Sir William Osler's contribution to the study of childhood aphasia

In 1889, William Osler published an important contribution to paediatric neurology, his monograph on The Cerebral Palsies of Children. It was composed of a series of 120 cases reviewed as a group with consideration given to relevant factors including gender, age at symptom onset, etiology, and laterality. Significant in this corpus was the inclusion of 13 children who also presented with aphasic symptoms.\ud \ud In the latter half of the 19th century most physicians considered aphasia in childhood to be a transient condition: Any language difficulty would disappear quickly, though the paralysis might remain indefinitely. Osler, in his influential textbook The Principles and Practice of Medicine (1892) made his position clear, In young persons the outlook is good, and the power of speech is gradually restored apparently by the education of the centres on the opposite side of the brain. Children often make rapid progress. Single case studies in which the child failed to recover language function did appear in the literature but were typically overlooked or viewed as anomalies; exceptions which proved the rule.\ud \ud Oslers monograph was the first systematic analysis of acquired aphasia accompanying paralysis in children. These 13 aphasic cases were all under the care of the same physician and were all subject to very similar assessment and treatment procedures. They provide important information on the long-term recovery patterns in child aphasic patients. This paper considers the importance of these early cases and Oslers later work on language impairment with the context of early modern neuroscientific theory