Acquired Childhood Aphasia

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					Acquired Childhood Aphasia


                   Braylen D. Rogers
Definition
 Children with acquired language disorders had begun to
  develop language normally but then lost all or part of
  their communicative abilities as a result of neurological
  damage.
Types of Brain Injury
 Traumatic Brain Injury (TBI)

 Strokes and Tumors

 Landau-Kleffner Syndrome
Traumatic Brain Injury (TBI)
 Every year children 14 years and younger sustain a TBI
  that result in 3,000 deaths

 29,000 hospitalization

 400,000 emergency department visits

 4% of all children kindergarten through twelfth grade
  have experienced some type of head trauma
Causes
 Different age groups= different causes

 Infants: falls or abuse

 Preschoolers: falls

 Young school-age: Sports (that’s me) and accidents
  involving them as pedestrians, bike or skateboard riders

 Adolescents sustain the most accidents, primarily as the
  result of motor vehicles
Classification
 Based on scores of the Glasgow Coma Scale

 13-15: mild brain injury

 9-12: moderate brain injury

 3-8: severe brain injury
The Glasgow Coma Scale
Best Eye Opening         Best Motor Response     Best Verbal Response
4 Open eyes on own       6 Follows simple        5 Carries on a
                         commands                conversation
3 Opens eyes when        5 Pulls examiner’s      4 Seems confused or
asked to in loud voice   hand away when          disoriented
                         pinched
2 Opens eyes when        4 Pulls part of body    3 Talks so examiner
pinched                  away                    can understand victim
                                                 but makes no sense
1 Does not open eyes 3 Flexes body               2 Makes sounds that
                     inappropriately to          examiner can’t
                     pain                        understand
                         2 Body becomes          1 Makes no noise
                         ridged in an extended
                         position
                         1 No motor response
Strokes and Tumor
 Are most common causes for adult aphasia

 Only 0.5 per 100,000 children under 15

 More than 1/3 of childhood strokes occur during the
  first two years of life
Causes
 The common causes of stroke in children are: cardiac
  disease, vascular occlusion sickle cell disease, vascular
  malformation and hemorrhage.
Landau-Kleffner Syndrome
 Least frequent cause of acquired language disorders

 A distinctive syndrome in which convulsive disorder,
  indicated by abnormal electroencephalogram (EEG)
  tracings, occurs at about the same time as a breakdown
  in language
Conditions
 It has a low incidence. Only 198 cases reported since
  1992

 Age of onset ranges from 1½ to 13 years

 Language regression may be gradual or sudden

 Males are affected twice as often as females

 Changes in aphasia, seizures and show normal EEG
  tracings but continue to exhibit aphasia. Others show
  opposite pattern
Language Development and
Language Recovery
 The prevailing view has been that brain-injured children
  differ from adults in three ways:

 They have a lower risk of aphasia

 They present different language symptoms

 They recover faster and more fully than adults
Recovery
 Toddlers and young children generally appear to recover
  best because:

 Their brains withstand injury better than those of
  infants

 They have established certain spoken language skills
  and sometimes written language skills prior to injury

 They still have enough plasticity for functional
  reorganization of the brain to occur
Recovery continued
 After age 5, children’s patterns of recovery from TBI
  become increasingly like those of adults

 However, children who acquire aphasia secondary to
  convulsive disorder generally recover better when onset
  occurs at older age

 Type and location of brain injury may also affect a
  child’s recovery
Language characteristics of kids
with acquired aphasia



The first three months to a year following the brain injury
  is referred to as a period of “spontaneous recovery”
Acute Recovery Period
 Comprehension: A wide range of comprehension
  impairments are found among children with acute
  aphasia

 The severity of the comprehension disorders
  corresponds to the severity of the injury

 A study of 57 children and adolescents with mild to
  moderate-sever closed head injury found that more
  than 18% had poor auditory comprehension of
  syntactically complex sentences but only 2% had trouble
  understanding single words.
Word Retrieval
 Difficulties with word retrieval are frequently observed
  in children with acquired aphasia

 9% of children with mild-to-moderate were hampered in
  confrontation naming

 18% had trouble retrieving words in specific category

 Few studies have documented lexical difficulties with
  left-sided vascular lesions

 Landau-Kleffner show word substitutions and word
  retrieval problems
Academic Achievement
 Though many children with acquired aphasia can be
  considered as “fully recovered” there still can be
  effects on academics

 Even effect intelligence testing

 Next table shows possible effect
Academic Difficulties for Kids
with Severe Head Injury
             25 % of the children had difficulty with reading vocab
             50% difficulty with rate of reading
Reading      70% difficulty with higher levels of comp
             90% trouble comprehension70% showed deterioration
             in auditory comp with amount increased
Auditory
Comp         25% performed moor poorly on standardized comp tests
             70% showed deterioration in auditory comprehension
Expressive   when the amount of language was increased
language
             14% had difficulty expressing simple ideas
Writing      75% difficulty expressing complex ideas in both spoken
             and written
             75% scored below the 15th percentile on timed writing
Memory       test
             77% showed deficits in long-term recall of verbal
Attention    material

             60% were distracted by auditory and visual stimuli in the
             classroom
Other Academic Problems
 Limited self-awareness of communication problems,
  which leads to a reluctance or unwillingness to work on
  them

 Difficulty initiating conversation

 General self-evaluations (“it’s okay” or “it’s all wrong”)
  that do not lead to constructive responses