Paracentesis
In those with severe (tense) ascites, therapeutic paracentesis may be needed in addition to medical treatments listed above. As this may deplete serum albumin levels in the blood, albumin is generally administered intravenously in proportion to the amount of ascites removed. Surgery
Ascites that is refractory to medical therapy is considered an indication for liver transplantation. In the United States, the MELD score (online calculator) is used to prioritize people for transplantation. In a minority of people with advanced cirrhosis that have recurrent ascites, shunts may be used. Typical shunts used are portacaval shunt, peritoneovenous shunt, and the transjugular intrahepatic portosystemic shunt (TIPS). However, none of these shunts has been shown to extend life expectancy, and are considered to be bridged to liver transplantation. A meta-analysis of randomized controlled trials by the international Cochrane Collaboration concluded that "TIPS was more effective at removing ascites as compared with paracentesis...however, people with TIPS develop hepatic encephalopathy significantly more often".Another potential treatment option for patients with refractory/malignant ascites is the alfapump, (automated low flow ascites pump) which is an implantable device that removes ascites out of the peritoneal cavity and transports it via the pump into the bladder, where it passed naturally from the body through urination. Low SAAG ("exudative") ascites
Exudative ascites generally does not respond to manipulation of the salt balance or diuretic therapy. Repeated paracentesis and treatment of the underlying cause is the mainstay of treatment. Society and culture
It has been suggested that ascites was seen as a punishment especially for oath-breakers among the Proto-Indo-Europeans.
Together, these findings strongly suggest that language impairments are the result of an underlying neurological defect in an area of the brain related to language. Studies looking at long-term outcomes for individuals with specific language impairments such as expressive language disorder track these individuals from childhood to adulthood. As Whitehouse and his colleagues  suggest, "When childhood language problems persist into adulthood, they can have far reaching consequences in terms of academic, social and vocational outcomes." These researchers found that children diagnosed with an SLI would have persistent problems with language and are more likely to pursue vocational training rather than university, thereby avoiding professions requiring high levels of literacy. A lower socioeconomic status was also noted by adults who were diagnosed with an SLI as a child. Whitehouse  also reported that these adults had more difficulties in establishing friendships, most likely due to a decreased ability to express themselves socially. Current educational interventions for students with an SLI
Specific language impairments are often secondary characteristics of other disorders such as autism spectrum disorder and attention deficit hyperactivity disorder. In these cases, issues with speech and language are often not treated specifically, but rather attention is given to the primary complaint. Due to the high correlation of an SLI with other disorders, it is difficult to tell the difference between "pure SLI" or language impairments due to the presence of another disorder. See also
Auditory processing disorder
Speech-Language Pathology
Mixed receptive-expressive language disorder

References
Further reading
Bacon C, Rappold GA (November 2012).