ERIC ED345433: National Strategic Research Plan for Balance and the Vestibular System and Language and Language Impairments. Panel Report (January 28-29, 1991).

117 Pages·1991·5.5 MB·English

by  ERIC

DOCIIIMNT REBUKE
EC 301 194
ED 345 433
National Strategic Research Plan for Balance and the
TITLE
Vestibular System and Language and Language
Impairments. Panel Report (January 20-29, 1991).
National Inst. on Deafness aad Other COmmunications
INSTITUTION
Disorders, Bethesda, RD.
REPORT NO
NIB-91-3217
PUB DATE
91
NOTE
117p.
Collected Works - Conference Proceedings (021)
PUB TYPE
EDRS PRICE
NFO1/PC05 Plus Postage.
Adults; Children; Clinical Diagnosis; Cognitive
DESCRIPTORS
Processes; Cultural Differences; Deafness;
Incidence; Language Acquisition; *Language
Handicaps; Neurology; Perceptual Developeent;
*Research Needs; Sensoily Integration; Sign Language;
Spatial Ability
*Balance; *Vestibular Stimulation
IDENTIFIERS
ABSTRACT
This report, arising from a 1991 meeting, provides an
update to two of the six areas covered in the 1909 long-term plan of
the National Institute on Deafness and Other Communication Disorders.
These include: (1) balance and the vestibular system; and (2)
language and language impairments. For each area, the state of the
art is reviewed, recent accomplishments summarized, and program goals
and research opportunities listed. Subcommittees in these areas
examined the Institute's research portfolio, identified changes in
the field, recommended levels and areas of research activity, and
smested potential initiatives. Among 11 areas of recommended
research in vestibular function are: signal transduction rry
vestibular end-organs; sensory integration in spatial orientation,
perception and motion sickness; development and aging of the
vestibular system; prevalence and environmental factors; diagnostic
methods and testing procedures; and adaptive mechanisms. Areas of
recommended research in language include: multicultural issues;
language and deaf people (language development in deaf children,
studies of literacy in deaf children and adults, and sign language
structure and function); language disorders in children (bases of
language disorders, assessment, academic and social/vorational
impact, and intervention); and language disorders in adults
(brain-language relations, processes underlying language disorders,
assessment and intervention, and comparative language). Appendices
include Public Law 100-553 (the National Deafness and Other
Communication Disorders Act of 1980) and a listing of panel members.
(DB)
***********************************************************************
Reproductions supplied by EDRS are the best that can be made
*
from the original document.
National Institute on Deafness and
Other Communication Disorders
National
Strategic
Research
Plan
for
Balance and the Vestibular System
and
Language and Language Impairments
UI COPANTIIIIIR OP EINSCATION
1991
CAare of Ettuosteget Resserctivra Ininicvenveni
TICOOLcENTRES=VOTOMASTION
This &cement hes WWI reproduced ss
received hots the Omen at organstaban
eneinelms 4
0 Minor Owens hew been made * meters
redreductice we*,
Ponds et vii* or opinions soled in the &few
rope do not necessenry rettresent
OER1 paw** Dr petit"
U.S. DEPARTMENT OF
HEALTH AND HUMAN SERVICES
Public Health Service
National Institutes of Health
MAKE
BEST COPY
a
ACKNOWLEDGMENTS
The Balance and Vestibular System and Language and Language Impairment
Panels extend their gradtude to Monica Davies, Executive Director of the National
Deafness and Other Communication Disorders Advisory Board, who coordinated this
projec4 to Marin Allen, Ph.D., Judith Cooper, Ph.D., Daniel Mare, Ph.D., and Mirene
Scorner, NIDCD staff who assisted the Panel members In preparing this report; and
to the staff of Social & Scientific Systems, Inc., of Bethesda, MD, which was the
support contractor for the entire project.
II
4';'744.7.1e
FOREWORD
On October 29, 1988 the National Deafness and Other Communication Disorders
Act of 1989 became Public Law 100453 (Appendix A) establishing the National
Institute cus Deafness and Other Communication Disorders (NIDCD) within the
Nudonal Institutes of Health (NIII). The law required that the Director, NIDCD,
establish a Natignial Deafness and Other Communication Disorders Program and
coordinate institute activities
prepare a plan to bdtiate, expand, intensify and
concerning disorders of headed, balance, smell, taste, voice, speech and language.
In response to this masaJate, in January 1989 a Task Force of scientific experts
representing the seven program areas of the Institute prepared the first National
Strategic Research Plan which has guided the Institute in its research activities over
inform
the last two years. The National Strategic Research Plan is also intended to
with
the Nation's scientists of areas of oppmiunity for research and to provkll thou
with
guidance as they formulate their own research plans. The plan informs persons
communication disorders and their support organisations of past research
accomplishments and potential future activities. In addition, the plan is intended to
inform members al Congress of research progress and fUture research opportunities
in scientific areas within the purview of the NIDCD.
P.L. 100453 requires the National De 3fness and Other Communication
Disorders Advisory Board to review, evaluate and update the plan periodically to
legislative mandate, the National
assure its continuing relevance. To meet this
the six
Advisory Board in the spring of 1990 decided that it would update two of
sections of the Plan every year thus updating the entire plan within a three-year
in 1991 were
period. The two sections the National Advisory Board selected to update
The
Balance and the Vestibular System and Language and Language Impairments.
which met
National Advisory Board established subcommittees for these two areas
and the
and made recommendations for panel members to update the Balance
Vestibular System and Language and Language Impairment sections of the plan,
Strategic Research
compared tin research portfolio of the Institute to the National
recommended
Plan, identified changes in the field since the plan was developed,
January
levels and areas of research activity and suggested potential initiatives. On
the vestibular
28-29, 1991 panels of scientific experts in the areas of balance and
convened . (Members of the
system and language and language impairment were
contained in this
panels are listed in Appendix B.) The results of these meetings are
report.
their
Members of the panels are due special thanks for giving generously of
Their meetings on
talents and time in seeing this document through to completion.
III
4
FOREWORD
January 28 and 29, 1991 brought together representatives of a broad array of
scientific disciplines within the areas of balance and the vestibuhtr system and
diverse
language and language impairments. Members of the panels sharid their
ideas and worked diligently to achieve consensus on a comprekpisive view of each
field and a vision for the future. Subsequently, panel members refined their efforts
with numerous revised texts.
Dr. Horst R. Kenrad and Dr. Barry W. Peterson, Cochairpersons of the Balance
and the Vestibular System Panel, and Dr. Rita S. Berndt and Dr. Laurence B.
should
Leonard, Cochairpersons of the Language and Language Impairment Panel,
be singled out for special appreciation. This update to the National Strategic
Research Plan is very much a product of their experience, expertise and guidance.
Joined by their fellow panel members, they have formulated a plan for future
research in two important scientific areas of the NIDCD.
James B. Snow, Jr., M.D.
Director
National Institute on Deafhess and
Other Communication Disorders
5
iv
PREFACE
Dealltess and
The National Strategic Research Plan of the National Institute mi
1989 and presented
Other Communication Disorders (NIDCD) was prepared in April
in the seven
the research recommendations of more than 100 eminent scientists
hearing, balance, smell, taste, voice,
program areas of the NIDCD. These areas are
and the
speech and language. This report contains an update of the balance
of the 1110 plan.
vestibular system and language and language impairments sections
populations, both
Although disorders of balance and language affect different
and productive lives. The
have a dramatic impact on the ability of people to live full
locomotion and other
vestibular system maintains balance and posture, regulates
orientation in space and
volitional movements and provides a conscious awareness of
aging, exposure to unusual motion or altered
a visual fixation in motion. Disease,
of vondbular
gravitational environments can impair balance. A nudor consequence
activity. A better
disturbance is diminished capability and desire for purposeful
vestibular
understanding of the normal function, development and aging of the
national health and reduce
system and the disorders which affect it would improve
future health care costs.
through which
Language is the uniquely human means of communication
ability to
knowledge, belief and behavior can be explained and shared. The
thoughts,
manipulate language to satisfy needs and desires and to express
influences the
observations and values Is an important human pursuit that directly
economic self-
quality of life for any individual. Language impairments impede
opportunities. In addition to loss
sufficiency, academic performance and employment
personal suffering on the
of livelihood, these disorders impose social isolation and
and economic burden on their
affected individuals and place an enormous emotional
families and on society as a whole.
but their causes
Language and balance disorders have long been recognised
in scientific knowledge and
have not been well understood. Currdnt advances
in these long
technology now make it possible to make unprecedented progress
neglected probliems.
PREFACE
This update of the balance and vestibular system and language and language
impairment sections of the National Strategic Research Plan has provided an
opportunity to evaluate the progress that has been made In these areas during the
first few years of the Institute and to assess future needs and opportunities. The
recommendations presented here are expected to lead to exciting advances in our
scientific knowledge and improve the qualiq of life for many people.
Horst R. Konrad, M.D.
Barry W. Peterson, Ph.D.
Cochairpersons, Balance and
the Vestibular System Panel
Rita Sloan Berndt, Ph.D.
Laurence B. Leonard, Ph.D.
Cochairpersons Language and
Language Impairments Panel
National Institute on Deafness and
Other Communication Disorders
vi
CONTENTS
Hi
FOREWORD
PREFACE
3
EXECUTIVE SUMMARY
25
BALANCE AND THE VESTIBULAR SYSTEM
LANGUAGE AND LANGUAGE IMPAIRMENTS
71
101
APPENDIX A PUBLIC LAW 100-553
APPENDIX B PANEL MEMBERS 111
vii
EXECUTIVE
SUMMARY
9
EXECUTIVE SUMMARY
Table of Contents
Balance and the Vestibular System
a
7
Major Basic Scientific Opportunities
Signal Transduction by Vestibular End-Organs
7
8
Reflex Control of Posture and Gate
Sensory Integration in Spatial Orientation, Perception
9
and Motion Sickness
9
Adaptive Changes in Vestibular Function
Development and Aging of the Vestibular System
10
Major Clinic Scientific Opportunities
10
Prevalence and Environmental Factors
11
Anatomic, Physiologic and Molecular Bases
11
Diagnostic Methods and Testing Procedures
12
Adaptive Mechanisms
12
Medical and Surgical Therapy
13
Language and Language Impairments
13
Mafor Scientific Opportunities
16
Multicultural Issues
16
Language and Deaf People
16
Language Development in Deaf Children
16
Studies of Literacy in Deaf Children and Adults
17
Basic Research on Sign Language Structure and Function
18
Language and Its Disorders in Children
19
Bases of Language Disorders in Children
19
20
Assessment
Academic, Social and Vocational Impact
21
Intervention
21