The Japanese journal of neuropsychology

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ArticleTitle	Linguistic and Cognitive Evaluation of Children with Acquired Aphasia
Language	J
AuthorList	Mitsuko Shindo¹⁾, Aya Eto²⁾ and Kiyoko Ichikawa³⁾
Affiliation	1) Sophia University Research Center for Communication Disorders 2) Kumada Clinic: Ear, Nose & Throat/Voice & Speech 3) Toranomon Hospital, Kajigaya
Publication	Japanese Journal of Neuropsychology: 24 (1), 61-69, 2008
Received
Accepted
Abstract	Traditional description of the clinical picture of acquired childhood aphasia claims that acquired childhood aphasia is), that recovery of language disorder is rapid and complete. In the past 20 years, however, several case studies indicate that even after recovering speech in daily communication, those children with acquired aphasia exhibit symptoms similar to its counterpart in adults. The investigation was made in 2004 by using questionnaires regarding the difficulties in language and social development of acquired childhood aphasia in Japan. The questionnaires were sent to children's hospitals, special center for the handicapped children, and special schools for the handicapped. The main findings were as follows: These children show difficulties in learning new Kanji letters, vocabulary, and "ku-ku," a Japanese multiplication tables. Their difficulties in learning these new subjects become more apparent as they advance in grades. In Japan, there is no appropriate clinical tool in evaluating language and cognitive development of children with acquired aphasia. Therefore, we have tried to develop two clinical tools to evaluate the development of (1) syntax and of (2) reading two-character kanji words. This syntax test was constructed to examine both comprehension and production abilities (in syntax). The results suggest that normally developing children can understand 'irreversible sentences' and 'adjunctive sentences' by 5 years old and 'the passive and causative voices' by 6 years. However, it was difficult for even 6 year olds to express 'the causative' style suggests the delayed acquisition of the reversible sentence by the children with acquired aphasia. The test results of those with acquired aphasia were compared with those of the normally developing children. Their development of grammatical particles and voices were slower when compared with those of normally developing children. Next, we developed a tool to clarify problems of oral reading "two-character kanji words" by a child with acquired aphasia. Evaluation materials consisted of 40 two-character kanji words for the 3rd grade level and 60 two-character kanji words for the 4^th grade level. The present study examined the 4th grade child with acquired aphasia and in comparison, 265 normally developing children from 3rd to 6^th grades. Main results among the normally developing children were as below: The higher the grades, the better the reading test score averages. Up to the 3^rd and 4^th grade, Kun-reading style (of Japanese origin) was dominant. Thereafter, On-reading style (of Chinese origin) dominated the other. After the 5^th and 6^th grades, the "consistency" effect could be seen in their reading style. The lower scores by the child with acquired aphasia may be attributed to poor abilities in switching from Kun-reading to On-reading style. The small vocabulary size and delayed development in phonological awareness might cause these lower scores. However, the percentage of incorrect responses in reading Kanji-words by the child with acquired aphasia is similar to those by the control group, and the difference appeared to be not only slow rate but also limitation in her word retrieval processing. Furthermore, in reading Kanji-words, the child with acquired aphasia as well as the controls seemed to use both semantic and lexical routes. Main findings for the child with acquired aphasia were as followings: The education and training for the acquired childhood aphasia needed two-fold strategies. The first attempt was to improve disorders of language functions resulting from the cortical lesions. The second was to have a longer term view in considering normal pattern of language acquisition; i.e. linguistic, cognitive, and social skills in a developing child. Moreover, it is necessary to develop effective assessment batteries for those with acquired aphasia, and to provide supportive training methods in considering psychological aspects as well as academic activities which were also characteristics of 3rd and 4th graders in the control group.
Keywords	clinical picture of acquired aphasia in children, language and cognition, syntactic development, reading two-character kanji words, learning difficulties