The Differences in Clinical Aspect Between Specific Language Impairment and Global Developmental Delay

Objective To compare and analyze the clinical characteristics of children with delayed language acquisition due to two different diagnoses, which were specific language impairment (SLI, a primarily delayed language development) and global developmental delay (GDD, a language delay related to cognitive impairment). Methods Among 1,598 children who had visited the developmental delay clinic from March 2005 to February 2011, 467 children who were diagnosed with GDD and 183 children who were diagnosed with SLI were included in this study. All children were questioned about past, family, and developmental history, and their language competences and cognitive function were assessed. Some children got electroencephalography (EEG), in case of need. Results The presence of the perinatal risk factors showed no difference in two groups. In the children with GDD, they had more delayed acquisition of independent walking and more frequent EEG abnormalities compared with the children with SLI (p<0.01). The positive family history of delayed language development was more prevalent in children with SLI (p<0.01). In areas of language ability, the quotient of receptive language and expressive language did not show any meaningful statistical differences between the two groups. Analyzing in each group, the receptive language quotient was higher than expressive language quotient in both group (p<0.01). In the GDD group, the Bayley Scales of Infant Development II (BSID-II) showed a marked low mental and motor quotient while the Wechsler Intelligence Scale showed low verbal and nonverbal IQ. In the SLI group, the BSID-II and Wechsler Intelligence Scale showed low scores in mental area and verbal IQ but sparing motor area and nonverbal IQ. Conclusion The linguistic profiles of children with language delay could not differentiate between SLI and GDD. The clinicians needed to be aware of these developmental issues, and history taking and clinical evaluation, including cognitive assessment, could be helpful to diagnose adequately and set the treatment plan for each child.

[1]  M. Shevell.  Global developmental delay and mental retardation or intellectual disability: conceptualization, evaluation, and etiology. , 2008, Pediatric clinics of North America.

[2]  Jin Hee Park,et al.  Relationship of Language, Intelligent and Social Quotients in Children with Speech and Language Disorder , 2008 .

[3]  A. Majnemer,et al.  Developmental and functional outcomes in children with global developmental delay or developmental language impairment , 2005, Developmental medicine and child neurology.

[4]  M. Gingold,et al.  CME Practice parameter : Evaluation of the child with global developmental delay , 2003 .

[5]  Chang-il Park,et al.  Early Treatment Effect in Children with Cerebral Palsy and Delayed Development , 1999 .

[6]  K. Stromswold,et al.  Genetics of spoken language disorders. , 1998, Human biology.

[7]  Parental phonological memory contributes to prediction of outcome of late talkers from 20 months to 4 years: a longitudinal study of precursors of specific language impairment , 2012, Journal of Neurodevelopmental Disorders.

[8]  P. Biondich,et al.  Identifying Infants and Young Children With Developmental Disorders in the Medical Home: An Algorithm for Developmental Surveillance and Screening , 2006, Pediatrics.

[9]  M. Shevell,et al.  Topical Review: Neurobiology of Specific Language Impairment , 2004 .

[10]  N. Sebire,et al.  The risks associated with pregnancy in women aged 35 years or older. , 2000, Human reproduction.

[11]  Jung Ju Lee.  Effect of women's first childbearing age on the risk of low birth weight , 2007 .

[12]  H. Chung,et al.  Well Baby Clinic: Developmental Guidance according to the Parent's Chief Complaints , 2009 .

[13]  H. Chung,et al.  Diagnosis and Clinical Features of Children with Language Delay , 2005 .

[14]  A. Majnemer,et al.  Diagnostic yield of the neurologic assessment of the developmentally delayed child. , 1995, The Journal of pediatrics.

[15]  M. Shevell.  Present Conceptualization of Early Childhood Neurodevelopmental Disabilities , 2010, Journal of child neurology.

[16]  Tiffany L. Hutchins,et al.  Speech-Language Impairment: How to Identify the Most Common and Least Diagnosed Disability of Childhood , 2008 .

[17]  Sandra M. Grether.  Global developmental delay and its relationship to cognitive skills , 2009, Developmental medicine and child neurology.

[18]  M. Kim,et al.  Assessment of Children with Developmental Delay: Korean-Ages & Stages Questionnaires(K-ASQ) and Bayley Scales of Infant Development test II(BSID-II) , 2010 .

[19]  A. Majnemer,et al.  Benefits of early intervention for children with developmental disabilities. , 1998, Seminars in pediatric neurology.