than their reading skills, and that spelling of words represented by photographs of well-known objects, presented visually only, seemed more difficult than spelling of words presented orally. A tentative explanation of these latter two results was proposed, namely that the phonological awareness of the subjects facilitated spelling, but that access to phonological and orthographic representation of visually presented material might be more difficult than orally presented material for non-speaking persons. The differences between the two groups also suggested that the subjects in the disabled group seemed to have difficulty in benefiting from formal literacy skills training at school.