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A group of children was identified as 'late talkers' who were slow in expressive language development (SELD) on the basis of small expressive vocabulary size at 20-34 months of age. The subjects were followed yearly throughout the preschool and early school-age periods in order to track growth in language and related skills. When the subjects were in second grade, their expressive language skills, as indexed by the Developmental Sentence Score, were measured. This measure was used as the outcome variable in regression and discriminant function analyses. Predictor variables included those gathered when the subjects entered the study at age 2. They included measures of early expressive and receptive language by parent report, nonverbal cognitive performance, Bayley Mental Scale score (a combined verbal and nonverbal cognitive measure), phonological skill, motor skills, maladaptive behaviors, social skills, birth order, socioeconomic (SES) level, and gender. Only SES and early expressive language skills predicted expressive language outcome in second grade. Discriminant function analysis revealed these two factors were significant in predicting success (scores above the tenth percentile), along with a contribution of early gross motor skills. The implications of these findings for understanding early language delays are discussed.

Several major transitions in language use take place during the first 5 years of life. Each transition allows the child to move to a higher level of complexity of expression and to accomplish communicative goals more flexibly and precisely than was done at the previous level. At least three of these transitions appear to be modulated to some degree by speech. In the first transition, prellnguistic to early linguistic communication, babbling provides the infant with a prelinguistic form of vocal behavior that is in many ways analogous to language. A second transition takes place in the movement from single words to multiword combinations. In the process of this transition, word order becomes a means by which children convey semantic role information, and transitional forms such as successive one-word utterances help to facilitate the child's leap from single-word speech to multiword sentences. A third transition involves the development of phonological awareness, an important basis for the acquisition of literacy, which builds on the foundation laid by the phonological system for articulation. In each of these transitions, speech appears important for mediating the move to a higher language level. This paper considers the question of how these transitions can be facilitated in children who use augmentative and alternative communication rather than speech as a first expressive system, in order to provide as precise and flexible a communication modality as possible to children with severe speech impairments.

This article discusses the integration of various aspects of the child's development, particularly the development of language and communication and the way in which these developments interact to enable the child to construct a coherent sense of self. Multiplex developmental disorder is presented as an example of a disorder that affects several of these crucial strands of development. Recent research and controversies regarding the diagnostic descriptions of multiplex and other pervasive developmental disorders are presented. This discussion is used to illustrate the ways in which such disorders affect not only the individual aspects of development, but the child's ability to form a cohesive sense of self. The implications of these difficulties in self-definition for treating children with disorders that affect a variety of aspects of development are also discussed.

This article examines the communication styles of children with mental retardation, emphasizing the assessment and intervention protocols used by health and education professionals. This article highlights the following approaches: a developmental psycholinguistic orientation, a pragmatics approach, and a supportive interdependent format consistent with the 1992 revision of how mental retardation is classified. This article discusses children with mental retardation who show challenging and disruptive behavior.

This article presents issues related to the communication assessment of children with psychiatric and communication disorders. Challenges inherent in assessing this population are discussed. Frequently used assessment instruments and procedures are described. Consideration is given to the assessment of very young or low-functioning children and older or high-functioning children.

This article discusses the assessment of communication skills in children from birth to 5 years of age. The different methods appropriate for different developmental levels and the relationship of collateral areas, such as hearing, cognition, and speech motor control to the communication process, are addressed. The need for standardized and informal measures is emphasized Case studies are presented to illustrate the principles outlined.

This article defines communication and describes its various disorders. Some of these disorders are associated with other DSM-IV conditions, such as mental retardation or pervasive developmental disorder. Others are specific to the language-learning process. The interactions between communication and psychiatric disorders are discussed. Suggestions for integrating treating approaches among communication disorders and mental health professionals are presented.

This study examines the temperamental characteristics of children who were identified at age two as being slow in expressive language development, and those of peers with normal language history. When the children were in first grade (approximately age six), parents and clinicians rated subjects' temperamental characteristics, using a standardized temperament assessment instrument. Subjects with a history of slow expressive language development were rated significantly lower on Approach/Withdrawal-indicating shyness, aloofness, or reduced outgoingness-than peers with normal language history. Approach/Withdrawal scores were significantly correlated with average sentence length in spontaneous speech, and this measure also predicted Approach/Withdrawal scores in regression analyses. The clinical and theoretical implications of these findings for early language delay are discussed.

Traumatic brain injuries (TBI) may result in a broad array of cognitive-communicative impairments. Cognitive-communicative impairments are the result of deficits in linguistic and nonlinguistic cognitive functions. The speech-language pathologist functions as a member of the multidisciplinary team of professionals that collaboratively assess and treat individuals with TBI. The role of the speech-language pathologist includes assessment of all aspects of communication, as well as the communicative implications of cognitive deficits, and swallowing; treatment planning and programming, as determined by the individual's stage of recovery; client and family training/counseling; and interdisciplinary consultation. The effectiveness of speech and language intervention for specific cognitive deficits (e.g., attention, memory, executive functions) as well as general issues of social-skills training and early intervention are illustrated by scientific and clinical evidence from group-treatment and single-subject studies as well as case studies.

A simplified, 3-category method for scoring the Kaufman Hand Movements test was devised to replace a previously used, more complex 21-category scoring method. The concurrent validity and diagnostic sensitivity of the rescored test as a measure of limb apraxia were investigated in a reanalysis of the test protocols of 23 aphasic adults. Using the Limb Apraxia Test as the criterion measure, a Pearson r of .71 and predictive validity of 100% were obtained. These results encourage further investigation of the Kaufman Hand Movements lest as an efficient measure of limb apraxia.

Preliminary findings from an ongoing investigation of the potential relationship between narrative discourse performance and executive functions in adults with traumatic brain injuries (TBI) are reported. Narrative stories were elicited from 32 adults with TBI. Stories were analysed at three levels: sentence production, intersentential cohesive adequacy, and story episode structure. These measures were then correlated with scores from the Wisconsin Card Sorting Test (WCST), the primary measure of executive function. A significant correlation was noted between a factor score from the WCST and the measure of story structure, but not sentence production or cohesive adequacy. These results suggest that executive functions may be a promising avenue to pursue in the search for underlying causal factors of narrative discourse dysfunction and, therefore to better delineate the nature of communicative deficits secondary to TBI.

This review analyses several recent studies of discourse deficits subsequent to traumatic brain injury. The review describes methodological problems related to incomplete subject descriptions, use of different discourse elicitation tasks and analyses, and examines the findings from each study by level of analysis. The limitations of these findings are discussed and general conclusions regarding discourse abilities following traumatic brain injury are offered. Implications for future research are also presented.