Neuropsychological and neuroimaging findings of developmental dysphasia: A longitudinal case study

This article presents an unusual and interesting neuropsychological and neuroimaging longitudinal study of a child who showed a relatively specific developmental language disorder in the absence of any other significant cognitive, emotional or neurological disturbance. The neuropsychological assessment included tests of intelligence, memory, language and frontal lobe functions. Our patient had a marked developmental language disorder characterized by severe impairment of oral and written language and a restricted vocabulary, even though the comprehension of both spoken and written language was relatively preserved. Moreover, his non-verbal intellectual ability was normal and he showed superior visuoconstructive and visuospatial abilities which suggested good development of right temporoparietal functions. On computerized tomography and magnetic resonance imaging there were no structural abnormalities in those cerebral areas concerned with language, although both neuroimaging studies did show a feasible reversed asymmetry or further atrophy on the left sylvian. It is noticeable that at age 17 a severe deficit in the expressive aspects of language remains. In contrast, visuo-constructive functions have improved. These results suggest a functional reorganization of the brain by increasing non-verbal capabilities. The prognosis in dysphasic syndromes is worse than in acquired aphasia in children, since despite speech therapy, an important language impairment persists during adulthood.