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PubMed1998

Prospective and retrospective studies of recovery in aphasia. Changes in cerebral blood flow and language functions.

Prospective and retrospective language evaluations and single photon emission computed tomography (SPECT) scans were performed in order to study the relationship between post-stroke recovery from aphasia and changes in cerebral blood flow (CBF) in groups of patients who had made a good recovery and those who had not. For the prospective study, 20 right-handed patients with aphasia secondary to an acute cerebrovascular accident (CVA) in the left middle cerebral artery territory received language evaluations with a Japanese Standard Language Test of Aphasia (SLTA), and SPECT scans performed twice, at a mean of 3.2 and a mean of 9.2 months post-onset. Only one slice of SPECT data was analysed. A significant correlation was observed between the severity of the initial language deficit and initial CBF on the left side, but not the right. Initial CBF was not a predictor for future language recovery in either hemisphere. There was a correlation between the change in the left mean hemispheric CBF (but not the right) and the change in the overall SLTA severity rating from 3 to 9 months post-stroke. In the retrospective study, 16 right-handed patients with residual aphasia secondary to CVA in the left middle cerebral artery territory received SLTA and SPECT at a mean of 82.8 months post-onset. The patients had also received initial language evaluation with SLTA at a mean of 6.5 months post-onset. In contrast to the prospective study, the results demonstrated that the mean left hemispheric CBF at approximately 7 years post-onset did not differ between good and poor recovery groups. However, the mean right hemispheric CBF of the good recovery group was higher than that of the poor recovery group in the frontal and the thalamic regions, and also in the left frontal region. The results of these complementary studies suggest that the initial language recovery within the first year post-onset may be linked primarily to functional recovery in the dominant hemisphere, where an increase in CBF was observed at 9 months post-onset. The increased perfusion adjacent to the lesion may be crucial for early recovery in aphasia. Subsequent language recovery and the long-term recovery in aphasia may be related to slow and gradual compensatory functions in the contralateral hemisphere, specifically in the homotopic frontal and thalamic areas.

Adult↗
PubMed1998

Functional MRI studies of auditory comprehension.

The location of brain regions essential for auditory language comprehension is an important consideration in the planning of neurosurgical procedures that involve resections within the dominant temporal lobe. Language testing during intraoperative and extraoperative cortical stimulation has been the primary method for localizing these regions; however, noninvasive alternatives using functional neuroimaging have been sought. Here we report on a study of 14 subjects who listened passively to alternating sentences spoken in their native English language and in unfamiliar Turkish while functional magnetic resonance images were acquired. The English sentences produced strong activation within the left superior temporal sulcus in all subjects. Lesser activation was seen in homotopic right hemisphere locations in several subjects. In addition to these posterior temporal activations, 8 subjects also showed activation to English sentences in the left inferior frontal gyrus. Turkish sentences evoked no coherent region of activation in any subject. As both the Turkish and English sentences were read by the same speaker, and were matched for length, volume, and intonation, we conclude that the activation pattern evoked by the English sentences reflects auditory comprehension. This conclusion is further supported by additional control studies that have shown a markedly different pattern of activation by pure tone frequency glides.

Acoustic Stimulation↗
PubMed2000

Predicting language outcomes for young prelinguistic children with developmental delay.

The purpose of this study was to examine potential relationships between children's prelinguistic communication behaviors and subsequent (12 months later) expressive and receptive language outcomes. Participants included 25 toddlers with developmental delay and their mothers. The dyads were observed during natural interactions at 6-month intervals over a 12-month period for a total of 3 observation points (O1, O2, O3). Children's rate of nonverbal behavior that is often perceived as communication by adults was identified at O1 and O2. In the investigation, the children's intentional nonverbal communication acts all included coordinated attention between the communication referent and the adult. The other types of prelinguistic communication behavior, termed gestural indicating behavior and social interaction signals, were produced without coordinated attention to the adult. Receptive and expressive language test scores and spontaneous word productions were analyzed at O3 and served as outcome measures in regression analyses. Results indicated that rate of intentional nonverbal communication at O1 was a predictor of spontaneous word productions at O3. At O2, rate of intentional communication and rate of gestural indicating behavior predicted subsequent language outcomes as measured by the Sequenced Inventory of Communication Development-Revised. The results are consistent with previous findings for intentional nonverbal communication that includes coordinated attention, but additionally demonstrate that prelinguistic behavior lacking coordinated attention also bears a relationship to subsequent language outcome. Discussion of observed patterns focuses on child and adult factors that may motivate the transition from prelinguistic to early symbolic communication.

Child Language↗
PubMed1996

Classification of adults for family studies of developmental language disorders.

A variety of approaches has been used to classify the status of adult subjects in familial studies of developmental language disorders. In this report, we directly compare the results of four different methods that appear in the research literature. Two of the approaches rely on case history reports, and two are performance-based methods. Subjects included 24 parents (12 mothers, 12 fathers) of children with developmental language disorders and 24 unrelated adult control subjects (12 female, 12 male) who completed case history items and standardized language testing designed for classification purposes. All classification methods identified more parents than control subjects as "affected". However, classification by case history methods resulted in fewer affected adults than classification through standardized testing. This outcome suggests that the variability in classification rates in studies to date may be the result of method rather than subject sample differences.

Adult↗
PubMed2005

Cognitive and neural mechanisms underlying reading and naming: evidence from letter-by-letter reading and optic aphasia.

We report detailed analysis of language performance in a patient, RMI, a 55-year-old man who presented with a homonymous hemianopsia, optic aphasia, and alexia without agraphia (with letter-by-letter reading) acutely after stroke. MRI showed infarct in the left occipital and medial temporal lobe and hypoperfusion of the entire posterior cerebral artery territory, including the splenium. Extensive language testing revealed severely impaired picture naming and oral reading, with relatively spared tactile naming and recognition of orally spelled words, consistent with impaired access to lexical and semantic representations from vision. In addition, he had a milder deficit in accessing lexical representations for output from all input modalities. RMI's execution of various language tasks provided considerable insight into the mechanisms that underlie oral reading. His performance indicated that both semantic access and orthographic to phonologic conversion mechanisms were partially intact. When information from these two impoverished systems was coupled (the picture of an object presented with its written name), his ability to read/name improved significantly, consistent with the hypothesis that partially accessed semantic information from vision can combine with partially accessed sublexical orthographic to phonologic conversion mechanisms to access phonological representations for output. Furthermore, his written word and picture recognition improved to normal at a time when magnetic resonance perfusion imaging demonstrated reperfusion of the splenium. We interpret these results, as well as results from previous studies in the literature, within a model of the neural regions critical for various cognitive processes underlying reading.

Aphasia↗
PubMed2001

Hypoperfusion of Wernicke's area predicts severity of semantic deficit in acute stroke.

Based on earlier findings that the presence of word comprehension impairment (a deficit in the meaning of words, or lexical semantics) in acute stroke was strongly associated with the presence of hypoperfusion or infarct in Wernicke's area, we tested the hypothesis that the severity of word comprehension impairment was correlated with the magnitude of delay in perfusion of Wernicke's area on magnetic resonance perfusion-weighted imaging. Eighty patients were prospectively studied within 24 hours of onset or progression of acute left hemisphere stroke symptoms, with diffusion-weighted imaging, perfusion-weighted imaging, and detailed language tests. For 50 patients without infarct in Wernicke's area, we found a strong Pearson correlation between the rate of errors on a word comprehension test and the mean number of seconds of delay in time-to-peak concentration of contrast in Wernicke's area, relative to the homologous region on the right. These results add further evidence for the crucial role of Wernicke's area (Brodmann's area 22) in word comprehension and indicate that the magnitude of delay on PWI may be a gross indicator of tissue dysfunction.

Adult↗
PubMed1987

Language in dementia of recent referral.

Twenty-four recently referred patients with dementia were assessed on a range of language tests and a mental status test. The tasks which appeared to present the most difficulties for the patients were written spelling, pragmatic processing tasks like sentence disambiguation and proverb interpretation. 'Straight' linguistic processing tasks sensitive to aphasia, like oral reading, serial identification of objects, naming and correction of semantically incorrect sentences, appeared to present fewer problems. It is concluded that certain language tasks may be useful and sensitive detectors of developing dementia, and that in early dementia those aspects of language which depend on straight linguistic processing can be relatively preserved.

Aged↗
PubMed2006

Structural development of the fictional narratives of African American preschoolers.

PURPOSE: This study examined the structural development of African American preschoolers' narratives. It also investigated the effect of background variables (e.g., gender, maternal education, stimulation and responsiveness of the home environment, and whether or not the child lived in poverty) on the children's narratives. METHOD: Sixty-five children completed a story-retelling task at age 4 and again at kindergarten entry. Narratives were then coded for story grammar elements. RESULTS: Four-year-olds narrated some attempts to solve the problem and some elements of the story ending. At kindergarten entry, children had higher total narrative scores and included more of every type of story grammar element except relationship. Overall, narratives were not related to background variables. CLINICAL IMPLICATIONS: The Bus Story Language Test (C. Renfrew, 1991) appears to be an assessment tool that is sensitive to structural growth in African American children's narratives from 4 years to kindergarten entry.

Black or African American↗
PubMed2004

Language dysfunction after frontal lobe partial seizures.

Postictal language delay (PILD) patterns can lateralize temporal lobe complex partial seizures (CPS). The authors studied PILD in 24 patients with 118 frontal lobe CPS. Prolonged PILD occurred in only 7% of CPS confined to the dominant frontal lobe compared with 91% of CPS that started as frontal and spread to the dominant temporal lobe (p = 0.0001). Postictal language testing provides important information on frontal CPS localization and spread.

Adolescent↗
PubMedDate not supplied

[Verbal abilities of normal adults submitting to an aphasia linguistic protocol].

A language test protocol for aphasia in French-speaking patients was drawn up recently by workers in Toulouse and Montreal. The protocol has been applied to sixty hospitalized sciatica patients of the same age range and socio-cultural level as the average population of aphasics in our department. Only one of the normal patients passed the test without any mistakes. The number and nature of the mistakes are studied statistically in relation to age, sex and socio-cultural level.

Adolescent↗
PubMed1982

Nursery nurses and nursery teachers I: Their assessment of children's verbal-social behaviour.

Ratings of verbal-social behaviour assigned by nursery nurses in day nurseries, nursery schools and centres were compared with those assigned by nursery teachers. There were significant differences in ratings assigned by the different professional groups of staff: nursery nurses in day nurseries assigned the highest verbal-social ratings, but these were not supported by observations of the children's verbal-social behaviour or by language test scores. Correlations showed that, while the nursery nurses were assessing directly measurable verbal and social behaviour, the teachers were not, and it is suggested that they were assessing a more complex reasoning skill.

Aggression↗
PubMed1996

A savant poet.

Poems by an individual with a diagnosis of Asperger's Syndrome were analysed and compared with those of a comparison poet. Though the savant poet performed less efficiently on formal language tests supposed to tap creativity, there were few differences between the two poets in regard to the poems' content and the use of various structural devices. The poems by the savant referred more often to aspects of self-analysis, while descriptions of people not related to the self were less frequent. Both poets made use of similes and metaphors. The results are discussed in terms of different modular domains within the language system.

Aptitude↗
PubMed2005

Continued catch-up and language delay in children adopted from China.

Most internationally adopted children learn their new language rapidly after adoption. What is not known is whether these gains continue at the same developmental pace throughout the preschool years. To answer this question, the continued language development of the 10 lowest performers from a cohort of 55 preschool-aged children adopted from China was examined. All 55 children had originally been assessed approximately 2 years earlier as preschoolers. The purpose was to examine whether continued English language exposure resulted in greater gain scores on a battery of standardized speech-language tests normed on monolingual English speakers. The 10 lowest performers were retested on the same battery approximately 2 years later. Scores on the second testing were examined in two ways. First, the amount of gain made from first to second testing for each child was examined, and second, the low performers were compared with adopted children from the original cohort who were matched for age and duration of time in the United States. It was found that more than half of the low-scoring children made clinically significant gains on the second assessment, but that low performers as a group scored below the level of matched peers in the cohort, even after approximately 2 years of additional English language exposure.

Adoption↗
PubMed1979

The effects of chronic middle ear effusion on speech and language development -- a descriptive study.

In this study, the speech and language skills of children with histories of chronic middle ear effusion were analyzed. Forty-seven children between the ages of one year eleven months and five years five months were given a battery of speech and language tests in the course of a diagnostic evaluation. All the children had been referred to speech pathology by a physician because of a suspected communication disorder. All subjects had histories of three or more episodes of middle era effusion, with the first episode occurring prior to 18 months of age. All medical records were checked and in-depth case histories were obtained in order to rule out other possible complicating factors that might have contributed to a speech and language delay. The results of this study revealed essentially age-appropriate receptive language skills in this group of children. Expressive language and articulatory skills were significantly below chronological age level expectation, indicating the possible serious effects of chronic middle ear effusion on speech and language development.

Child, Preschool↗
PubMed2003

Word-learning by preschoolers with specific language impairment: what predicts success?

Thirty preschool children with specific language impairment (SLI) and 30 age-matched controls with normal language (NL) participated in a study to compare group performance and to examine the relationship between fast mapping and word learning and between comprehension and production of new words. The groups performed similarly on the fast-mapping task. The NL group comprehended and produced significantly more words than the SLI group, and did so in fewer trials. Language test scores did not predict word-learning performance for either group. Some children with SLI may need to hear a new word twice as many times as their NL peers before comprehending it and may need twice as many opportunities to practice producing the word before using it independently.

Child, Preschool↗
PubMed1979

Written language skills of children with cleft palate.

The written language abilities of children with cleft palates aged eight to 13 were studied to compare performance with norms for the Picture Story Language Test. Although intelligence of this sample, as measured by the performance portion of the WISC, was skewed toward the superior and very superior ranges, the group ranked below the 50th percentile in total words used, words per sentence, and syntax quotients. Also, percentile scores on the PSLT declined as the age of the subjects increased. These results differ from the Ebert, McWilliams, and Woolf (1974) study where younger children with cleft palates (ages six to eight) were found to exhibit age-appropriate written language. The influence of factors affecting language development among the cleft palate population, such as methods and success of management, hearing, articulation, intelligence, sex, and psychosocial adjustment needs to be further investigated.

Adolescent↗
PubMed1992

Longitudinal evaluation of communication skills of children with single- or multichannel cochlear implants.

Performance on speech perception, speech production, and language tests was measured over time in children who used the 3M/House or the Nucleus cochlear implant. The speech perception and production results demonstrated higher performance levels and faster rates of learning for the multichannel than for the single-channel users. The performance of the children with the single-channel implant on the speech perception and production measures reached a plateau by 1.5 years post implant, whereas the children using the multichannel device continued to show improvement after 2 or more years of implant use. Changes in language were limited over time with no obvious difference in performance as a function of type of implant.

Acoustic Stimulation↗
PubMedDate not supplied

Language, articulation, voice and resonance characteristics in 4 children with Goldenhar syndrome: a pilot study.

The purpose of this study was to describe the language, articulation, voice and resonance characteristics in children with Goldenhar syndrome. The 4 Dutch-speaking subjects were 2 boys (age 4.5 and 10.2 years) and 2 girls (aged 5.0 and 5.4 years) with normal cognitive functioning. Language testing showed a delay in the development of morphosyntactic abilities. Speech analysis showed that these four children were capable of producing all the sounds of their mother tongue. One type of distortion error, namely dentalization, was found in 2 children. Phonological process analysis revealed the persistence of processes such as final consonant deletion, unstressed syllable deletion and cluster reduction, which are normal in young children but are suppressed with maturation. Also the substitution process of devoicing was observed in these 4 children. It is not clear how the speech and language problems demonstrated in these 4 children are to be explained. It must be taken into consideration that the Goldenhar syndrome has a variable expression. It is possible that the presence of a mandibular defect, hearing impairment, the type and severity of palatal abnormality and decreased linguistic processing skills influence articulation in an individual child. The voices of 2 children were characterized by the presence of slight roughness, corresponding with a higher jitter percentage. How the occurrence of the hoarse voices is to be explained is not quite clear. Laryngoscopic evaluation of the vocal folds showed no organic or functional voice disorder. Regarding resonance, only the child with a cleft palate showed hypernasality and nasal emission. The ENT specialist and the speech-language pathologist must be aware of these communication disorders in order to start preventive and early 'tailor-made' speech and language intervention as soon as possible.

Articulation Disorders↗