By John E. Obrzut and George W. Hynd (Eds.)
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Extra resources for Child Neuropsychology. Clinical Practice
P. Moore, 1971). Although the child neuropsychologist should be familiar with the various types of voice disorders, this category of speech problems in and of itself has minimal implications for a child's learning. The third category of speech problems is speech dysfluency. Speech dysfluency refers to any behavior, such as repetitions or prolongation of sounds, syllables, or words, that disrupts the rhythm and flow of speech. Abnormally long pauses, or blocks, also are included as contributing to speech dysfluency.
Many children with neurodevelopmental learning disorders experience secondary, if not co-existing primary, emotional difficulties. These emotional problems, in turn, can assert their effects in a neuropsychological evaluation by producing an impaired level of performance. In children with neurodevelopmental or chronic learning problems, this is even more problematic. Not only will their present functioning appear impaired, but typically these children also will not master the prerequisite skills and abilities necessary for more advanced learning.
Support for this latter point has been generated from electrophysiological studies (Duffy, 1981; Duffy, Burchfield, & Lombroso, 1979; Duffy, Denckla, Bartels, & Sandini, 1980; Duffy, Denckla, Bartels, Sandini, & Kiessling, 1980), neuroanatomical postmortem studies (Drake, 1968; Galaburda & Kemper, 1979; Galaburda, Sherman, & Geschwind, in press), as well as studies of the hemispheric functioning of children (Bakker, 1983; Obrzut, Hynd, Obrzut, & Pirozzolo, 1981; Pirozzolo & Rayner, 1979). Much of the earlier work with children experiencing learning problems sought to identify the single deficient process that was contributing to the learning difficulties.