THE BRAIN AND DISORDERS OF COMMUNICATION. READING AND SPEECH PROBLEMS AS EXPRESSIONS OF SPECIFIC LANGUAGE DISABILITY.
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Brain↗
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THE BRAIN AND DISORDERS OF COMMUNICATION. AFFECTIONS OF SPEECH WITH LESIONS OF THE NON-DOMINANT HEMISPHERE.
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Agnosia↗
Correlation between serum and urinary calcium levels and psychopathology in patients with affective disorders. Short communication.
To examine whether serum and urinary calcium levels were related to the psychopathology index (i.e. average score in clinically relevant scales of Minnesota Multiphasic Personality Inventory), 24 women aged 35.6 +/- 2.5 years and 20 men aged 34.3 +/- 2.1 years, suffering from affective disorders, were studied. A non-parametric bivariate correlation analysis revealed a negative correlation between PI and serum calcium (r = -0.256, p < 0.01), while urinary calcium levels correlated positively with PI (r = 0.236, p < 0.02). A positive correlation occurred between serum and urinary calcium (r = 0.968, p < 0.0001). When the data were analyzed by categorical classification of patients with normal or abnormal PI scores, serum calcium levels were smaller, and urinary calcium levels higher, in patients with abnormal PI (p < 0.01). The results support to the concept that alterations of calcium homeostasis occur in psychopathology.
Adult↗
Studies in skeletal tracer kinetics. V: Computer-simulated Tc-99m (Sn)MDP bone-scan changes in some systemic disorders: concise communication.
Using compartmental analysis techniques, we modeled the biodistribution of Tc-99m(Sn)methylene diphosphonate in humans on a computer, and by selectively perturbing appropriate rate constants, we simulated changes in contrast between bone and soft tissue in a number of systemic disorders. The model predicts low contrast in patients with moderate to marked edema, obesity, congestive heart failure or decreased cardiac output states and high contrast with as little as 25% increase in bone avidity for the tracer. In acute renal failure without fluid-volume imbalance, image contrast should be normal. The model predicts greater contrast shortly after injection in patients with increased cardiac output, skeletal blood flow, or bone avidity; images made at these times would be indistinguishable. These simulations are in keeping with reports in the literature of bone images and bone-to-soft tissue ratios in many of these conditions, suggesting that modeling studies could play an important role image interpretation.
Acute Kidney Injury↗
Evidence of unmet need in the care of severely physically disabled adults.
OBJECTIVE: To identify unmet needs in the care of severely disabled people aged 16-64. DESIGN: Detailed personal interview and physical assessment of physically disabled adults; personal or telephone interview with carers. SETTING: Somerset Health District. SUBJECTS: 181 severely disabled adults and their carers. MAIN OUTCOME MEASURES: Independence in activities of daily living; identity of requirements for assessing communication disorders; appropriate provision of services and allowances. RESULTS: 53 (29.3%) of the 181 disabled subjects had unmet needs for aids to allow independence in activities of daily living-namely, 43% of subjects (41/95) with progressive disorders and 14% of subjects (12/86) with non-progressive disorders. The prevalence of unmet need was higher among subjects whose sole regular professional contact was with health services personnel (48 (40.3%) of 119 subjects). Only 18 (31.6%) of the 57 subjects with communication disorders had ever been assessed by a speech therapist. CONCLUSIONS: This study shows that the needs of severely physically disabled adults in the community--especially those with progressive disorders--are being monitored inadequately by health professionals.
Activities of Daily Living↗
[Associative processes disorders in schizophrenia].
This paper tries to approach and systematize knowledge about the character of associative process disorders in schizophrenia. In considering schizophrenia as an illness composed of various symptoms which may lead to different clinical progress, the paper is mainly focused on disorganization of thinking and, consequently, speaking and communication disorders. Authors reviewed various concept of pathogenesis and course of associative process disorders in schizophrenic patients. Special attention was paid to a connectionist model of disturbed associations. This model originates from cognitive psychology and assumes that concepts are represented as networks in the mental lexicon. Following from this model, a hypothesis was presented, claiming that disturbed associations in schizophrenia may be related to abnormalities in semantic networks. Results of research, supporting this hypothesis, were referred. Moreover, authors tried to describe the relationship between associative processes disorders in schizophrenia and abnormalities in neurophysiological (event--related potentials) and neuropathological (MRI) examinations. At least hypotheses describing the role of neurotransmission disorders was presented.
Cognition Disorders↗
An application of Rasch analysis to the measurement of communicative functioning.
PURPOSE: The purposes of this investigation were to examine the construct dimensionality and range of ability effectively measured by 28 assessment items obtained from 3 different patient-reported scales of communicative functioning, and to provide a demonstration of how the Rasch approach to measurement may contribute to the definition of latent constructs and the development of instruments to measure them. METHOD: Item responses obtained from 421 stroke survivors with and without communication disorders were examined using the Rasch partial credit model. The dimensionality of the item pool was evaluated by (a) examining correlations of Rasch person ability scores obtained separately from each of the 3 scales, (b) iteratively excluding items exceeding mean square model fit criteria, and (c) using principal-components analysis of Rasch model residuals. The range of ability effectively measured by the item pool was examined by comparing item difficulty and category threshold calibrations to the distribution of person ability scores and by plotting the modeled standard error of person ability estimates as a function of person ability level. RESULTS: The results indicate that most assessment items fit a unidimensional measurement model, with the notable exception of items relating to the use of written communication. The results also suggest that the range of ability that could be reliably measured by the current item pool was restricted relative to the range of ability observed in the patient sample. CONCLUSIONS: It is concluded that (a) a mature understanding of communicative functioning as a measurement construct will require further research, (b) patients with stroke-related communication disorders will be better served by the development of instruments measuring a wider range of communicative functioning ability, and (c) the theoretical and methodological tools provided by the Rasch family of measurement models may be productively applied to these efforts.
Activities of Daily Living↗
Family studies of schizophrenia: an update and commentary.
Recent family studies of schizophrenia which address the question of etiology are reviewed. The majority of these studies continue to focus on two major aspects of family life, deviant role relationships and disordered communication processes among family members. By and large the research on role relationships has not gone beyond demonstrating that correlations exist between these family variables and the occurrence of schizophrenia in an offspring. By contrast, recent research on disordered communication has begun to employ methodologies appropriate to testing the direction of the relationship between these family interaction patterns and schizophrenia. On a limited scale, some investigators have also begun to consider the etiologic role of family communication variables within more complex causal models, incorporating factors outside the domain of family interaction. To date greatest attention has been given to the combined role of genetic and family interaction variables. The need for multivariate and longitudinal approaches which examine the moderating effects of the social context of the family on relations between family variables and schizophrenia is discussed.
Adolescent↗
Public Health Service--Privacy Act of 1974. Notification of establishment of a new Privacy Act System of Records 09-25-0148.
In accordance with the requirements of the Privacy Act, the Public Health Service (PHS) is publishing notice of a proposal to establish a new Privacy Act System of Records 09-25-0148. Contracted and Contract-Related Research: Records of Subjects in Clinical, Epidemiological and Biomedical Studies of the National Institute of Neurological and Communicative Disorders and Stroke, HHS/NIH/NINCDS. We are also proposing routine uses for this system. This system will be used to support (1) epidemiological, clinical and biometric investigations into the causes, nature, outcome, therapy, prevention and cost of neurological and communicative disorders and stroke, and (2) review and evaluation of the progress of these research projects, and identification and planning for improvements or for additional research.
Civil Rights↗
MCMI-II personality traits and symptom traits in parents of children with selective mutism: a case-control study.
The etiology of selective mutism (SM) in children is unknown but is regarded as multifactorial. SM is frequently associated with social anxiety and language disorder or delay. The present study addresses SM and social anxiety as a familial phenomenon by comparing self-reported personality traits and symptom traits (Millon Clinical Multiaxial Inventory) in parents of 50 SM children with control parents. Personality and symptom traits reflecting social anxiety are also explored separately in the parents of SM children with and without a comorbid communication disorder. The results confirm SM and social anxiety as a familial phenomenon. Assessment and treatment planning should take this into account. The family data also suggest different family transmissions of SM and social anxiety in the SM group with and without a comorbid communication disorder.
Case-Control Studies↗
A comparison of conflict tactics in the supervisory process.
This study investigated three different tactics clinical supervisors in communication disorders predicted they would use in a specific conflict situation. One hundred-sixty supervisors were asked to read one of three case scenarios describing a conflict situation within the supervisory process. All scenarios depicted a student-clinician who had not completed a reading assignment requested by the supervisor. The scenarios differed only in the supervisee's response to the supervisor's question about the incomplete assignment. Subjects were asked to indicate how likely they might be to use each of 15 comments that reflected categories of conflict tactics: avoidance, competitive, or collaborative tactics. Supervisors' choice of tactics differed depending on the response of the supervisee. Overall, supervisors most often chose collaborative responses, followed by avoidance responses and (least often) competitive responses. Implications are discussed in terms of impact on the supervisory process in communication disorders.
Communication↗
Evaluation and treatment planning for patients with cleft lip and cleft palate.
The Oral-Facial and Communicative Disorders Program of the University of North Carolina has provided comprehensive diagnostic evaluation and inpatient and outpatient treatment for patients with cleft lip, cleft palate, and related problems for 22 years. A major aspect of the program is the initial diagnostic evaluation of patients and long-term follow-up evaluation of the results of treatment. The Oral-Facial and Communicative Disorders Program acts as both a consultant in providing requested information to referring professionals and agencies and also as a multi- and interdisciplinary treatment center. The nature of the evaluation process and the manner in which findings and recommendations are agreed upon in order that a comprehensive and coherent treatment plan can be established has been presented. It has been stressed that the needs of the patient can best be met by representatives from disciplines important to the diagnosis and management of patients with cleft lip and cleft palate who can meet together, and after discussion and negotiation arrive at a consensus for every aspect of treatment that is required, as well as a time that is most desirable for each patient.
Child↗
Speech and language impairment and oromotor dyspraxia due to deletion of 7q31 that involves FOXP2.
We report detailed clinical, cytogenetic, and molecular findings in a girl with a deletion of chromosome 7q31-q32. This child has a severe communication disorder with evidence of oromotor dyspraxia, dysmorphic features, and mild developmental delay. She is unable to cough, sneeze, or laugh spontaneously. Her deletion is on the paternally inherited chromosome and includes the FOXP2 gene, which has recently been associated with speech and language impairment and a similar form of oromotor dyspraxia in at least three other published cases. We hypothesize that our patient's communication disorder and oromotor deficiency are due to haploinsufficiency for FOXP2 and that her dysmorphism and developmental delay are a consequence of the absence of the other genes involved in the microdeletion. We propose that this patient, together with others reported in the literature, may define a new contiguous gene deletion syndrome encompassing the 7q31-FOXP2 region. Cytogenetic and molecular analysis of this region should be considered for other individuals displaying similar characteristics.
Abnormalities, Multiple↗
Autism as a neurodevelopmental disorder affecting communication and learning in early childhood: prenatal origins, post-natal course and effective educational support.
Colwyn Trevarthen, working on autism, discussed the importance of time, rhythm and temporal processing in brain function. The brains of new born infants show highly coherent and coordinated patterns of activity over time, and their rhythms are remarkably similar to those of adults. Since the cortex has not yet developed, this coordination must be subcortical in origin. The likely source is the emotional motor system. He noted that the cerebellum might regulate the intricate timing of the development and expression of emotional communication. He also pointed out that emotional and motivational factors have often been seriously neglected in psychology (largely owing to a misplaced focus on 'cognition' as some isolated entity) and emphasized the potential importance of empathetic support and music therapy in helping autistic children.
Adult↗
Determinants of vascular dementia in the Cardiovascular Health Cognition Study.
OBJECTIVE: The authors evaluated 3,375 participants without dementia at the time of MRI in 1991 to 1994 over 5.7 years for incident dementia and type of dementia. METHODS: Incidence of and risk factors for vascular dementia (VaD) were measured using both pre-MRI and modified State of California Alzheimer's Disease Diagnostic and Treatment Centers (ADDTC) post-MRI review and further classified Alzheimer disease (AD) by the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA) criteria. RESULTS: Approximately 44% (213) of 480 incident dementia cases were classified as possible or probable VaD by ADDTC. The incidence of VaD increased with age and was greater in blacks than whites. Risk factors for VaD included age, Modified Mini-Mental State Examination, high white matter grade, number of MRI infarcts, ventricular size, and history of stroke. CONCLUSIONS: Vascular disease in the brain is prevalent among incident dementia cases. There is a substantial overlap between cases classified as Alzheimer disease by Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association and vascular dementia (VaD) by modified State of California Alzheimer's Disease Diagnostic and Treatment Centers criteria. The substantial contribution of vascular disease would be missed without inclusion of MRI. Treatment of risk factors for VaD could have an important impact on incidence of dementia.
Age Factors↗
Speech and language therapy for dysarthria due to non-progressive brain damage.
BACKGROUND: Dysarthria is a common sequel of non-progressive brain damage (typically stroke and traumatic brain damage). Impairment-based therapy and a wide variety of compensatory management strategies are undertaken by speech and language therapists with this patient population. OBJECTIVES: To determine the efficacy of speech and language therapy interventions for adults with dysarthria following non-progressive brain damage. SEARCH STRATEGY: This review has drawn on the search strategies developed for the following Cochrane Groups as a whole: Stroke, Injuries, and Infectious Diseases. Relevant trials were identified in the Specialised Registers of Controlled Trials (see Review Group Details for more information). We also searched the trials register of the Cochrane Rehabilitation and Related Therapies Field. The Cochrane Controlled Trials Register, MEDLINE, EMBASE, CINAHL, PsycLIT, and Linguistics and Language Behavior Abstracts were electronically searched. Hand-searching of The International Journal of Language and Communication Disorders and of reference lists from relevant articles and conference proceedings was also undertaken. Colleagues were approached to identify other possible published and unpublished studies. Date of most recent searches: May 2000. SELECTION CRITERIA: Unconfounded randomised controlled trials. DATA COLLECTION AND ANALYSIS: One reviewer assessed trial quality. Two co-reviewers were available to examine any potential trials for possible inclusion in the review. MAIN RESULTS: No trials of the required standard were identified. REVIEWER'S CONCLUSIONS: There is no evidence of the quality required by this review to support or refute the effectiveness of Speech and Language Therapy interventions for dysarthria following non-progressive brain damage. There is an urgent need for good quality research in this area.
Adult↗
The cognitive basis of disorganization symptomatology in schizophrenia and its clinical correlates: toward a pathogenetic approach to disorganization.
This article focuses on the schizophrenic disorganization syndrome, which was initially described by Bleuler (who used the term "dissociation") as lying at the heart of schizophrenia. While adopting a neo-Bleulerian approach, we describe schizophrenic disorganization using a pathogenetic hypothesis and a three-part structure. First, we discuss previous approaches to characterizing and defining schizophrenic disorganization, providing arguments in favor of a complementary approach to describing schizophrenic disorganization that relies on a pathogenetic analysis of the disorganization syndrome, and especially thought and language disorders. Second, we present two possible cognitive pathophysiological mechanisms that may explain schizophrenic disorganization: (1) a deficit in the integration of contextual information, based on the results of semantic priming studies; and (2) a theory of mind deficit, based on the results of studies of the attribution of mental states to others. We propose a cognitive model of schizophrenic dysfunctioning on the basis of these two anomalies. Third, we summarize our published findings to examine the implications of these two cognitive pathophysiological mechanisms for schizophrenic disorganization. On the basis of the same two anomalies, we then propose and illustrate a neo-Bleulerian approach to the assessment of communication disorders that is critical to the improvement of schizophrenic disorganization's clinical description.
Cognition Disorders↗
Speech, prosody, and voice characteristics of a mother and daughter with a 7;13 translocation affecting FOXP2.
PURPOSE: The primary goal of this case study was to describe the speech, prosody, and voice characteristics of a mother and daughter with a breakpoint in a balanced 7;13 chromosomal translocation that disrupted the transcription gene, FOXP2 (cf. J. B. Tomblin et al., 2005). As with affected members of the widely cited KE family, whose communicative disorders have been associated with a point mutation in the FOXP2 gene, both mother and daughter had cognitive, language, and speech challenges. A 2nd goal of the study was to illustrate in detail, the types of speech, prosody, and voice metrics that can contribute to phenotype sharpening in speech-genetics research. METHOD: A speech, prosody, and voice assessment protocol was administered twice within a 4-month period. Analyses were aided by comparing profiles from the present speakers (the TB family) with those from 2 groups of adult speakers: 7 speakers with acquired (with one exception) spastic or spastic-flaccid dysarthria and 14 speakers with acquired apraxia of speech. RESULTS: The descriptive and inferential statistical findings for 13 speech, prosody, and voice variable supported the conclusion that both mother and daughter had spastic dysarthria, an apraxia of speech, and residual developmental distortion errors. CONCLUSION: These findings are consistent with, but also extend, the reported communicative disorders in affected members of the KE family. A companion article (K. J. Ballard, L. D. Shriberg, J. R. Duffy, & J. B. Tomblin, 2006) reports information from the orofacial and speech motor control measures administered to the same family; reports on neuropsychological and neuroimaging findings are in preparation.
Adolescent↗