Browsing by Subject "kielellinen erityisvaikeus"

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  • Tillander, Saara (Helsingfors universitet, 2016)
    Objectives. Specific language impairment (SLI) is a heterogeneous disorder and its symptoms change with development. For most people it has a profound effect on functional ability, participation, and learning. The symptoms are persistent especially among those with difficulties in speech-reception. Simultaneous learning of multiple languages increases the individual variation in linguistic difficulties. Language functioning of Finnish monolingual and multilingual children at age over 10 years has not been thoroughly investigated. The objective of this study was to describe how SLI manifests itself in 11–12-years-old monolingual and multilingual children. The study focused on language ability and health-related quality of life. The acquired information may help in improving supporting practices. Methods. Four male participants at age of 11–12 years living in the Capital Region of Finland, and with SLI diagnosis (F80.2) were recruited from Helsinki University Central Hospital Audiophoniatric ward 22 for the study. Two participants were monolingual and two were multilingual learning Finnish as their second language. The gathered data consisted of language tests and questionnaires intended for parents, teachers, and the participants. Testing was videotaped and the acquired narratives were transcribed. Results were compared against age norms as well as previous literature. Furthermore, the questionnaire data were grouped based on the content, and the results were analyzed qualitatively. In addition, the test results and questionnaire data were compared to each other. Finally, the differences in language abilities were examined in relation to medical reports written before school age. Results and conclusions. All participants had deficiencies in language abilities, but language symptoms, social ability, academic achievement, and quality of life varied individually. Results were in line with previous studies. Difficulties were observed especially in grammatical and reading abilities, short-term memory and word naming. Moreover, according to parents and teachers, the participants had problems in speech reception, narration, pragmatics, and some of them also in social interactions. Finnish vocabulary among the multilingual participants was smaller than that of their monolingual counterparts. However, differences in other areas were larger at single-level than at group-level. Three of the participants still received substantial support in school. Support of the fourth participant had been discontinued due to favorable progress. Majority of the participants perceived their health-related quality of life slightly weaker than that of controls. Based on the results, it is important to support pragmatic skills at school age since previous studies have shown an association of these to social integration. A Study with a larger sample size and longitudinal setting is needed in the future.
  • Leppänen, Saara (Helsingfors universitet, 2011)
    Goals. Specific language impairment (SLI) has a negative impact on child's speech and language development and interaction. Disorder may be associated with a wide range of comorbid problems. In clinical speech therapy it is important to see the child as a whole so that the rehabilitation can be targeted properly. The aim of this study was to describe the linguistic-cognitive and comorbid symptoms of children with SLI at the age of five, as well as to provide an overview of the developmental disorders in the families. The study is part of a larger research project, which will examine paths of development and quality of life of children with SLI as young adults. Methods. The data consisted of patient documents of 100 5-year old children, who were examined in Lastenlinna mainly at 1998. Majority of the subjects were boys, and children's primary diagnosis was either F80.1 or F80.2, which was most common, or both. The diagnosis and the information about the linguistic-cognitive status and comorbid symptoms were collected from reports of medical doctors and experts of other fields, as well as mentions related to familiality. Linguistic-cognitive symptoms were divided into subclasses of speech motor functions, prosessing of language, comprehension of language and use of language. Comorbid symptoms were divided into subclasses of interaction, activity and attention, emotional and behavior problems and neurologic problems. Statistical analyses were based mainly on Pearson's Chi Square test. Results and conclusions. Problems in language processing and speech motor functions were most common of the linguistic-cognitive symptoms. Most of the children had symptoms from two or three symptom classes, and it seemed that girls had more symptoms than boys. Usually children did not have any comorbid symptoms, or had them from one or three symptom classes. Of the comorbid symptoms the most prevalent ones were problems in activity and attention and neurological symptoms, which consisted mostly of motoric and visuomotoric symptoms. The most common of the comorbid diagnoses was F82, specific developmental disorder of motor function. According to literature children with SLI may have problems in mental health, but the results of this study did not confirm that. Children with diagnosis F80.2 had more linguistic-cognitive and comorbid symptoms than children with diagnosis F80.1. The cluster analyses based on all the symptoms revealed four subgroups of the subjects. Of the subjects 85 percent had a positive family history of developmental disorders, and the most prevalent problem in the families was delayed speech development. This study outlined the symptom profile of children with SLI and laid a foundation for the future longitudinal study. The results suggested that there are differences between linguistic-cognitive symptoms of boys and girls, which is important to notice especially when assessing and diagnosing children with SLI.
  • Surakka, Susanna (Helsingfors universitet, 2015)
    Target. There are currently few tools to evaluate young adults' linguistic abilities in the Finnish language. Previous studies have shown that nonword repetition, sentence repetition and grammaticality judgment are typically weak functions in language impairment in some languages. The aim of this study was to create a tool for evaluating grammaticality judgment and pilot that tool. The assessment tool developed here is based on Poll, Betz and Miller's (2010) study on identification of clinical markers of specific language impairment (SLI) in English-speaking adults. In addition, the studies of grammatical difficulties by Finnish-speaking children with specific language impairment were also considered when developing the new tool. Methods. Six young adults with the history of SLI and six young adults with typical language development, matched as closely as possible with the SLI persons, participated in this study. Participants were 19;2-20;8 years of age. This study started with creation of the new assessment tool. Data were then collected using the assessment tool. Altogether 108 sentences were created to evaluate grammaticality judgment. Out of these 50 sentences were translated from the study of English-speaking young adults, 48 sentences were created based on the studies of Finnish-speaking children having SLI and the remaining 10 sentences were training items. Participants listened to sentences and were asked to judge their grammaticality and by indicating whether the sentence was right or wrong. Data were analyzed mainly quantitatively due to the relatively small number of participants. Results and conclusions. The participants with SLI made more errors in this test than did their peers with typical language. However, the result was not found statistically significant. Participants with SLI also used more time running the test than their counterparts. SLI participants made most of the errors in sentences, which included accusative case or tense inflection. The results are similar to the study on English-speaking young adults. Therefore, examination on a larger test group is needed in the future.
  • Paalasmaa, Salla (Helsingin yliopisto, 2012)
    Aims. Knowledge of performance in other areas of cognitive processing in children with specific language impairment is contradictory. The aim of this study was to research verbal and cognitive performance as well as intelligence of children with specific language impairment using neuropsychological evaluation data. In addition, the methods used to evaluate neuropsychological processing of the children and their school recommendations were studied. Methods. The participants (N=67) were diagnosed with F80.1 and / or F80.2 in Lastenlinna hospital in 1998-1999 and were neuropsychologically evaluated in 1996 2001. The study retrospectively examined which methods of evaluation were used to assess children with specific language impairment. The participants' test battery scores were gathered. Descriptions of spontaneity, ability to cooperate and concentrate as well as school recommendations were gathered from neuropsychologists' reports. Occurrences of and connections between variables were analyzed with descriptive statistics, graphs, t-tests, chi-square tests, one-way ANOVAs and contrasts. Results and conclusions. The methods used to neuropsychologically evaluate children with specific language impairment in Lastenlinna hospital in 1996 2001 included different versions of Wechsler intelligence scales with which verbal and non-verbal processing were analyzed. In addition, the neuropsychological evaluation was often augmented with the linguistic subtests of Nepsy and Nepsu. The participants performed worse than standard on verbal tasks, whereas in non-verbal tasks their performance was close to standard. Participants with expressive language disorder F80.1 had the verbal IQ close to normal, and only participants with receptive language disorder F80.2 had a significantly low verbal IQ. Children with specific language impairment were mostly recommended to participate in prolonged primary education, full-time special education or general education. The school recommendations were connected to verbal performance: the more severe the problems with language, the more rehabilitating education was recommended. The evaluation of children with specific language impairment should be more comprehensive so that a clearer picture of their cognitive processing and ability to function could be attained. The difference between the verbal and non-verbal performance
  • Karhu, Anu (Helsingin yliopisto, 2017)
    Aim: An undiagnosed language learning disability, such as SLI (specific language impairment), may play a role in an adult immigrant's learning problems. There is no previous research in Finland on referrals to assessment or the assessment process of adult immigrants based on symptoms of SLI. The purpose of this study was to find out how SLI symptoms are recognized in adult immigrants, how are referrals for assessment being made and what kind of specific issues are related to these assessments. Methods: The methods in this study are a short email survey and semi-structured interviews. The survey and the interviews were carried out between March 2016 and Ferbruary 2017. The survey area covered the whole country, but all but one of the interviews were carried out in three regions of Southern Finland. The research material consists of the email responses from 27 health care professionals and one teacher as well as the interviews of two L2 teachers, two adult immigrants, two SLTs and one neurologist. The material was analyzed with theory-bound content analysis. Results and conclusions: The results show that adult immigrants are rarely referred to assessment based on symptoms of SLI. There is no uniform practice in referring adult immigrants to an SLP. Health care professionals see diagnosing an SLI in adult immigrants as problematic, since a person's learning abilities may be affected by a number of other background factors besides an SLI. L2 teachers have a crucial role in recognizing verbal learning disabilities in adult immigrants as well as in referring them to assessment. Special knowledge gained on learning disabilities helps them in recognizing verbal learning disabilities. However, recognizing the problem and referring a person to assessment may be delayed due to lack of background information, lack of information about assessment opportunities and immigrants not being open about their learning difficulties. The composition of the team involved in the assessment process may vary, and there is no harmonised assessing protocol to follow. The use of assessment methods is largely based on the clinicians' own clinical experience. A clinical interview is an important assessment method. An interpreter also plays a vital role in the assessment, but the use of an interpreter involves challenges of its own.
  • Luukkanen, Henna (Helsingin yliopisto, 2017)
    Objectives. Specific language impairment (SLI) is a heterogeneous disorder varying in both symptom profile and severity and it often involves a variety of co-morbid problems. Language problems seem to be somewhat persistent until adolescence and adulthood but there is still little known about the wider long-term effects of the disorder. Information could help, for instance, in early identification and prevention of potential problems. The purpose of this study was to examine the impact of the childhood diagnosis of SLI on self-perceived quality of life and well-being of young adults aged 20–22 years. The focus was on the subjects' self-perceived health-related quality of life and their own views on the effects of the SLI diagnosis on their lives. The study is part of a larger research project, which examines symptom profiles and longitudinal effects of childhood SLI. Methods. The study was carried out as a survey. The study sample consisted of persons who had received at Lastenlinna, the children's hospital of Helsinki University Central Hospital, a primary diagnosis of specific language impairment (F80.1 expressive and/or F80.2 receptive language disorder) in 1998 or 1999. The survey consisted of a 15D questionnaire measuring health-related quality of life (HRQoL) and a separate SLI questionnaire which gathered other information relevant for the study. A total of 74 subjects answered the questionnaire resulting in a response rate of 38,5 percent. The data of the multiple-choice questions of the 15D and SLI questionnaires were analysed quantitatively by computing frequencies, averages, standard deviations and percentages of the answers and examining correlations between different variables. Answers of the open question were analysed using qualitative content analysis which brought forth some descriptive themes. Results and conclusions. The subjects perceived their HRQoL (15D) to be significantly worse off compared with age- and gender-matched control population which was apparent in the total 15D score and in several dimensions (hearing, sleeping, speech, usual activities, mental function, depression, distress and vitality). Subjects' views on the effects of the SLI diagnosis on their lives were individual and varied, which reflects the heterogeneous nature of the disorder also from the perspective of the long-term effects. The effects of the SLI diagnosis extended to several areas of life, but the results included also positive effects and mitigation of problems. In the future additional research will be needed to, for instance, identify factors predicting long-term effects of SLI. The acquired information could help to focus the preventive supportive actions, rehabilitation and follow-up on children at greatest risk of negative long-term effects.
  • Seppälä, Metti (Helsingin yliopisto, 2018)
    Aims. Bilingual language development can have positive or negative effects on phonological development. Children with specific language impairment can have difficulties in phonological skills. This study aimed to compare the paradigmatic and phonotactic skills of sequential bilingual children with SLI to the skills of monolingual children with SLI in the Finnish language. The connection between paradigmatic and phonotactic skills was studied. The effect of bilingual language impaired children's age, sex and duration of Finnish acquisition and the effect of monolingual language impaired children's age and sex on their phonotactic skills was researched. Methods. The participants were sequentially bilingual language impaired children (N = 46) aged 3;5– 5;10 and monolingual language impaired children (N = 46) aged 3;5–5;9. The participants had been recruited to Helsinki Longitudinal SLI study in 2013–2015. The evaluation method was Finnish Test of Phonology (Fonologiatesti). The paradigmatic and phonotactic skills of the two groups were compared using statistical methods. The connection between paradigmatic and phonotactic skills was studied in both groups. A linear regression model was conducted for each group. In both models the dependent variable was phonotactic skills. In the bilingual language impaired group the explanatory variables were age, sex and duration of Finnish acquisition. In the monolingual language impaired group the explanatory variables were age and sex. Results and conclusions. Bilingual children with SLI had better paradigmatic and phonotactic skills compared to monolingual children with SLI. Paradigmatic and phonotactic skills correlated strongly in both groups. The correlations in the monolingual language impaired group were statistically more significant. Age was a statistically significant explanatory variable for phonotactic skills in both groups. The duration of language acquisition of bilingual children with SLI was not a statistically significant explanatory variable for phonotactic skills. Bilingual children with SLI may have more articulate speech than monolingual children with SLI. Bilingualism may function as a protective factor in phonological difficulties associated with SLI.
  • Koverola, Mika Jaakko Tapio (Helsingfors universitet, 2016)
    Specific Language Impairment is a broad spectrum disorder of language development, not including deficits of non-verbal intelligence. It typically manifests in a slower rate of learning new words. According to previous research, the disorder is connected with anomalous lateralization of speech related neural processes. The neural basis of Specific Language Impairment has mainly been studied in adults and school aged children, even though the disorder manifests already in preschool age. Studying the neural representations of words and their changes during a learning process in preschool children can help to recognize the cognitive risk factors of Specific Language Impairment. This study aims to confirm, whether neural representations of words are anomalously lateralized in Specific Language Impairment. In addition, differences in the rate of formation of the neural representation of words between children with Specific Language Impairment and children with typically developed language skills are studied. 12 children with Specific Language Impairment and 12 children with typically developed linguistic abilities between the ages 3 to 6 participated in the study. The differences between groups in event related potentials for a known word and an unknown pseudoword and the changes they undergo during passive listening were explored. It was found that the evoked response potentials for both stimulus types were more clearly lateralized on the left side in linguistically typically developed children than in those with Specific Language Impairment, suggesting atypical organization of word representations. Group differences were also found in the event related potentials elicited by the pseudoword: in the control group the event related potential for the pseudoword differed significantly from the one for the known word in the beginning of the experiment (lexicality effect) and resembled it by the end of the experiment (lexicalization), whereas no such difference in the beginning of and change during the experiment was observed in the experimental group. Based on this study Specific Language Impairment is associated with anomalous neural functions both in the automatic activation of the neural representations of words and in the formation of new word representations during passive listening. Both of these phenomena may be related to abnormal language development, but the mechanisms should be determined in more detail in further investigations.
  • Hänninen, Riikka (Helsingin yliopisto, 2018)
    Objectives: Specific language impairment (SLI) is a developmental language disorder characterised by deficits in linguistic cognitive abilities. There's still evidence that SLI-children have also deficits in non-linguistic cognitive abilities (e.g. executive functions, processing speed). Parent-child interaction is crucial to a child's development. A parent's ability to support their child in the zone of proximal development is an important feature of positive parent-child interaction. Indeed, parent-child interaction is central to the rehabilitation of SLI. Prior research on the interaction of SLI-children and their parents has focused on the association between linguistic deficits and interaction. The aim of this study was to examine how the SLI-child's non-linguistic cognitive abilities are associated with parent behaviours during parent-child interaction, and to the parent-child relationship. Methods: The sample was part of Helsinki Longitudinal SLI study and consisted of 85 parent-child dyads. All children had been diagnosed with SLI and were 3–6 years of age. Parent-child dyads were videotaped in three different situations: drawing, free play and puzzle-making. Erickson's parenthood scales were used to evaluate parent behaviour. The parent-child relationship was evaluated by using Erickson's interaction scales and Mutual Responsive Orientation Scale. Children's non-linguistic abilities were assessed with neuropsychological tests, WPPSI-III and NEPSY-II. Associations were examined using linear and logistic regression analyses. Results: There were a negative association between the SLI-child's processing speed and the sensitivity and timing of parent's instructions. Other SLI-child's non-linguistic cognitive abilities were not associated with parent behaviours. The SLI-child's non-linguistic cognitive abilities were not associated with the parent-child relationship. Conclusions: Parents give more sensitive and well-timed instructions when the SLI-child's speed of information processing is slower. This suggests that parents may adapt their behaviour to the SLI-child's processing speed. Further research is needed to clarify why parents give more sensitive and well-timed instructions to SLI-children with slower processing speeds.
  • Huttunen, Kerttu; Kosonen, Joanna; Waaramaa, Teija; Laakso, Marja-Leena (Kela, 2018)
    Sosiaali- ja terveysturvan raportteja
    Tässä tutkimuksessa kartoitettiin joihinkin kommunikointihäiriöryhmiin kuuluvien 6–10-vuotiaiden lasten taitoja erottaa tunteita puheesta ja kasvoilta ja lisäksi muita tunnetaitoja. Tutkittavina oli 35 lasta, joilla oli jokin autismin kirjon häiriö (useimmiten Aspergerin oireyhtymä), ADHD, kielellinen erityisvaikeus tai kuulovika ja joilla vanhemmat, opettajat ja/tai kuntouttajat olivat havainneet olevan hankaluuksia tunteiden tunnistamisessa. Koeryhmän lapset harjoittelivat tunteiden erottelua ja muita taitoja internetissä pelattavan Tunne-etsivät-pelin avulla kahden kuukauden ajan keskimäärin tunnin viikossa. Taitoja testattiin ennen interventiota, heti sen päätyttyä ja vielä kuukauden kuluttua pelaamisjakson päättymisen jälkeen. Lasten arkipäivän sosioemotionaalisia taitoja tarkasteltiin vanhempien täyttämien kyselylomakkeiden avulla (VAS-arviot tunteiden tunnistamiskyvystä ja Vahvuuksien ja vaikeuksien kyselylomake, SDQ). Koeryhmän lasten tunteiden erottelutaito oli ennen pelaamisjaksoa kaikissa tehtävissä heikompi kuin ikätovereilla (N = 101). Taidot olivat peli-intervention jälkeen kuitenkin tilastollisesti merkitsevästi lähtötilannetta paremmat sekä heti peli-intervention jälkeen että vielä kuukausi sen päättymisestä. Taidot paranivat eri tehtävissä keskimäärin 5–19 prosenttiyksikköä ja ne vastasivat pelijakson päätyttyä ikätovereiden taitoja kaikissa paitsi yhdessä tehtävässä. Vanhempien VAS-asteikolla antamat arviot lapsensa tunteiden tunnistamistaidoista ja SDQ-kyselylomakkeen avulla antamat arviot sosioemotionaalisista vahvuuksista ja vaikeuksista eivät sen sijaan muuttuneet pelaamisjakson jälkeen. Toisin kuin ennen pelaamisjaksoa, peli-intervention jälkeen vanhempien VAS-arviot lapsensa tunteiden tunnistustaidosta kasvoilta vastasivat kuitenkin kohtalaisesti testaustilanteessa todettuja lapsen taitoja FEFA2-testissä ja tehtävässä, jossa oli eroteltava tunteita valokuvista.
  • Kulmala, Carita (Helsingin yliopisto, 2019)
    Objectives. Although children with language impairment typically have difficulties processing linguistic structures and with pragmatics, they have also been described as resourceful in conversations. Difficulties in linguistic skills affect speech production, causing communication breakdowns in conversations. When a problem occurs in a conversation, people can use compensatory strategies to get their message understood. These compensatory means can be verbal or non-verbal. There is only little research on children’s compensatory skills and how they act when a communicational problem occurs. Previous research has also been focused mainly in verbal communication. In order to gain an accurate understanding of a child’s linguistic performance, it is beneficial to gather individual information on how the child behaves in natural contexts. Especially the child’s parents are a valuable source of information in addition to a specialist’s assessment. The aim of this study was to examine the interactional skills of school-age children with specific language impairment and to describe what kind of compensatory strategies they use based on their parents’ observations. In addition, this study gathered information on parents’ experiences of the support the families have received. Methods. Twelve parents were interviewed in nine interviews for this study. The interviews were done in 2018. At the time, the children were aged between 6;2–10;0 years. This study used a semi-structured theme interview, and the data were analysed using a theory-driven content analysis. Results and conclusions. The parents reported that their children use several verbal and non-verbal compensational strategies. Pointing and the use of circumlocutions were the most reported strategies. It was also typical for the children that they relied on adult’s help to solve communicational breakdowns. The parents reported that they have found the best solutions and support methods for their family in daily living, but they also have received some advice from professionals. Family courses on SLI and peer support were reported as especially helpful and important support methods.