Magazine article Clinical Psychiatry News

Developmental Language Impairment May Be Due to Diffuse CNS Dysfunction. (Related to Other Neurologic Anomalies)

Magazine article Clinical Psychiatry News

Developmental Language Impairment May Be Due to Diffuse CNS Dysfunction. (Related to Other Neurologic Anomalies)

Article excerpt

BALTIMORE -- Developmental language impairment is not due to focal pathology in a "language center" of the brain, but to a more diffuse dysfunction of the nervous system.

Defined as delayed or abnormal receptive or expressive language in a child with normal intelligence and no sensory or neurologic disorder, developmental language impairment was long thought to be an isolated condition unrelated to other CNS dysfunction, speakers said in two presentations at a meeting on developmental disabilities sponsored by the Johns Hopkins Medical Institutions.

Now, however, researchers have begun to realize that it is associated with several neurologic abnormalities, and new techniques in brain research are beginning to reveal associated abnormalities in brain structure as well.

"Why is it that kids with lesions you could put your fist through in the left, the so-called 'language,' hemisphere develop essentially normal language, while those with language impairment but no obvious lesions do not?" asked Elizabeth Bates, Ph.D., director of the University of California, San Diego, Center for Research in Language.

"Why does the brain's customary plasticity fail in children with language impairment?"

Dr. Bates' colleague at UCSD, Dr. Doris Trauner, proposed that children with massive left hemisphere lesions have other undamaged areas of the brain that can take over language functions, while those with language impairment must have such diffuse damage that there aren't enough unaffected areas to compensate.

Several studies have documented a link between developmental language impairment and physical clumsiness; toe-walking; attention deficit; problems discriminating left and right; perceptual abnormalities; and sensorimotor problems such as hypotonia, spasticity, and ataxia.

"In our studies of more than 100 children with language impairment, neurologic exams have demonstrated a high incidence of obligatory synkinesis and fine-motor impairments, as well as a higher than expected incidence of hyperreflexia, oromotor apraxia, gross motor impairment, and sensory deficits, compared with their agematched controls," said Dr. Trauner, chief of pediatric neurology at UCSD. …

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