Measuring communication outcomes

Abstract

abnormalities suggesting that functional abnormalities of the perisylvian region could be present. Interestingly, six out of the 20 children with unilateral perisylvian polymicrogyria presented with pseudobulbar palsy despite the unilaterality of their brain malformations. It is likely that these six children also had contralateral perisylvian functional abnormalities. Similarly, we reported four children with unilateral MRI perisylvian abnormalities and diverse clinical manifestations ranging from speech and cognitive delay to intractable epilepsy. Electroencephalography in two of these four patients showed multifocal spike and wave activities involving left and right hemispheres independently. Their 2-deoxy-2-[18F]fluoro-D-glucose (FDG) positron emission tomography (PET) showed cortical glucose metabolism abnormalities not only in the MRI-detected perisylvian abnormalities but also in the contralateral side (three had contralateral decreases whereas one had contralateral increase in glucose metabolism). The findings suggest that PET may be a useful complementary investigation to MRI in further characterizing the syndrome.4 Ahnlide et al. also reported a case of clinical perisylvian syndrome with normal MRI.5 Ictal single photon emission computed tomography (SPECT) in this case demonstrated a seizure focus in the perisylvian region suggesting that SPECT together with the clinical data may also be helpful in further understanding this disorder.In the Clark et al. paper, the common occurrence of epilepsy in patients with perisylvian polymicrogyria detected on MRI is not surprising since polymicrogyria is known for its epileptogenic nature. An interesting seizure phenotype was also described. Five children presented with profound loss of muscle tone bilaterally associated with apnea and retained consciousness. This type of seizure has not been previously reported in patients with perisylvian polymicrogyria. In this series, there were also patients who developed epileptic encephalopathy. Among these children, four had acquired pseudobulbar palsy related to seizure activity (three CUPP and one CBPP), a finding that has also been reported in a case of acquired epileptic opercular syndrome where the primary seizure focus has been localized in the sylvian fissure. 6 With the overlapping clinical features of congenital perisylvian syndrome and WDS and the presence of clinical features without visible structural imaging abnormalities in the perisylvian region, the authors' proposal to view congenital perisylvian dysfunction as a spectrum with or without MRI abnormalities is reasonable. The authors suggest that the syndrome may be underdiagnosed when there is normal structural imaging. We therefore suggest that if the syndrome is suspected based on clinical features, PET be used as a diagnostic tool in the recognition of the syndrome.

Tutorial: Speech Assessment for Multilingual Children Who Do Not Speak the Same Language(s) as the Speech-Language Pathologist

“…Although traditional speech assessments are focused on discrete skills (e.g., speech sound production), the goal of intervention is to increase children's ability to use speech to participate in their environment (Pennington, 2010). The International Classification of Functioning, Disability and Health: Children and Youth Version (World Health Organization, 2007) provides a structure for examining children's activities, participation, and real-world functioning and is the basis for the Focus on the Outcomes of Communication Under Six (FOCUS; Thomas-Stonell, Washington, Oddson, Robertson, & Rosenbaum, 2013), which is an easily accessible, SLP- and parent-friendly tool.…”

Neglect-like characteristics of developmental disregard in children with cerebral palsy revealed by event related potentials

“…EF is an umbrella term for different higher order cognitive abilities, such as higher order attentional processes, vigilance, and inhibitory control [ 21 ]. It is known that EFs rely on an extensive interconnectivity between different parts of the brain especially involving the prefrontal cortex [ 22 ]. As the frontal lobes as well as the intricate connections from underlying brain regions are known to be the last to reach maturity, EFs are known to be the last cognitive area to mature and are therefore especially influenced by developmental periods in middle childhood [ 22 ].…”

“…It is known that EFs rely on an extensive interconnectivity between different parts of the brain especially involving the prefrontal cortex [ 22 ]. As the frontal lobes as well as the intricate connections from underlying brain regions are known to be the last to reach maturity, EFs are known to be the last cognitive area to mature and are therefore especially influenced by developmental periods in middle childhood [ 22 ]. Damage to, or delays in development of these white matter tracts are associated with executive dysfunctions [ 19 , 21 , 22 ].…”