Sandy Friel-Patti

Tympanometry and otoscopy prior to myringotomy: issues in diagnosis of otitis media

Tympanometry and pneumatic otoscopy were compared to findings at myringotomy in 86 children (163 ears). Seventy percent of the ears (115) had effusion, as revealed by myringotomy. Sensitivity and specificity for tympanometry were 90% and 86%, respectively. Sensitivity and specificity for pneumatic otoscopy were 93% and 58%, respectively. A chi-square was performed to compare the sensitivity and specificity to tympanometry to otoscopy, revealing tympanometry significantly better at determining non-effusion states. Additionally, a combined otoscopy and tympanometry sensitivity and specificity were calculated for those otoscopy and tympanometry determinations in agreement, revealing both sensitivity and specificity above 90%. A Fishers exact probability test revealed no significant differences for the accuracy of tympanometry over otoscopy when the determinations of each were not in agreement. Implications of these results are discussed.

Clinical Decision-Making in the Assessment and Intervention of Central Auditory Processing Disorders

Central auditory processing disorders (CAPDs) are fraught with problems arising from confusion concerning the clinical evidence of the disorder. A major controversy revolves around characterizing the disorder as a unique cluster of behaviors reflecting impairment in some underlying mechanism(s) or as a disorder defined on the basis of performance on a set of tests. This article reviews some recent developments in auditory processing research and considers the role of the speech-language pathologist in evaluating and treating children with suspected auditory processing problems. Particular attention is given to clinical criteria, including characteristics of the population, assessment, and intervention considerations. Areas for clinical caution are highlighted.

Phonological processing and oral language abilities in fourth-grade poor readers.

UNLABELLED This study investigated the contribution of phonological processing and oral language skills to reading abilities (word attack, word recognition, and comprehension) in 17 fourth graders identified as poor readers. Participants were assessed in the areas of phonological awareness, verbal working memory, and rapid naming, in addition to oral language abilities as predictors of poor reading skills. Results indicated that the strongest predictors of word attack skills were phonological awareness and grammaticality judgment. The combination of phonological awareness, grammaticality judgment, phoneme manipulation, and rapid naming of digits accounted for more than half of the variance in word recognition. Furthermore, the amount of discrepancy between IQ scores and reading achievement did not distinguish groups of poor readers. The results support the importance of metalinguistic skills to support reading ability. Phonological processing and oral language abilities may vary in children with poor reading skills as processing demands change with age and task. LEARNING OUTCOMES As a result of this activity, the reader will be able to: (1) identify phonological processing and oral language skills that are most predictive of specific reading skills in poor readers; (2) describe further evidence of the lack of utility of the discrepancy model to define reading disorders in children.

Patterns of change in maternal¿child discourse behaviors across repeated storybook readings

Fourteen mother–child dyads were videotaped four times over 16 days as they repeatedly read an initially unfamiliar storybook. Videotapes were transcribed and a variety of discourse measures were coded for both mother and child. Principal components analysis was used to combine three maternal and three child variables into a single composite variable, engagement, which described levels and quality of maternal and child participation in extratextual interactions during the first reading session. Dyads with the highest levels of engagement during the first session showed the greatest rates of change for a number of discourse measures. Results are discussed in terms of maternal scaffolding approaches, child participation, the importance of context and the nature of the task, and implications for intervention.

Mother‐child dialogues: Considerations of cognitive complexity for young language learning children

The application of the Blank and Franklin (1980) cognitively based dialogue coding system to conversations between mothers and their young normal language learning children (age range 12 to 24 months) was explored. The original coding system was adapted to accommodate the childrens use of actions as well as language to partake in dialogue. Videotaped, naturally occurring mother-child interactions for ten dyads provided the data base for the present study. Results demonstrate that mothers address their utterances at, or one level above, the level of complexity to which the children responded most effectively. There was a correspondence between the level of the utterances initiated most often by the children and the level to which they responded best. The use of the adapted coding system with language impaired mother-child dyads is discussed.

Commitment to Theory

In summary, authors Rimland, Edelson, and Veale are to be commended for bringing the topic of auditory integration training forward for professional review and debate. AIT offers an excellent forum for consideration of the role of theory in intervention for clinicians engaged in treatment of persons with communication disorders. Each clinician must take a step back on occasion and face the question about treatment efficacy from an objective, data-driven perspective. Such public discussion of AIT as intervention inevitably leads to reexamination of what is meant by success/failure in treatment; indeed, what constitutes intervention itself. AIT is being held up to the scrutiny of both the clinical and research communities, and, if it is valid, it will withstand such inquiry and will even advance our understanding of some very perplexing disorders. In order for that to happen, responsible researchers and clinicians must be willing to shed biases, ask questions, conduct studies, and report them to their profe...

Evaluating changes in the communication skills of deaf children using vibrotactile stimulation

Results of a 9-mo longitudinal study designed to evaluate the efficacy of a vibrotactile aid, the SRA-l o, with four profoundly deaf preschool children are reported. During the study the subjects were enrolled in 30-min triweekly language therapy sessions, and changes in communication skills in connected discourse (vocalization only, sign language only, and vocalization PIUS sign language) were measured using a computer-based observation system. Changes in structural and semantic aspects of language were also measured. The four subjects were evaluated during one 16-week phase in which the aid was used (aid-on condition) and another 8 weeks in duration in which the aid was not used (aid-off condition). Communication skills improved in the aid-on condition and decreased in the aid-off condition. The changes were found to be significant for the communication involving the vocalization plus sign language (Total Communication) measure, indicating that the vibrotactile stimulation was Positively associated with the communicative act.

Discourse Development in Atypical Language Learners

During the last two decades, the study of language development in children has experienced a broadening of perspective from an emphasis on form to a concern with function. There has also been a move from the analysis of the speaker to the analysis of the communicative dyad. This change in focus has brought about new methodologies, issues, and problems that are the current concern of both psychologists and linguists alike.

Research in Child Language Disorders: What Do We Know and Where Are We Going?

Advances in understanding the nature of language impairment in children over the past decade have been abundant. In this paper, several recurring hypotheses about the nature of the clinical disorder of language impairment in children and underlying etiologies are explored and the ways in which we are moving forward in our understanding of them are considered. Specifically, in the first part, the recent thinking on the nature of specific language impairment as a clinical concept is examined. Characteristics of the population are reviewed and the search for causation is considered. Literature on the relations between language and cognition and between language and social cognition is probed for contributions to our understanding of developmental disorders of language. Two areas in which we have seen marked progress and which hold promise for development in the coming decade are the focus of the second part of the paper. The focal areas are: computer-assisted language sample analyses and neurophysiological contribution to understanding language impairment in children. Thoughts about future directions for work in the area of developmental disorders of language are offered in conclusion.