Language outcomes subsequent to treatment of brainstem tumour in childhood

While the occurrence and management of brainstem tumours in children would not traditionally indicate potential direct structural impact on classical language centres, recent theories have implicated some involvement of the brainstem in a functional language and cognitive neural loop between the cerebellum and the cerebral hemispheres. Thus, the present paper explored the impact of treatment for brainstem tumour on the general and high-level language abilities of six children treated for brainstem tumour, in addition to phonological awareness skills. Group analysis revealed that children treated for brainstem tumour demonstrated intact language and phonological awareness abilities in comparison to an age- and gender-matched control group. Individual analysis revealed only one of six children treated for brainstem tumour revealed evidence of language disturbances, with an additional child demonstrating an isolated mildly reduced score on one phonological awareness task. Language deficits identified in a child treated with a combination of both radiotherapy and chemotherapy were noted in the high-level language area of lexical generation. Findings highlighted that no overt language disturbances were evident in children treated for brainstem tumour. However, further analysis into higher-level language skills in the present study indicated that both general and high-level language abilities require long-term monitoring in this population

General language abilities following management of childhood supratentorial tumour: Part 1

Background. To date few studies have investigated the impact of management for supratentorial tumour on the language abilities of children. In reporting children with brain tumour as part of a larger cohort of various aetiologies of brain injury, such studies have failed to differentiate between the causes of acquired childhood language disorders, or specifically report associated information relating to site and treatment. Material and methods. The present study examined the general language abilities of six children managed for supratentorial tumour, using a comprehensive standardized general language assessment battery, including receptive and expressive components, receptive vocabulary, and naming. Results. At a group level, children managed for supratentorial tumour performed below an individually matched control group in the area of general expressive language. However, at an individual case level it was revealed that only two cases exhibited specific language deficits. Reduced performance in the area of expressive language and syntax was evident in the language profile of one child treated surgically for a left parietal astrocytoma, while a child treated surgically for an optic nerve glioma demonstrated difficulties in receptive semantic abilities. The remaining four cases with similar treatments and locations demonstrated intact general language abilities. Conclusions. Factors such as site, long-term presence of tumour prior to diagnosis, young age at diagnosis, and variations in time post treatment were considered to have contributed to the findings. The need for long-term monitoring of language abilities post treatment as well as larger group sizes and the investigation of higher-level abilities was highlighte

An investigation of general and high level language skills in children treated with CNS-targeted chemotherapy for acute lymphoblastic leukaemia

The general language skills of 13 children (mean age: 8; 2 years) treated with a central nervous system (CNS)-targeted chemotherapeutic regimen for acute lymphoblastic leukaemia (ALL) and 13 control children matched on age, sex, and educational level were assessed using the Clinical Evaluation of Language Fundamentals – Fourth Edition or the Clinical Evaluation of Language Fundamentals – Preschool and the Peabody Picture Vocabulary Test – Third Edition, Form A. The high level language skills of a subgroup of the children (N = 18) were assessed with age-appropriate tests from the Test of Problem Solving series and the Test of Language Competence-Expanded Edition. The group of children with a history of CNS-targeted chemotherapeutic treatment for ALL presented with impaired expressive language skills and reduced proficiency with figurative language. Tentative conclusions, based on the findings, suggest impaired language skills may follow CNS-targeted chemotherapy-only treatment for ALL. Replication of the study with a larger sample is required, as are longitudinal studies, given the progressive CNS changes associated with the neurotoxicity of CNS-targeted interventions. These findings alert clinicians to the potential for language difficulties following the sole use of CNS-targeted chemotherapy in the treatment of ALL and the need for long-term monitoring of such children. Keywords Childhood acute lymphoblastic leukaemia; CNS-targeted chemotherapy; Intrathecal Mexotrexate; general language skills; high level language skill

The role of elicited verbal imitation in toddlers' word learning

This study is about the role of elicited verbal imitation in toddler word learning. Forty-eight toddlers were taught eight nonwords linked to referents. During training, they were asked to imitate the nonwords. Naming of the referents was tested at three intervals (one minute later [uncued], five minutes, and – days later [cued]) and recognition at the last two intervals. Receptive vocabulary, nonword repetition, and expressive phonology were assessed. The accuracy of elicited imitation during training predicted naming at one and five minutes, but not – days later. Neither nonword repetition nor expressive phonology was associated with naming over time but extant vocabulary predicted performance at all time intervals. We hypothesize that elicited imitation facilitates word learning in its earliest stages by supporting encoding of the word form into memory and allowing practice of the articulatory-phonological plan. At later stages, vocabulary facilitates integration of the word form into the lexical network

Post-operative cerebellar mutism syndrome : rehabilitation issues

Introduction Tumors of the cerebellum are the most common brain tumors in children. Modern treatment and aggressive surgery have improved the overall survival. Consequently, growing numbers of survivors are at high risk for developi

Changes in semantic fluency across childhood : normative data from Australian-English speakers

Purpose: Verbal fluency tests are often used as part of an assessment battery to investigate children’s lexical knowledge as well as executive function skills. To date, however, issues surrounding consistency of measurement cloud comparisons across studies, with the developmental performance of Australian-English speaking children also currently lacking. This study tracked verbal fluency development as measured by two semantic fluency tasks that included coding of fluency, clustering and switching type responses. Method: Participants included 355 typically developing Australian-English speaking children (4–10 years) and 46 young adults. Total fluency was determined by the number of words produced for each category (Animals or Food), minus repetitions and rule violations. Semantic clusters (words generated within a subcategory) were coded while switches between single words or subcategories were differentiated and coded as either hard or cluster switches. Result: Fluency showed consistent improvement over age. Cluster Switches and Hard Switches showed some evidence of a plateau in performance relative to fluency, but in opposite direction. Other measures showed no strong trends over age. Results were similar for both semantic categories. Conclusion: Our results highlight the rich information available within a semantic fluency task and the importance of differentiating hard and cluster switches in paediatric samples