The influence of premorbid language skills and behavior on language recovery in children with verbal auditory agnosia

Previous studies of children with Landau-Kleffner syndrome and related lang uage-epilepsy syndromes have focused on the relationship of seizure control to language recovery. We examined the effect of premorbid language skills and behavior, as well as some characteristics of clinical seizures and elec troencephalograms, on language recovery in a retrospective study of 67 chil dren with the severe receptive and expressive language disorder, verbal aud itory agnosia. Fifty-eight percent of these children had seizures, 76% were autistic, and 24% had a history of language regression after showing previ ously normal language skills. The duration of language loss was not influen ced by the persistence of clinical seizures. Premorbid language and behavio r were more predictive of language recovery in these children. Most childre n with normal early language (acquired verbal auditory agnosia) had onset o f language loss after age 3 years, in contrast to those with abnormal early language. Children with acquired verbal auditory agnosia were more likely to show fluctuations in language skills than those in other groups. Autisti c children were more likely to begin having seizures before age 3 years, an d had a longer duration of language loss and lower educational placement at time of last follow-up than those with normal behavior This study emphasiz es the importance of assessing premorbid language and behavior in predictin g recovery of language skills in children with language-epilepsy syndromes.