ACQ Vol 10 No 1 2008

A round the J ournals

Andrew Whitehouse

barium, curd-type yoghurt and boiled rice. At the same time, a physiatrist who is a specialist in physical medicine and rehabilitation completed the VDS, a checklist that measures swallowing performance along 14 parameters of ability (e.g., lip closure, mastication, laryngeal elevation). The swallowing ability of the participants was reassessed with videofluoroscopy 6-months later (on average, 183 days post-stroke). The researchers examined the relation between the 14 parameters of swallowing ability observed at initial assessment and the presence of subglottic aspiration at the 6-month follow-up assessment. Based on the predictive power of the different parameters, a scoring system for the VDS was formulated (total score = 100). The parameters that best predicted aspiration at follow-up (i.e., poor tongue-to-palate, laryngeal elevation, coating of the pharyngeal wall, pharyngeal transit time, aspiration) were given greater weighting towards the total score, while those parameters that showed relatively weak predictive power (lip closure, apraxia) had a reduced contribution. The scoring system is outlined below: 1. Lip closure (intact = 0; inadequate = 2; none = 4) 2. Bolus formation (intact = 0; inadequate = 3; none = 6) 3. Mastication (intact = 0; inadequate = 4; none = 8) 4. Apraxia (none = 0; mild = 1.5; moderate = 3; severe = 4.5) 5. Tongue-to-palate contact (intact = 0; inadequate = 5; none = 10) 6. Premature bolus loss (none = 0; <10% = 1.5; 10-50% = 3; >50% = 4.5) 7. Oral transit time ( ≤ 1.5 seconds = 0; >1.5 seconds = 3) 8. Triggering of pharyngeal swallow (normal = 0; delayed = 4.5) 9. Vallecular residue (none = 0; <10% = 2; 10–50% = 4; >50% = 6) 10. Laryngeal elevation (normal = 0; delayed = 9) 11. Pyriform sinus residue (none = 0; <10% = 4.5; 10–50% = 9; >50% = 13.5) 12. Coating of pharyngeal wall (no = 0; yes = 9) 13. Pharyngeal transit time ( ≤ 1 second = 0; >1 second = 6) 14. Aspiration (none = 0; supraglottic penetration = 6; subglottic aspiration = 12) Further analysis indicated that a cut-off score of 47 or above shows optimal sensitivity and specificity for long-term dysphagia prediction, i.e., those who score 47 or above at initial assessment are most at risk for long-term dysphagia. Genetic overlap between SLI and autism? Whitehouse, A. J. O., Barry, J. G., & Bishop, D. V. M. (2007). The broader language phenotype of autism: A comparison with Specific Language Impairment. Journal of Child Psychology and Psychiatry , 48 , 822–830. In the recent years, evidence that autism and specific language impairment may share a common underlying genetic cause has been accumulating. One of the strongest pieces of evidence is that relatives of individuals with autism often show language impairments similar to that experienced by individuals with SLI. This study investigated the idea of a common genetic cause for autism and SLI, by comparing the language functioning of parents of children with SLI and parents of children with autism. If there is a shared genetic liability for the two disorders, then it was expected that the

Behaviour problems in children with language impairment Van Daal, J., Verhoeven, L. & van Balkom, H. (2007). Behaviour problems in children with language impairment. Journal of Child Psychology and Psychiatry , 48 , 1139–1147. There is a well-established association between language impairment and childhood behavioural problems. Behavioural difficulties fall into two broad categories. Externalising problems relate to a child’s outward behaviour and reflect a child negatively acting on the external environment (e.g., aggression, delinquency), while internalising problems relate to behaviours that are directed inward (e.g., withdrawal, anxiety, low self-esteem). The current study sought to investigate the presence of internalising and externalising behaviours in children with language impairment, and to determine whether these behaviours are related to any specific pattern of speech/language deficit. The sample was 71 five-year-old children recruited from schools around the Netherlands that specialise in the education of children with language impairment. Children were given a battery of standardised psychometric tests assessing various aspects of language ability. Parents of the children completed the Child Behaviour Checklist (CBCL) – a questionnaire assessing various non-adaptive behaviours. As expected, the bulk of the children performed poorly on the language tasks. Similarly, there was a high level of reported behavioural disturbances, with around 40% of children scoring in the “clinical” (impaired) or “borderline” (near-impaired) range on the CBCL. The most frequently reported internalising problems were somatic complaints and withdrawn behaviours, while externalising problems were most commonly exhibited in the form of aggression. Intern­ alising and externalising behaviours tended to occur to the same extent in this sample of children. Further analyses found that internalising problems (anxiety/ depression and withdrawn behaviours) were most commonly seen in those children with phonological or semantic deficits. Externalising problems, on the other hand, were related to phonological problems only. Speech problems appeared to carry the least risk for any form of behavioural problem. These findings highlight the importance of gauging both language and behavioural abilities at initial assessment. Development of a scale that predicts long-term dysphagia progress Han, T. R., Paik, N-J, Park, J-W., & Kwon, B. S., (2008). The prediction of persistent dysphagia beyond 6 months after stroke. Dysphagia , 23 (1), 59–64. This paper reports the development of the Videofluoroscopic Dysphagia Scale (VDS), an instrument designed to provide an objective prediction of long-term persistent dysphagia after stroke. Eighty-three participants with dysphagia underwent a videofluoroscopic swallowing examination upon their admission to a rehabilitation unit (on average, 40 days post-stroke). Participants received a standard swallowing assessment, where they were asked to ingest 2ml and 5ml of diluted

25

ACQ uiring knowledge in speech , language and hearing , Volume 10, Number 1 2008