Biological Bases of Specific Language Impairment (Developmental Aphasia)

  • Dorothy Bishop


When a child is brought to a pediatrician because language is not developing normally, there are several investigations that are typically carried out. The child’s hearing is tested, and cognitive and social development are assessed. The medical history is scrutinized to see if there is any evidence of neurological disease or trauma early in life, and the child is examined for neurological signs and abnormalities of the speech apparatus. The parents are interviewed about the family circumstances. Although in many cases one might find some explanation for the child’s language disorder in the course of these investigations, all too often this is not the case. The child appears to be physically normal with adequate hearing, good nonverbal ability and normal social relationships, and the medical history and home background are unremarkable. Traditionally the terms “developmental aphasia” or “developmental dysphasia” have been used to describe cases of abnormal language development of unknown origin. However, this terminology is not entirely satisfactory. Use of a neurological label implies similarities with adult acquired dysphasia, but this is usually misleading since, as we shall see, there is seldom any indication of brain damage in these children. Furthermore, the label suggests a clear-cut syndrome, whereas in fact a wide range of problems is included in this definition. For these reasons, more neutral terms such as “specific developmental language disorder” or “specific language impairment” are frequently preferred (Bishop and Rosenbloom, 1987).


Otitis Medium Specific Language Impairment Developmental Dyslexia Language Disorder Developmental Medicine 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Atkinson J, Barlow HB, Braddick O (1982): The development of sensory systems and their modification by experience. In: The Senses, Barlow HB, Mollon J, eds. Cambridge: Cambridge University PressGoogle Scholar
  2. Basser LS (1962): Hemiplegia of early onset and the faculty of speech with special reference to the effects of hemispherectomy. Brain 85:427–460CrossRefGoogle Scholar
  3. Biles RW, Buffler PA, O’Donnell AA (1980): Epidemiology of otitis media: a community study. American Journal of Public Health 70:593–598CrossRefGoogle Scholar
  4. Bishop DVM (1983): Linguistic impairment after left hemidecortication for infantile hemiplegia? A reappraisal. Quarterly Journal of Experimental Psychology 35A: 199–207Google Scholar
  5. Bishop DVM (1988a): Language development after focal brain damage. In: Language Development in Exceptional Circumstances, Bishop DVM, Mogford K, eds. Edinburgh: Churchill LivingstoneGoogle Scholar
  6. Bishop DVM (1988b): Otitis media and developmental language disorder: a reply to Gordon. Journal of Child Psychology and Psychiatry 29:365–368CrossRefGoogle Scholar
  7. Bishop DVM (1990a): Handedness and developmental disorder. Clinics in Developmental Medicine 110: London: MacKeith Press/Black well ScientificGoogle Scholar
  8. Bishop DVM (1990b): Handedness, clumsiness and developmental language disorders. Neuropsychologia, 28:681–690CrossRefGoogle Scholar
  9. Bishop DVM, Adams C (1990): A prospective study of the relationship between specific language impairment, phonological disorders and reading retardation. Journal of Child Psychology and Psychiatry 31:1027–1050CrossRefGoogle Scholar
  10. Bishop DVM, Edmundson A (1986): Is otitis media a major cause of specific developmental language disorders? British Journal of Disorders of Communication 21: 321–338CrossRefGoogle Scholar
  11. Bishop DVM, Edmundson A (1987): Specific language impairment as a matura-tional lag: evidence from longitudinal data on language and motor development. Developmental Medicine and Child Neurology 29:442–459CrossRefGoogle Scholar
  12. Bishop DVM, Rosenbloom L (1987): Classification of childhood language disorders. In: Language Development and Disorders. Clinics in Developmental Medicine (double issue), Nos. 101-2, Yule W, Rutter M, eds. London: MacK-eith Press/BlackwellGoogle Scholar
  13. Caparulo BK, Cohen DJ, Rothmann SL, Young JG, Katz JD, Shaywitz SE, Shay-Witz BA (1981): Computed tomographic brain scanning in children with developmental neuropsychiatric disorders. Journal of the American Academy of Child Psychiatry 20:338–357CrossRefGoogle Scholar
  14. Cappa SF, Guariglia C, Papagno C, Pizzamiglio L, Vallar G, Zoccolotti P, Ambrosi B, Santiemma V (1988): Patterns of lateralization and performance levels for verbal and spatial tasks in congenital androgen deficiency. Behavioural Brain Research 31:177–183CrossRefGoogle Scholar
  15. Chalmers D, Stewart I, Silva P, Mulvena A (1989): Otitis media with effusion in children—the Dunedin study. Clinics in Developmental Medicine 108. Oxford: Blackwell Scientific; Philadelphia: LippincottGoogle Scholar
  16. Conti-Ramsden G (1985): Mothers in dialogue with language-impaired children. Topics in Language Disorders 5:58–68CrossRefGoogle Scholar
  17. Dalby MA (1977a): Aetiological studies in language retarded children. Neuropae-diatrie, supplement to vol 8:499–500CrossRefGoogle Scholar
  18. Dalby MA (1977b): Diagnose und Aetiologie der Dysphasie. In Dysphasie im Kindesalter, Elstner W, Karlstad H, eds. Oslo: UniversitetsforlatetGoogle Scholar
  19. Dennis M, Kohn B (1975): Comprehension of syntax in infantile hémiplégics after cerebral hemidecortication: left-hemisphere superiority. Brain and Language 2:472–482CrossRefGoogle Scholar
  20. Dennis M, Whitaker H (1976): Language acquisition following hemidecortication: linguistic superiority of the left over the right hemisphere. Brain and Language 3:404–433CrossRefGoogle Scholar
  21. Dunn HG, ed. (1986): Sequelae of low birthweight: the Vancouver study. Clinics in Developmental Medicine 95–96. Oxford: Blackwell Scientific/ Philadelphia: LippincottGoogle Scholar
  22. Fitzhardinge PM, Steven EM (1972): The small-for-date infant: II. Neurological and intellectual sequelae. Pediatrics 50:50–57Google Scholar
  23. Galaburda AM, Sherman GF, Rosen GD, Aboitiz F, Geschwind N (1985): Developmental dyslexia: four consecutive patients with cortical anomalies. Annals of Neurology 18:222–233CrossRefGoogle Scholar
  24. Galaburda AM, Corsignlia J, Rosen GD, Sherman GF (1987): Planum temporale asymmetry, reappraisal since Geschwind and Levitsky. Neuropsychologia 25:853–868CrossRefGoogle Scholar
  25. Geschwind N (1983): Genetics: fate, change, and environmental control. In: Genetic Aspects of Speech and Language Disorders. Ludlow CL, Cooper JA, eds. New York: Academic PressGoogle Scholar
  26. Geschwind N, Galaburda A (1985): Cerebral internalization. Biological mechanisms, associations and pathology. I, II, and III. Archives of Neurology 42:428–459; 521-552; 634-654CrossRefGoogle Scholar
  27. Geschwind N, Levitsky W (1968): Left-right asymmetries in temporal speech region. Science 161:186–187CrossRefGoogle Scholar
  28. Harcherik DF, Cohen DJ, Ort S, Paul R, Shaywitz BA, Volkmar FR, Rothman SLG, Leckman JF (1985): Computed tomographic brain scanning in four neuropsychiatric disorders of childhood. American Journal of Psychiatry 142:731–734Google Scholar
  29. Haslam RHA, Dalby JT, Johns RD, Rademaker AW (1981): Cerebral asymmetry in developmental dyslexia. Archives of Neurology 38:679–682CrossRefGoogle Scholar
  30. Holm VA, Kunze LH (1969): Effect of chronic otitis media on language and speech development. Pediatrics 43:833–839Google Scholar
  31. Hurst JA, Baraitser M, Auger E, Graham F, Norell S (1990): An extended family with a dominantly inherited speech disorder. Developmental Medicine and Child Neurology 32:352–355CrossRefGoogle Scholar
  32. Jernigan TL, Tallal P (1990): Late childhood changes in brain morphology observable with MRI. Developmental Medicine and Child Neurology 32:379–385CrossRefGoogle Scholar
  33. Johnston RB, Stark RE, Mellits ED, Tallal P (1981): Neurological status of language-impaired and normal children. Annals of Neurology 10:159–163CrossRefGoogle Scholar
  34. Klein S, Rapin I (1988): Intermittent conductive hearing loss and language development. In: Language Development in Exceptional Circumstances, Bishop DVM, Mogford K, eds. Edinburgh: Churchill LivingstoneGoogle Scholar
  35. Landau W, Kleffner F (1957): Syndrome of acquired aphasia with convulsive disorder in children. Neurology 7:523–530Google Scholar
  36. LeMay M (1977): Asymmetries of the skull and handedness. Journal of the Neurological Sciences 32:243–253CrossRefGoogle Scholar
  37. Levene MI, Whitelaw A, Dubowitz V, Bydder GM, Steiner RE, Ranell CP, Young IR (1982): Nuclear magnetic resonance imaging of the brain in children. British Medical Journal 285:774–776CrossRefGoogle Scholar
  38. Lewis BA (1990): Familial phonological disorders: four pedigrees. Journal of Speech and Hearing Disorders: 55:160–170Google Scholar
  39. Lous J, Fiellau-Nikolajsen M (1984): A 5-year prospective case-control study of the influence of early otitis media with effusion on reading achievement. International Journal of Pediatric Otorhinolaryngology 8:19–30CrossRefGoogle Scholar
  40. Mogford K, Bishop DVM (1988): Five questions about language acquisition considered in the light of exceptional circumstances. In: Language Development in Exceptional Circumstances, Bishop DVM, Mogford K, eds. Edinburgh: Churchill LivingstoneGoogle Scholar
  41. Pasamanick B (1952): Patterns of research in mental hygiene. Psychiatric Quarterly 26:577–589CrossRefGoogle Scholar
  42. Pasamanick B, Constantinou F, Lilienfeld AM (1956): Pregnancy experience and the development of childhood speech disorders. American Journal of Diseases of Children 91:113–118Google Scholar
  43. Pennington BF, Smith SD, Kimberling WJ, Green PA, Haith MM (1987): Left-handedness and immune disorders in familial dyslexics. Archives of Neurology 44:634–639CrossRefGoogle Scholar
  44. Rasmussen T, Milner B (1977): The role of early left-brain injury in determining lateralization. Annals of the New York Academy of Science 299:255–269CrossRefGoogle Scholar
  45. Roberts JE, Sanyal MA, Burchinal MR, Collier AM, Ramey CT, Henderson FW (1986): Otitis media in early childhood and its relationship to later verbal and academic performance. Pediatrics 78:423–430Google Scholar
  46. Robinson RJ (1987): Introduction and overview. In: Proceedings of the First International Symposium on Specific Speech and Language Disorders in Children. London: Association for All Speech Impaired ChildrenGoogle Scholar
  47. Rosenberger PB, Hier DB (1980): Cerebral asymmetry and verbal intellectual deficits. Annals of Neurology 8:300–304CrossRefGoogle Scholar
  48. Ruben RJ, Rapin I (1980): Plasticity of the developing auditory system. Annals of Neurology 89:303–311Google Scholar
  49. Rumsey JM, Dorwart R, Vermess M, Denckla MB, Kruesi MJ, Rapoport JL (1986): Magnetic resonance imaging of brain anatomy in severe developmental dyslexia. Archives of Neurology 43:1045–1046CrossRefGoogle Scholar
  50. Rutter M (1984): Issues and Prospects in Developmental Neuropsychiatry. In: Developmental Neuropsychiatry, Rutter M, ed. Edinburgh: Churchill LivingstoneGoogle Scholar
  51. Rutter M, Graham P, Yule W (1970): A neuropsychiatric study in childhood. Clinics in Developmental Medicine 35–36. London: SIMPGoogle Scholar
  52. Schiff-Myers N (1988): Hearing children of deaf parents. In: Language Development in Exceptional Circumstances, Bishop DVM, Mogford K, eds. Edinburgh: Churchill LivingstoneGoogle Scholar
  53. Silva P, Kirkland C, Simpson A, Stewart IA, Williams SM (1982): Some developmental and behavioral problems association with bilateral otitis media with effusion. Journal of Learning Disabilities 15:417–421CrossRefGoogle Scholar
  54. Silva PA, Chalmers D, Stewart I (1986): Some audiological, educational and behavioral characteristics of children with bilateral otitis media with effusion —a longitudinal study. Journal of Learning Disabilities 19:165–169CrossRefGoogle Scholar
  55. Sparks SN (1984): Birth Defects and Speech-Language Disorders. San Diego: College Hill PressGoogle Scholar
  56. Stewart AL, Reynolds EOR, Hope PL, Hamilton PA, Baudin J, Costello AM, Bradford BC, Wyatt JS (1987): Probability of neurodevelopmental disorders estimated from ultrasound appearance of brains of very preterm infants. Developmental Medicine and Child Neurology 29:3–11CrossRefGoogle Scholar
  57. Tallal P, Katz W (1989): Neuropsychological and neuroanatomical studies of developmental language/reading disorders: recent advances. In: Brain and Reading, von Euler C, Lundberg I, Lennerstrand G, eds. New York: Stockton PressGoogle Scholar
  58. Tallal P, Ross R, Curtiss S (1989): Familial aggregation in specific language impairment. Journal of Speech and Hearing Disorders 54:167–173Google Scholar
  59. Taylor DC (1969): Differential rates of cerebral maturation between sexes and between hemispheres. Lancet 2:140–142CrossRefGoogle Scholar
  60. Teele DW, Klein JO, Rosner BA, and The Greater Boston Otitis Media Study Group (1984): Otitis media with effusion during the first three years of life and development of speech and language. Pediatrics 74:282–287Google Scholar
  61. Waldo MC, Cohen DJ, Caparulo BK, Young JG, Prichard JW, Shaywitz BA (1978): EEG profiles of neuropsychiatrically disturbed children. Journal of the American Academy of Child Psychiatry 17:656–670CrossRefGoogle Scholar

Copyright information

© Birkhäuser Boston 1992

Authors and Affiliations

  • Dorothy Bishop

There are no affiliations available

Personalised recommendations