PEDIATRICS Vol. 81 No. 6 June 1988, pp. 795-806
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Oral and Written Language Abilities of XXY Boys: Implications for Anticipatory Guidance

John M. Graham Jr MD, ScD1, Anthony S. Bashir PhD1, Rachel E. Stark PhD1, Annette Silbert PhD1, and Stanley Walzer MD1

1 From the Clinical Genetics and Child Development Center, Department of Maternal and Child Health, Dartmouth-Hitchcock Medical Center, Hanover, New Hampshire; Departments of Otolaryngology and Communication Disorders and Psychiatry, The Children's Hospital, Boston; and Communication Sciences and Disorders, John F. Kennedy Institute, Johns Hopkins Medical Institutions, Baltimore

Previous studies of XXY boys suggest that they are at risk for certain communication disorders involving oral and written language. In this study, the language, reading, and spelling skills of a group of 14 XXY boys identified during neonatal cytogenetic screening were compared with those of a group of 15 control children. The two groups were matched for age, grade, race, parity, birth weight, parental age and education, and socioeconomic status. The mean age of the XXY group was 9 years 7 months and that of the control group was 9 years 3 months. The mean academic grade level for both groups was at the transition between third and fourth grade. There was selective reduction in verbal IQ scores for the XXY group and no significant differences apparent between groups for performance IQ scores. The decrease in verbal IQ was associated with a reduced full-scale IQ and also with significant problems in expressive language, auditory processing abilities, and auditory memory. Word-finding difficulties and problems in the production of syntax were major components of the specific expressive language deficit. Except for difficulties in the understanding of complex sentence structures, the receptive language skills of XXY boys did not differ significantly from those of the control group. These reductions in speech and language abilities correlated with decreased achievement by the XXY group on a variety of reading and spelling tasks. These results suggest that difficulty learning how to read and spell may be due to a preexistent language disability. Early attention to such expressive language problems may be essential to ameliorate secondary maladaptive behaviors due to chronic language-related learning disabilities.

Key Words: language disability • chromosome anomaly • 47 • XXY • Klinefelter syndrome • dyslexia • school problem

Submitted on August 7, 1987
Accepted on August 7, 1987




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