Neurological and MRI profiles of children with developmental language impairment

Children with developmental language impairment (LI) are defined partly by the absence of other identifiable neurological diagnoses. Such children are generally considered to be neurologically normal, but no systematic studie s of neurological function have been reported. We obtained detailed medical histories and conducted neurological examinations for 72 children aged 5 t o 14 years with LI and 82 typically developing age-matched control children . All the children took a standardized test of language, and those who mere at least 8 years old and were willing to have brain MRI scans (35 children with LI and 27 control children) had scans, Analysis of developmental mile stones from the medical histories revealed that children with LI were not o nly significantly later in speaking, but also mildly but significantly dela yed in motor milestones, particularly walking, On neurological examination, abnormalities were found in 70% of the children with LI and only 22% of th e control children. The most common abnormalities in the LI group included obligatory synkinesis, fine motor impairments, and hyperreflexia. The child ren with LI with the most abnormal neurological findings had the lowest lan guage scores. Finally, 12 of 35 children with LI had abnormalities on their MR I scan, while none of the 27 control children had abnormal scans. Abnor mal findings included ventricular enlargement (in five), central volume los s (in three), and white matter abnormalities (in four). These findings sugg est that developmental LI is not an isolated finding but is indicative of m ore widespread nervous system dsyfunction. Children with LI may Heed more c omprehensive intervention programs than language therapy done, depending on their other areas of dysfunction, Early identification of such problems ma y allow for more successful remediation.