Dorothy M. Aram

EARLY LEXICAL DEVELOPMENT IN CHILDREN WITH FOCAL BRAIN INJURY

Early lexical development in 27 children with focal brain injury was studied cross-sectionally and longitudinally. Data were obtained from children between 12 and 35 months of age who acquired their lesion prenatally or within the first 6 months of life. Results for the group as a whole provide clear evidence for delays in lexical comprehension and production, and for a larger number of comprehension/production dissociations than would be expected by chance. In addition, a significant number of children were observed having unusual difficulty mastering predication and/or using an atypically high proportion of closed class words (suggesting reliance on holistic/formulaic speech). Analyses by lesion type revealed no effect of lesion size. Analyses according to side of lesion revealed that children with right-hemisphere damage produced a higher proportion of closed class words, suggesting heavy reliance on well-practiced but under-analyzed speech formulae. Children with left-hemisphere damage were slightly better in comprehension than children with right-hemisphere damage. In addition, left posterior lesions were associated with greater delays in expressive language, and delays were more protracted in children with left posterior damage. No differential effects of left posterior damage were found for lexical comprehension.

From first words to grammar in children with focal brain injury

The effects of focal brain injury were investigated in the first stages of language development, during the passage from first words to grammar. Parent report, free‐speech data, or both are reported for 53 infants and preschool children between 10 and 44 months of age. All children had suffered a single, unilateral brain injury to the left or right hemisphere, incurred before 6 months of age (usually in the pre‐ or perinatal period). This is the period in which one would expect to see maximal plasticity, but it is also the period in which the initial specializations of particular cortical regions ought to be most evident. In direct contradiction of hypotheses based on the adult aphasia literature, results from 10 to 17 months suggest that children with right‐hemisphere injuries are at greater risk for delays in word comprehension and in the gestures that normally precede and accompany language onset. Although there were no differences between left‐ and right‐hemisphere injury per se on expressive language...

Developmental Apraxia of Speech: I. Descriptive and Theoretical Perspectives

Developmental apraxia of speech (DAS) is a putative diagnostic category for children whose speech errors presumedly (a) differ from the errors of children with developmental speech delay (SD) and (b) resemble the errors of adults with acquired apraxia of speech. The studies reported in this series (Shriberg, Aram, & Kwiatkowski, 1997a, 1997b) concern both premises, with primary focus on the first--that children with DAS can be differentiated from children with SD on the basis of one or more reliable differences in their speech error profiles. Immediate goals are to identify a diagnostic marker for DAS and to consider implications for research and clinical practice. A long-term goal is to identify the phenotype marker for DAS, on the assumption that it may be a genetically transmitted disorder. This first paper reviews relevant descriptive and theoretical perspectives. Findings from a local ascertainment study support the clinical functionality of the term suspected DAS.

Developmental Apraxia of Speech: II. Toward a Diagnostic Marker

This second paper in a series on developmental apraxia of speech (DAS) (Shriberg, Aram, & Kwiatkowski, 1997a) reports findings from two studies. Study I compares speech and prosody-voice profiles of a group of 14 children with suspected DAS to profiles of 73 children with speech delay (SD). Results suggest that the only linguistic domain that differentiates some children with suspected DAS from those with SD is inappropriate stress. Study II cross-validates these findings, using retrospective data from a sample of 20 children with suspected DAS evaluated in a university phonology clinic over a 10-year period. Discussion considers methodological and conceptual issues in the measurement of linguistic stress. Theoretical issues and implications for research and clinical practice are deferred for synthesis of the present findings with those from a multi-site cross-validation project (Shriberg, Aram, & Kwiatkowski, 1997b).

Intellectual stability in children with unilateral brain lesions

In this paper we report on the longitudinal stability of IQ in 26 children with unilateral left (LL N = 18) or right (RL N = 8) hemisphere damage. Results revealed (i) normal or near normal levels of intellectual performance in both LL and RL groups, and, (ii) hemispheric differences in the level and stability of intellectual performance. RL children achieved lower IQ scores than LL children and were more likely to decrease in VIQ over time. Cross-sectional analyses revealed a tendency for injury sustained earlier (e.g. during the first 5 years of age), rather than later in development to be associated with lower IQ scores.

Reading among children with left and right brain lesions

Twenty left hemisphere lesioned and 10 right hemisphere lesioned children between 6 and 20 years old were administered a battery of tests assessing phonetic analysis and segmentation, single word decoding, reading comprehension, and spelling. Although group mean performance on all tasks was consistently below that of controls matched for age, sex, race, and social class, few differences reached statistical significance. These findings demonstrate that the majority of children with unilateral brain lesions learn to read quite adequately, evidencing considerable functional reorganization of higher cognitive abilities following brain lesions sustained early in life. Yet five left‐ and two right‐lesioned children did present marked reading deficits in contrast to 1 of the 30 control subjects. A family history for reading disorders was implicated in one left lesioned, one right lesioned and the control subject, suggesting the contribution of a genetic basis. Age of lesion onset was not found to be related to r...