Book Reviews

Abstract

His interest in the problem of diagnosis, assessment and management of children with language disorder developed when working in East Africa as an ear nose and throat surgeon and organizing special clinics to investigate severely deaf children. The author therefore brings medical, audiological and linguistic insight to a subject which is more frequently written about by linguists, psychologists or speech therapists.The first five chapters of the book are devoted to the development of language; beginning at the neonatal period with mother child interaction and going through the sensory motor stage, vocalization, one word utterance to two and three word utterances. The author skilfully integrates information from the literature in psychology, paediatrics and audiology with emphasis on the prelinguistic stages. Chapter four on Vocal Behaviour and the Origins of Speech contains detailed records in chronological sequence of the vocal behaviour of twenty three children of different nationalities from 22 hours to, in 2 children, 20 months. The display shows a continuous intensity variation, a phonetic transcription of the sounds produced, the utterances of the interacting adult, adventitious noises and the time scale in seconds. This material takes up some 60 pages of the book. The format is unusual, but it is an interesting attempt to put this early vocal behaviour in a visual form for further study.The last four chapters cover delay and disorder in the development of language. Here the author gives us the benefit of his philosophy developed no doubt over many years of detecting and attempting to find the reason why spoken language has failed to develop normally. Since causal mechanisms are poorly understood, he advocates that discussion is best centred on antecedents of the disorder (author's italics). "The antecedents are all the relevant contributory factors operating together which can, in the present state of our knowledge, provide a reasonable explanation of the one individual child's impaired acquisition and use of spoken language." The author, therefore discusses the antecedents of the different aspects of disorder in turn: antecedents of comprehension disorder, antecedents of voice speech and language disorder and antecedents of communication disorder. Reference is made to the writer's "unselected series of 315 children seen in a period of 2% years who presented with difficulty in the learning or use of spoken language", giving comparative figures for different aspects of disorder. Numerical data on 2,988 children with hearing loss from the CEC Report Childhood Deafness in the European Community 1980" is also given, revealing among other things that hearing loss was often diagnosed late despite being suspected by parents and screening programmes being in operation. H e identifies 28 profiles among his series of 315 children, each of which he considers to be a syndrome of disordered language, but these are not described and the reader is referred to a previous publication. There are well selected case reports o...