Language development in children with spina bifida

Fletcher JM, Barnes M, Dennis M. Language development in children with spina bifida. Seminars in Pediatric Neurology. 2002 Sep;9(3):201-8. Review.

Spina bifida meningomyelocele (SBM) is the most common severely disabling birth defect in North America. It is a disorder of the central nervous system that includes, in addition to the defining spinal dysraphism, congenital malformations of the cerebellum and corpus callosum that, along with hydrocephalus, produces a range of cognitive and motor difficulties, including language. In the language domain, many children with SBM demonstrate adequate development of language at the level of form and content (grammar and lexicon). However, most children with SBM experience significant difficulties in the construction of meaning and in pragmatic communication, both of which require flexible language processing in real time. Assessment and intervention should specifically attend to the development of meaning construction and semantic-pragmatic communication.

PMID: 12350041

Language differences in young children with myelomeningocele and shunted hydrocephalus

Vachha B, Adams R. Language differences in young children with myelomeningocele and shunted hydrocephalus. Pediatric Neurosurgery. 2003 Oct;39(4):184-9.

OBJECTIVE: This comparative cohort study examined language differences in young children (preschool to first grade) with myelomeningocele and shunted hydrocephalus (MM/SH).

METHOD: A well-validated, standardized language test was administered to 17 children with MM/SH (age range 4-6 years) and 16 age-matched, nonaffected children.

RESULTS: Standard scores were obtained within lexical/semantic, syntactic, and pragmatic domains. An analysis of performance on individual subtests within the lexical/semantic domain was striking. Children with MM/SH performed significantly worse (p<0.01) on a test measuring the comprehension of words representing important early learning concepts and on pragmatic tasks that measured their ability to use language functionally in social situations.

CONCLUSIONS: Words representing basic precepts and concepts are commonly used in instructions to children in early childhood. Difficulty with functional pragmatic language results in suboptimal communication skills. Academic and community implications are discussed.

PMID: 12944698