| 1. |
- Ek, Ulla, 1948-, et al.
(författare)
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Teenage outcomes after speech and language impairment at preschool age
- 2012
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Ingår i: Neuropsychiatric Disease and Treatment. - 1176-6328 .- 1178-2021. ; 8, s. 221-227
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Tidskriftsartikel (refereegranskat)abstract
- Aim: Ten years ago, we published developmental data on a representative group of children (n = 25) with moderate or severe speech and language impairment, who were attending special preschools for children. The aim of this study was to perform a follow-up of these children as teenagers. Methods: Parents of 23 teenagers participated in a clinical interview that requested information on the child's current academic achievement, type of school, previous clinical assessments, and developmental diagnoses. Fifteen children participated in a speech and language evaluation, and 13 participated in a psychological evaluation. Results: Seven of the 23 teenagers had a mild intellectual disability, and another three had borderline intellectual functioning. Nine had symptoms of disorders on the autism spectrum; five of these had an autism spectrum disorder, and four had clear autistic traits. Six met criteria for attention-deficit hyperactivity disorder (ADHD)/subthreshold ADHD. Thirteen of 15 teenagers had a moderate or severe language impairment, and 13 of 15 had a moderate or severe reading impairment. Overlapping disorders were frequent. None of the individuals who underwent the clinical evaluation were free from developmental problems. Conclusion: A large number of children with speech and language impairment at preschool age had persistent language problems and/or met the criteria for developmental diagnoses other than speech and language impairment at their follow-up as teenagers. Language impairment in young children is a marker for several developmental disorders, particularly intellectual disability and autism spectrum disorder.
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| 2. |
- Fernell, Elisabeth, 1948, et al.
(författare)
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Developmental profiles in preschool children with autism spectrum disorders referred for intervention.
- 2010
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Ingår i: Research in Developmental Disabilities. - : Elsevier BV. - 0891-4222 .- 1873-3379. ; 31:3, s. 790-799
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to characterize the panorama of developmental disorders in 208 preschool children with a clinical diagnosis of autism spectrum disorder (ASD), referred to a specialized centre, the Autism Centre for Young Children (ACYC), for intervention. At the centre, a research team examined all children according to structured protocols and interviews. All available test data from their assessments prior to referral were scrutinized. The boy:girl ratio was 5.5:1. In 22% of the total group a period of regression, including speech and language, had occurred. Epilepsy had been diagnosed in 6% of the children. In 38% of the children there was a definite or highly suspected learning disability/mental retardation according to cognitive test results. About the same proportion had a developmental delay that at the time of assessment could not be definitely classified and in 23% there were clear indications of a normal intellectual function. About 40% of the group exhibited hyperactivity. Differences in expressive vocabulary and adaptive functioning were strongly related to cognitive level. About 20% of the group had AD as the dominating developmental disorder, i.e., they represented a clinical picture of "classic" autism. The majority in this group also had learning disability. Another 20%, had ASD combined with a normal intellectual level, some of these conformed to the clinical picture of Asperger syndrome. In a relatively large group (more than half) learning disability or a general developmental delay was as evident as the ASD. In a smaller group (8%) ASD criteria were questionably met. In this group attention deficits in connection with speech and language problems were prominent. The highly individual developmental profiles seen in children with ASDs have to be taken into account when planning intervention and follow-up. The children's medical characteristics also vary considerably and will be detailed in a further report.
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| 3. |
- Fernell, Elisabeth, 1948, et al.
(författare)
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Early intervention in 208 Swedish preschoolers with autism spectrum disorder. A prospective naturalistic study.
- 2011
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Ingår i: Research in Developmental Disabilities. - : Elsevier BV. - 1873-3379 .- 0891-4222. ; 32:6, s. 2092-2101
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Tidskriftsartikel (refereegranskat)abstract
- Early intervention has been reported to improve outcome in children with autism spectrum disorders (ASDs). Several studies in the field have been randomized controlled trials (RCTs). The aim of this study was to assess ASD outcome in a large naturalistic study. Two hundred and eight children, aged 20-54 months, with a clinical diagnosis of ASD were given intervention and monitored prospectively in a naturalistic fashion over a period of 2 years. The toddlers were considered representative of all but the most severely multiple disabled preschool children with ASD in Stockholm county. They fell into three cognitive subgroups: one with learning disability, one with developmental delay, and one with normal intellectual functioning. Data on intervention type and intensity were gathered prospectively in a systematic fashion. Intervention was classified into intensive applied behaviour analysis (ABA) and non-intensive, targeted interventions, also based on ABA principles. Children were comprehensively assessed by a research team before the onset of intervention, and then, again, 2 years later. Change in Vineland adaptive behaviour scales composite scores from intake (T1) to leaving the study (T2) was set as the primary outcome variable. The research team remained blind to the type and intensity of interventions provided. One hundred and ninety-eight (95%) of the original samples stayed in the study throughout the whole 2-year period and 192 children had a complete Vineland composite score results both at T1 and T2. Vineland composite scores increased over the 2-year period. This increase was accounted for by the subgroup with normal cognitive functioning. There was no significant difference between the intensive and non-intensive groups. Individual variation was considerable, but no child in the study was "problem-free" at follow-up. Our data do not support that children with ASD generally benefit more from the most intensive ABA intervention programs than from less intensive interventions or targeted interventions based on ABA.
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| 4. |
- Höglund Carlsson, Lotta, et al.
(författare)
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Coexisting disorders and problems in preschool children with autism spectrum disorders
- 2013
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Ingår i: TheScientificWorldJournal. - : Hindawi Limited. - 1537-744X. ; 2013, s. 213979-
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Tidskriftsartikel (refereegranskat)abstract
- Objectives. To analyze cooccurring disorders and problems in a representative group of 198 preschool children with autism spectrum disorders (ASD) who had had interventions at a specialized habilitation center.Methods. Parents and children were seen by a research team. Data were based on parental interviews, pediatric assessments, and tests of the child. Information on autistic symptoms, general cognitive function, speech and language, motor function, epilepsy, vision, hearing, activity level, behavior, and sleep was collected.Results. Three ASD categories were used: (1) autistic disorder (AD), (2) autistic-like condition (ALC) or Asperger syndrome, and (3) one group with autistic symptoms/traits but not entirely all its criteria met for ASD. Children with autism had a mean of 3.2 coexisting disorders or problems, the ALC/Asperger group had a mean of 1.6, and children with autistic traits had a mean of 1.6. The most common disorder/problems in the total group pertained to language problems (78%), intellectual disability (ID) (49%), below average motor function (37%), and severe hyperactivity/ADHD (33%).Conclusions. The results accord with the concept of early symptomatic syndromes eliciting neurodevelopmental clinical examination (ESSENCE), and highlight the need of considering ASD in a broad perspective taking also other cooccurring developmental disorders into account.
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| 5. |
- Jensdottir, Margret, et al.
(författare)
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Standardized reporting of adverse events and functional status from the first 5 years of awake surgery for gliomas: a population-based single-institution consecutive series.
- 2022
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Ingår i: Acta neurochirurgica. - : Springer Science and Business Media LLC. - 0942-0940. ; 164:8, s. 1995-2008
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Tidskriftsartikel (refereegranskat)abstract
- To report our experience and investigate frequencies of adverse events and functional status from the first 5 years of performing awake surgery for gliomas in a single-center population-based setting.We conducted a review of all patients with a glioma treated with awake surgery during the first 5 years following introduction of awake surgery at our center (February 2015 to February 2020). We assessed functional and radiological outcome, with adverse events classified according to the Landriel-Ibanez classification for neurosurgical complications, while neurological deficits were further subdivided into transient vs permanent. We sought to analyze our initial results and learning curve, as well as compare our results with literature.Forty-two patients were included. The median age was 38 years (range 18-66) and 13 (31%) were female. The indication for awake surgery was a presumed glioma in or near an eloquent area. The overall 30-day complication rate was 25 (59%), with 19 (45%) grade I complications, 3 (7%) grade II complications, and 3 (7%) grade III complications. Fifteen patients (36%) experienced transient neurological deficits, and 11 (26%) permanent neurological deficits. At 3-month follow-up, the Karnofsky Performance Score was 80 or higher for the entire cohort. The median extent of resection was 87%, with GTR achieved in 11 (26%). In search of potential learning curve difficulties, patients were divided into the 21 patients treated first (Early Group) versus the remaining 21 patients treated later (Late Group); no statistically significant difference in operating time, amount of tumor removed, or incidence of long-term postoperative neurological deficit was identified between groups. No awake surgery was aborted due to seizures. Comparison to the literature was limited by the diverse and unsystematic way in which previous studies have reported adverse events after awake craniotomy for gliomas.We provide a standardized report of adverse events and functional status following awake surgery for glioma during a single-center 5-year learning period, with similar rates of severe adverse events and functional outcome compared to literature without concerns of substantial learning curve difficulties. However, this comparison was flawed by non-standardized reporting of complications, highlighting a demand for more standardized reporting of adverse events after awake craniotomies.
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| 6. |
- Kjellmer, Liselotte, et al.
(författare)
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Language and communication skills in preschool children with autism spectrum disorders: contribution of cognition, severity of autism symptoms, and adaptive functioning to the variability.
- 2012
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Ingår i: Research in Developmental Disabilities. - : Elsevier BV. - 0891-4222 .- 1873-3379. ; 33:1, s. 172-180
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Tidskriftsartikel (refereegranskat)abstract
- This study examined the contribution of cognitive function, severity of autism, and adaptive functioning to the variability in language and communication skills in 129 preschool children (aged 24-63 months) with autism spectrum disorder (ASD). Participants were selected from a representative research cohort of 208 preschool children on the basis of caregiver completion of the MacArthur-Bates Communicative Development Inventories (CDI). The children were classified into three cognitive groups: (a) Normal intelligence; (b) Developmental delay; and (c) Intellectual disability. Autism symptom severity was measured by the Autistic Behavior Checklist (ABC), and adaptive functioning by the Daily Living Skills (DLS) and Socialization (Soc) subscales from the Vineland Adaptive Behavior Scales. For each of five CDI variables (Phrases understood, Words understood, Words produced, Gestures and actions, and Language use), the contribution of cognition, severity of autism symptoms, and adaptive functioning to the variability was examined. Cognition and age explained about half or more of the variance in the four verbal language CDI variables, but only about one fourth of the variance in the non-verbal communication variable Gestures and actions. Severity of autism symptoms and the two adaptive measures (DLS and Soc) each only accounted for a few percent more of the variance in the four CDI language variables; however, for Gestures and actions, an additional 11-21% of the variance was accounted for. In conclusion, for children with ASD, receptive and expressive language is mainly related to cognitive level, whereas non-verbal communication skills seem to also be related to severity of autism symptoms and adaptive functioning.
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| 7. |
- Kjellmer, Liselotte, et al.
(författare)
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Language comprehension in preschoolers with autism spectrum disorders without intellectual disability: Use of the Reynell Developmental Language Scales.
- 2012
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Ingår i: Research in Autism Spectrum Disorders. - : Elsevier BV. - 1750-9467. ; 6:3, s. 1119-1125
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Tidskriftsartikel (refereegranskat)abstract
- This study aimed to (a) assess language comprehension in children with autism spectrum disorders (ASD) without intellectual disability, (b) assess differences between ASD diagnostic subgroups, and (c) analyze the relationship between language comprehension and performance and verbal IQ, respectively. The 94 participants (83 boys, 11 girls; 4:0–6:8 years) were a subgroup of a large cohort of 208 Swedish preschool children with ASD that had been followed longitudinally over 2 years. The Comprehension Scale of the Reynell Developmental Language Scales III (RDLS) was used at follow-up to assess language comprehension. Results revealed a delay in the development of language comprehension as well as high variability within the group as a whole. The Asperger syndrome and the Autistic feature groups performed within the normal range whereas the PDD-NOS and the Autistic disorder groups performed at the lower boundary of the normal range. However, importantly, 38% or more of the children showed results in the impaired range (i.e., <10th percentile) regardless of ASD type. Explained variance in language comprehension scores were 10% for non-verbal and 41% for verbal IQ. Many children with ASD without intellectual disability may have difficulties comprehending instructions in the classroom and in other everyday situations. The results highlight the need for detailed linguistic assessment of children with ASD.
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| 8. |
- Kjellmer, Liselotte, et al.
(författare)
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Speech and language profiles in 4-to 6-year-old children with early diagnosis of autism spectrum disorder without intellectual disability
- 2018
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Ingår i: Neuropsychiatric Disease and Treatment. - 1176-6328 .- 1178-2021. ; 14, s. 2415-2427
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: This study aimed to present speech and language data from a community-representative group of 4- to 6-year-old children with early-diagnosed autism spectrum disorder (ASD) without intellectual disability (ID). Methods: The study group comprised 83 children 4-6 years of age with ASD without ID. They had been diagnosed with ASD before age 4.5 years and had received intervention at a specialized habilitation center. At 2-year follow-up, their language abilities were evaluated comprehensively by two speech-language pathologists using a battery of assessments. Receptive and expressive language and phonology were examined. The phonology evaluation included measures of phonological speech production and of phonological processing. Results: Results revealed that almost 60% had moderate-severe language problems. Nearly half exhibited combined expressive and receptive language problems, of which a majority also had phonology problems. Phonological speech problems were found in 21% of the total group. Conclusion: The findings underscore the importance of considering speech/language disorders in children with ASD without ID, since they usually attend mainstream classes but need specific educational adaptations.
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| 9. |
- Kjellmer, Liselotte, 1970-, et al.
(författare)
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Speech and language profiles in 4-to-6-year-old children with early diagnosis of autism spectrum disorder without intellectual disability
- 2018
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Objectives: This study aimed to investigate speech and language profiles in a community-representative group of preschool children with autism spectrum disorder (ASD) without intellectual disability (ID).Methods: The 83 participants, age 4-6 years, were a subgroup of a large research cohort of 208 Swedish preschool children diagnosed with ASD before age 4.5 years. After diagnosis they had obtained intervention at a specialized habilitation center. At a two-year follow-up, comprehensive research data on their speech and language abilities were collected by two speech-language pathologists.Results: Moderate to severe language problems were found in almost 60% of the children; only one in six had no such problems. Nearly half exhibited a combination of receptive and expressive language difficulties, of which a majority also had phonological difficulties, here defined as pronunciation problems and/or problems with phonological processing.Conclusions: The findings highlight that many children with ASD without ID face major language challenges similar to those seen in children diagnosed with language disorder. These coexisting speech and language problems in children with ASD without ID require specific assessments, interventions and follow-up to ensure an optimal and adapted school situation for the child.
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| 10. |
- Lundholm-Hedvall, Åsa, et al.
(författare)
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Preschoolers with Autism Spectrum Disorder Followed for 2 Years : Those Who Gained and Those Who Lost the Most in Terms of Adaptive Functioning Outcome
- 2015
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Ingår i: Journal of autism and developmental disorders. - : Springer Science and Business Media LLC. - 0162-3257 .- 1573-3432. ; 45:11, s. 3624-3633
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Tidskriftsartikel (refereegranskat)abstract
- Clinical predictors of 2-year outcome in preschoolers with ASD were studied in a population-based group of very young children with ASD (n = 208). Children who gained the most (n = 30) and lost the most (n = 23), i.e., increased or decreased their adaptive functioning outcome according to the Vineland Composite Score between study entry (T1) and follow-up (T2), 2 years later were compared. Individual factors that differed significantly between the two outcome groups were cognitive level, age at referral, not passing expected milestones at 18 months, autistic type behavior problems and regression. However, logistic regression analysis showed that only cognitive level at T1 (dichotomized into IQ < 70 and IQ a parts per thousand yen 70) made a unique statistically significant contribution to outcome prediction (p = <.001) with an odds ratio of 18.01. The findings have significant clinical implications in terms of information at diagnosis regarding clinical prognosis in ASD.
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| 11. |
- Norrelgen, Fritjof, et al.
(författare)
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Children with autism spectrum disorders who do not develop phrase speech in the preschool years.
- 2015
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Ingår i: Autism : the international journal of research and practice. - : SAGE Publications. - 1461-7005. ; 19:8, s. 934-943
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Tidskriftsartikel (refereegranskat)abstract
- There is uncertainty about the proportion of children with autism spectrum disorders who do not develop phrase speech during the preschool years. The main purpose of this study was to examine this ratio in a population-based community sample of children. The cohort consisted of 165 children (141 boys, 24 girls) with autism spectrum disorders aged 4-6years followed longitudinally over 2years during which time they had received intervention at a specialized autism center. In this study, data collected at the 2-year follow-up were used. Three categories of expressive language were defined: nonverbal, minimally verbal, and phrase speech. Data from the Vineland Adaptive Behavior Scales-II were used to classify expressive language. A secondary objective of the study was to analyze factors that might be linked to verbal ability, namely, child age, cognitive level, autism subtype and severity of core autism symptoms, developmental regression, epilepsy or other medical conditions, and intensity of intervention. The proportion of children who met the criteria for nonverbal, minimally verbal, and phrase speech were 15%, 10%, and 75%, respectively. The single most important factor linked to expressive language was the child's cognitive level, and all children classified as being nonverbal or minimally verbal had intellectual disability.
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| 12. |
- Norrelgen, Fritjof
(författare)
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Development of working memory, speech perception and auditory temporal resolution in children with attention deficit hyperactivity disorder and language impairment
- 2002
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Speech perception (SP), verbal working memory (WM) and auditory temporal resolution (ATR) have been studied in children with attention deficit hyperactivity disorder (ADHD) and language impairment (LI), as well as in reference groups of typically developed children. A computerised method was developed, in which discrimination of same or different pairs of stimuli was tested. In a functional Magnetic Resonance Imaging (fMRI) study a similar test was used to explore the neural correlate of the verbal WM. In addition the neurodevelopmental profiles of language impaired children have been investigated. (i) Speech perception is deeply intertwined with language learning. If SP is not functioning, language learning will be impaired. SP has previously not been studied in children with neurodevelopmental disorders. To test SP, stimulus pairs with nine different consonant contrasts were used. Examination of LI children showed that they had reduced speech perception for three of the contrasts. However, it is uncertain whether this has negative consequences for language functions. Children with ADHD and children with ADHD + developmental coordination disorder (DCD) performed equally well as a control group. There was no apparent change of SP in typically developed children between five and eight years of age. (ii) Verbal WM is important for the development of lexicon, language comprehension and expression both in typical children and in those with Ll. To test verbal WM with different memory loads, pairs of two to five syllable long non-words were used. A study of verbal WM in children with ADHD and ADHD+DCD, revealed that the latter group performed worse at higher memory loads than both the control group and the children with ADHD. The result was interpreted as a genuine WM problem since it could not be explained by group differences in IQ, hyperactivity or attention. An examination of LI children showed that their performance was worse than that of the controls for all memory loads. Yet, the LI group's performance was better than that reported in previous studies probably caused by differences in the methods. In typically developed children we found an improvement in verbal WM capacity between six and seven years of age. (iii) A controversial hypothesis has suggested that poor ATR underlies specific Ll. To test ATR, stimulus pairs with two 20 ms long tones, 878Hz and 1350Hz, presented with five different inter stimulus intervals between 256 and 16 ms were used. In typically developed children we found weak associations between ATR and verbal WM and speech perception. In a second experiment, a weak association was found between ATR and gender and phonological awareness. The results did thus not indicate that ATR plays an important role for language functions in children. A possible developmental effect was found between five and six years of age. In Ll children we found no impairment in ATR, supporting that language problems are not related to ATR. In all experimental groups a high variability in ATR was observed. (iv) The temporal sequence of cortical activations in a verbal working memory task was investigated with fMRI. Increased activation was found in the right pre-motor area when the subject was listening to the first stimulus of a pair. During rehearsal the right temporal cortex was activated in addition to the right pre-motor area. When the second stimulus in the pair was presented and a response decision was made, there were bilateral activations in the temporal cortex, ventro- and dorso-lateral prefrontal cortex and in the supplementary motor area. The findings indicate that the prefrontal cortex, and possibly the posterior parietal cortex, is more involved in response selection than in rehearsal in WM tasks. The lack of prefrontal activity during rehearsal is controversial and the experiment needs to be replicated before any definite conclusions can be drawn from the findings. (v) We examined a broad spectrum of neurodevelopmental symptoms in a group of language impaired preschool children. Among children with moderate or severe LI, 90 % had additional functional deficits. In the motor assessment, deficits were found in 42% of the children and an additional 13% had isolated fine motor problems. The cognitive assessment showed that 12% of the LI group had an IQ < 71 and that 16% had an IQ of 72 to 85. Diagnostic levels in one or more of four standardised behaviour scales were found in 44% and when a milder degree of symptoms were measured 80% in the LI group were affected. The findings show that LI usually is accompanied by other dysfunctions, thereby demonstrating the need for multidisciplinary assessments of children with Ll.
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| 13. |
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| 14. |
- Åsberg Johnels, Jakob, 1978, et al.
(författare)
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Language/cognitive predictors of literacy skills in 12-year-old children on the autism spectrum
- 2022
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Ingår i: Logopedics Phoniatrics Vocology. - : Informa UK Limited. - 1401-5439 .- 1651-2022. ; 47:3, s. 166-170
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Tidskriftsartikel (refereegranskat)abstract
- Aim Some school age children with autism spectrum disorder (ASD) struggle with literacy development, yet, the individual differences are major and not well understood. Moreover, literacy attainment is multi-faceted and literacy skills and difficulties manifest in more than one way. The aim of this study was to describe this variability and to identify language/cognitive predictors of different literacy skills. Methods We assessed different literacy skills (word reading accuracy, reading fluency, reading comprehension, and spelling), along with a set of language/cognitive predictor skills (listening comprehension, rapid automatized naming, phonological awareness and nonverbal cognitive ability), in 12-year-old children with ASD without intellectual disability recruited from a longitudinal study in Sweden. Results There was great heterogeneity (from floor to ceiling levels) in literacy skills, with a statistically increased prevalence of poor reading comprehension and reading fluency compared with population norms. In regression analyses, it was shown that concurrent language/cognitive predictor skills (e.g. phonological awareness) were differentially associated with literacy subskills. Moreover, a longitudinal analysis showed that preschool language problems were associated with poor word reading accuracy and spelling in middle school. Conclusions The results confirm previous findings as well as provide new knowledge regarding profiles of literacy (difficulties) in children with ASD; interestingly, the identified predictors of literacy skills in ASD resembled those identified as important in general reading (and dyslexia) research, which might indicate that similar kinds of support and training would be beneficial.
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