Elisabeth L. Hill

Non-specific nature of specific language impairment: a review of the literature with regard to concomitant motor impairments

In the light of emerging suggestions that language and motor deficits may co-occur, the literature on specific language impairment (SLI) was reviewed to investigate the prevalence of co-morbidity between SLI and poor limb motor skill in children diagnosed with language impairments. An extensive literature search was undertaken and the subsequent findings evaluated with particular reference to issues surrounding symptom co-occurrence, as well as to theoretical and aetiological accounts of SLI. Clearly substantial co-morbidity exists between SLI and poor motor skill, suggesting that SLI is not a specific disorder of language, but rather that children with SLI experience a broader range of difficulties, of which motor incoordination is one. Current theoretical explanations of SLI do not account fully for such wide-ranging difficulties and it may be useful in the future to focus on a more detailed explanation in terms of shared cognitive processes or neuromaturational delay to understand further the nature of the disorder, to explain it theoretically and to deal with it practically.

Brief Report: Cognitive Processing of Own Emotions in Individuals with Autistic Spectrum Disorder and in Their Relatives

Difficulties in the cognitive processing of emotions—including difficulties identifying and describing feelings—are assumed to be an integral part of autism. We studied such difficulties via self-report in 27 high-functioning adults with autistic spectrum disorders, their biological relatives (n = 49), and normal adult controls (n = 35), using the 20-item Toronto Alexithymia Scale and the Beck Depression Inventory. The individuals with autism spectrum disorders were significantly more impaired in their emotion processing and were more depressed than those in the control and relative groups.

A dyspraxic deficit in specific language impairment and developmental coordination disorder? Evidence from hand and arm movements

The extent to which children with either specific language impairment (SLI) or developmental coordination disorder (DCD) could be considered dyspraxic was examined using three tasks involving either familiar, or unfamiliar actions. SLI is diagnosed in children who fail to develop language in the normal fashion for no apparent reason, while the DCD diagnosis is applied to a child who experiences problems with movement in the absence of other difficulties. Seventy‐two children aged between 5 and 13 years participated, falling into one of four groups: (1) children with specific language impairment (SLI), (2) children with developmental coordination disorder (DCD), (3) age‐matched control children, and (4) younger control children. The performance of the clinical groups resembled that of younger normally developing children. Children with SLI, DCD, and the younger controls showed significant difficulty on the task requiring the production of familiar, but not unfamiliar postures. The deficit observed in the SLI group is particularly striking because it was seen both in those with and those without recognized motor difficulties.

Representational gestures in developmental coordination disorder and specific language impairment: Error types and the reliability of ratings

Gesture production was studied in children with developmental coordination disorder (DCD) and specific language impairment (SLI) in comparison to normally developing age-matched and younger control children. The pattern of error production was investigated to characterize the praxis skills seen in these two developmental disorders as well as to inform understanding of the aetiology of both DCD and SLI. Given the subjective nature of the categorization of errors, a separate study was conducted to investigate inter-rater reliability. Independent adult raters consistently used four out of fourteen error-types and for these four, inter-rater reliability was found to be good. The type of errors made by children with DCD, SLI and the younger controls were very similar. The only difference between the groups was in the frequency with which errors were displayed, suggesting that the performance of the clinical children might be an indicator of immature praxis development. It is suggested that the inclusion of a younger control (similar to a “motor match”) group is an important methodological device for investigating the underlying nature of disorders such as DCD and SLI. PsycINFO classification: 3250; 3270

Impairments on "open-ended" executive function tests in autism

The executive function (EF) theory of autism has received much support recently from a growing number of studies. However, executive impairments have not always been easy to identify consistently and so novel “ecologically valid” tests have been designed which tap into real‐life scenarios that are relevant to and representative of everyday behavior. One characteristic of many of these tasks is that they present the participant with an “ill‐structured” or “open‐ended” situation. Here, we investigated the possibility that tasks with greater degrees of open‐endedness might prove more sensitive to detecting executive impairment in autism. Forty‐five children with autism spectrum disorder (ASD) were compared to 27 age‐ and IQ‐matched control children on a range of cognitive tests of EF. Group differences were found on half of the tasks, with the greatest degree of impairment detected on the more open‐ended tasks. The ASD group also performed more poorly on a simple control condition of a task. Detailed consideration of task performance suggested that the ASD group tended to create fewer spontaneous strategies and exhibit more idiosyncratic behavior, which particularly disadvantaged them on the more open‐ended tasks. These kinds of behaviors have been reported in studies of neurological patients with frontal lobe involvement, prima facie suggesting a link between the scientific fields. However, we suggest that this behavior might equally result from a poor understanding of the implicit demands made by the experimenter in open‐ended test situations, due to the socio‐communicative difficulties of these children.

A Reaching Test Reveals Weak Hand Preference in Specific Language Impairment and Developmental Co-ordination Disorder

A reaching test for quantifying hand preference (QHP task) was given to 7- to 11- year-old children with specific language impairment (SLI) or developmental coordination disorder (DCD). The performance of these clinical children was compared to both an age-matched and younger control group. The four groups did not differ in terms of preferred writing hand or preference on a handedness questionnaire. The QHP measure discriminated the clinical and younger control groups from the age-matched controls, but not from each other. Right-handed children with SLI, DCD, and the younger controls reached predominantly with the right hand to spatial positions located to the right of their bodys midline and with the left hand to positions situated to its left. Right-handers in the age-matched control group showed a significantly greater tendency to use their right hand to reach to all spatial positions. The increased tendency of the children with SLI to use the non-preferred hand was particularly striking because it was seen both in those with and without recognised motor difficulties. The QHP task appears to be a sensitive, but non-specific, indicator of developmental disorders.

An investigation of the impact of regular use of the Wii Fit to improve motor and psychosocial outcomes in children with movement difficulties: a pilot study

BACKGROUND Children with Developmental Co-ordination Disorder (DCD) experience poor motor and psychosocial outcomes. Interventions are often limited within the healthcare system, and little is known about how technology might be used within schools or homes to promote the motor skills and/or psychosocial development of these children. This study aimed to evaluate whether short, regular school-based sessions of movement experience using a commercially available home video game console (Nintendos Wii Fit) would lead to benefits in both motor and psychosocial domains in children with DCD. METHODS A randomized crossover controlled trial of children with movement difficulties/DCD was conducted. Children were randomly assigned to an intervention (n = 10) or comparison (n = 8) group. The intervention group spent 10 min thrice weekly for 1 month using Wii Fit during the lunch break, while the comparison group took part in their regular Jump Ahead programme. Pre- and post-intervention assessments considered motor proficiency, self-perceived ability and satisfaction and parental assessment of emotional and behavioural problems. RESULTS Significant gains were seen in motor proficiency, the childs perception of his/her motor ability and reported emotional well-being for many, but not all children. CONCLUSIONS This study provides preliminary evidence to support the use of the Wii Fit within therapeutic programmes for children with movement difficulties. This simple, popular intervention represents a plausible method to support childrens motor and psychosocial development. It is not possible from our data to say which children are most likely to benefit from such a programme and particularly what the dose and duration should be. Further research is required to inform across these and other questions regarding the implementation of virtual reality technologies in therapeutic services for children with movement difficulties.

Anxiety profiles in children with and without developmental coordination disorder.

Previous work has highlighted that children diagnosed with DCD may be at risk of greater problems related to emotional wellbeing. However, to date much work has relied on population based samples, and anxiety has not been examined within a group of children given a clinical diagnosis of DCD. Additionally, the profile of individual differences has generally not been considered within this group. Therefore, a group of parents (n=27) completed the parent version of the Spence Childrens Anxiety Scale (SCAS-P; Spence, 1998) in relation to their children with a diagnosis of DCD. Their responses on this measure were compared to those of parents with typically developing (TD) children (n=35; both groups 6-15 years of age). Children diagnosed with DCD were reported to experience significantly greater levels of anxiety overall, as well as having significantly greater difficulty than the TD group in the domains of panic/agoraphobic anxiety, social phobia, and obsessive compulsive anxiety. In addition, the individual profiles of types of anxiety reportedly experienced varied widely across the DCD group. These findings suggest that anxiety is a major problem for a proportion of children diagnosed with DCD, and raises questions regarding intervention, long term outcomes, and the nature of the disorder itself.

`Hath charms to soothe . . .': An exploratory study of how high-functioning adults with ASD experience music

Semi-structured interviews were conducted with 12 high-functioning adults on the autism spectrum, in order to examine the nature of their personal experiences of music. Consistent with the literature on typically developing peoples engagement with music, the analysis showed that most participants exploit music for a wide range of purposes in the cognitive, emotional and social domains, including mood management, personal development and social inclusion. However, in contrast to typically developing people, the ASD groups descriptions of mood states reflected a greater reliance on internally focused (arousal) rather than externally focused (emotive) language.

Experiences of autism diagnosis: A survey of over 1000 parents in the United Kingdom:

A sample of 1047 parents completed an online survey about their experiences and opinions regarding the process of attaining a diagnosis of autism spectrum disorder for their children. The results revealed that parents usually waited a year from when they first had concerns about their child’s development before they sought professional help. On average, there was a delay of around 3.5 years from the point at which parents first approached a health professional with their concerns to the confirmation of an autism spectrum disorder diagnosis. Just over half of the parents surveyed were dissatisfied with the diagnostic process as a whole. Several factors predicted parents’ overall levels of satisfaction with the diagnostic process, including the time taken to receive a diagnosis, satisfaction with the information provided at diagnosis, the manner of the diagnosing professional, the stress associated with the diagnostic process and satisfaction with post-diagnostic support. Post-diagnosis, the support (if any) that was provided to parents was deemed unsatisfactory, and this was highlighted as an area of particular concern among parents.