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PubMed2004

[What is the role of neuropsychological testing in the investigation and management of pharmacologically intractable partial epilepsy?].

Neuropsychological testing is an integral part of investigation and management of pharmacologically intractable epilepsy. Patients often complain of cognitive difficulties, in particular memory disturbances. A review of the literature demonstrates that correlations between subjective memory difficulties and objective memory deficits are often poor with mood correlating more consistently with subjective complaints. Nevertheless, objective memory difficulties are often found, especially in patients with temporal lobe epilepsy. Many factors can contribute to cognitive difficulties in patients with pharmacoresistant partial epilepsy. These include brain pathology that may be the cause or the consequence of chronic seizures (or both), physiological brain dysfunction due to epileptic activity and effects of antiepileptic medications. We review some of the abundant relevant literature. Neuropsychological evaluation is routinely used in pre-surgical evaluations of patients and cognitive dysfunction has some degree of correlation with lateralization and localization of epileptic activity, thus helping to determine a surgical strategy. The goal of seizure control is tempered with an assessment of the potential cognitive loss resulting from resective surgery. A number of studies have addressed postoperative neuropsychological findings and it is universally recognized that patients who have high levels of cognitive functioning in the areas targeted for resection (for instance verbal memory in dominant temporal lobe) show the greatest functional loss following surgery. More selective surgery probably results in some level of preservation of cognitive function.

Adult↗
PubMedDate not supplied

[Language therapy results with adolescents of the autistic spectrum].

BACKGROUND: Results of language therapy with adolescents and children with autistic spectrum disorders. AIM: to identify changes, after a six-month period of speech-language therapy, in a group of adolescents and to compare them with a group of children. METHOD: Data referring to the communicative profile and social-cognitive performance of 12 adolescents and 12 children were analyzed. RESULTS: Just one of the 10 observed areas presented meaningful progress for the group of adolescents and 5 areas presented progress for group of children. CONCLUSION: The results reinforce the importance of language therapy for autistic children, as more progress can be obtained at this age.

Adolescent↗
PubMed2005

Diagnosis and evaluation of pervasive developmental disorders.

Accurate diagnosis and appropriate treatment of pervasive developmental disorders (PDDs), including autistic disorder, Asperger's disorder, and pervasive developmental disorder not otherwise specified, are necessary to ensure the best possible outcomes for children with these disorders. In the past, it was not uncommon for children with PDDs to wait several years from the time of parental recognition of developmental delay to the determination of the correct diagnosis and initiation of treatment. Increased awareness of PDDs and the availability of better assessment tools have improved the detection of these conditions in children. A wide variety of standardized diagnostic checklists, interviews, and observational measures are available to assist the clinician in making an accurate PDD diagnosis. A comprehensive evaluation also establishes a baseline of adaptive functioning and problematic behavior, which is essential for subsequent assessment of progress. This article discusses the differential diagnosis and evaluation of PDDs, focusing on the various assessment tools. The elements of a contemporary diagnostic evaluation and behavioral assessment are presented. The application of discretionary evaluations for special situations are also introduced.

Adult↗
PubMed2006

[Clinical characteristics and speech therapy of lingua-apical articulation disorder].

OBJECTIVE: To explore the clinical characteristics and speech therapy of 62 children with lingua-apical articulation disorder. METHODS: Peabody Picture Vocabulary Test (PPVT), Gesell development scales (Gesell), Wechsler Intelligence Scale for Preschool Children (WPPSI) and speech test were performed for 62 children at the ages of 3 to 8 years with lingua-apical articulation disorder. PPVT was used to measure receptive vocabulary skills. GESELL and WPPSI were utilized to represent cognitive and non-verbal ability. The speech test was adopted to assess the speech development. The children received speech therapy and auxiliary oral-motor functional training once or twice a week. Firstly the target sound was identified according to the speech development milestone, then the method of speech localization was used to clarify the correct articulation placement and manner. It was needed to change food character and administer oral-motor functional training for children with oral motor dysfunction. RESULTS: The 62 cases with the apical articulation disorder were classified into four groups. The combined pattern of the articulation disorder was the most common (40 cases, 64.5%), the next was apico-dental disorder (15 cases, 24.2%). The third was palatal disorder (4 cases, 6.5%) and the last one was the linguo-alveolar disorder (3 cases, 4.8%). The substitution errors of velar were the most common (95.2%), the next was omission errors (30.6%) and the last was absence of aspiration (12.9%). Oral motor dysfunction was found in some children with problems such as disordered joint movement of tongue and head, unstable jaw, weak tongue strength and poor coordination of tongue movement. Some children had feeding problems such as preference of eating soft food, keeping food in mouths, eating slowly, and poor chewing. After 5 to 18 times of therapy, the effective rate of speech therapy reached 82.3%. CONCLUSION: The lingua-apical articulation disorders can be classified into four groups. The combined pattern of the articulation errors is the most common one. Most of the apical sounds are replaced by velar sounds. The speech localization method is very useful in the therapy of apical articulation disorder. For children with feeding problems and oral motor dysfunction, it is needed to improve food texture and administer oral motor skill training.

Articulation Disorders↗
PubMed1991

[Language development and play behavior of retarded children].

The relationship of symbolic play behavior, general cognitive functioning and language in 108 mentally retarded children was studied. Correlations between play and language measures were found with mental age partialed out. Clinical implications for planning language facilitation programs with mentally retarded children are discussed.

Child↗
PubMed1991

Three cases of anomic aphasia after lesions in and/or around the basal ganglia.

The present paper reports 3 cases of aphasia with small lesions in the region of the basal ganglia to discuss whether neostrial dysfunction can cause aphasic symptoms. The Standard Language Tests of Aphasia (SLTA) was used to assess the type and degree of aphasia. Two patients with infarction either in the left putamen or in the head of the left caudate nucleus showed severe disturbance only in recalling words, especially nouns. The other patient showed the same symptom, in addition to writing disturbance that developed shortly after surgical extirpation of an arteriovenous malformation (AVM) in the left caudate nuclei. The symptoms common to the 3 patients corresponded well to the "anomic aphasia" proposed by Benson. The aphasic symptoms disappeared completely or largely within several months. This easy reversibility suggests that the aphasic disorder in the three patients was caused by damage not to the basal ganglia themselves, but to the affecting axons passing through or by the nuclei.

Aged↗
PubMed1988

Cueing verbs: a treatment strategy for aphasic adults (CVT).

This investigation demonstrated that the treatment protocol, "Cueing Verbs: A Treatment Strategy for Aphasic Adults" (hereafter referred to as CVT), was an effective rehabilitation technique. Specifically, this CVT was shown to be beneficial with marked/moderate to mild fluent aphasic adults. Additionally, the study addressed such issues as optimal treatment frequencies, treatment initiation and termination points, and criteria for success and failure. Finally, the six-tier hierarchy of treatment levels are presented with all variables operationally defined.

Aged↗
PubMed1986

Risks and benefits of adenotonsillectomy for children with Down syndrome.

A questionnaire survey of 74 parents of children with Down syndrome was conducted. Results indicated that adenotonsillectomy benefited their children by eliminating or reducing the symptoms of snoring, sleep apnea, nasal drainage, and mouth breathing. On the basis of parental responses, it appears that in the absence of nasal obstruction, adenotonsillectomy fails to improve drooling or tongue protrusion. Adenoid tissue is physiologically important to the child with Down syndrome and its removal can result in hypernasality. Two children in the survey sample who underwent adenoidectomy and/or tonsillectomy developed this complication. They were given complete speech and language testing and evaluated with cinefluoroscopy. Both structural and functional causes of hypernasality were identified. Structural abnormalities included a high-arched short hard palate and a short soft palate. Hypotonia, slowed motor learning, and oral motor developmental delay were confounding functional factors in these patients. The incidence of postoperative hypernasality found in these patients is higher than in the general population and should be an important consideration before performing an adenoidectomy.

Adenoidectomy↗
PubMed1987

Language training for generalization.

This paper presents a classroom-based language intervention program for preschool children with language delays or deficits. A major goal of the program is to ensure that children acquire missing skills through daily speech therapy and that they actively generalize these skills from therapy times to other classroom activities. This paper presents data collected with two children during daily speech therapy sessions and daily play activities. Instances in which the children generalized new language acquired in therapy to play activities will be discussed as well as instances in which the children failed to generalize new language. In addition, the influence of peer and teacher language usage on children's language production will be discussed. Finally, recommendations to enhance generalization of language skills within and across school settings will be presented.

Child↗
PubMed1985

Neuropsychological sequelae of childhood cancer in long-term survivors.

In order to assess the effects of various cancer treatments on neuropsychological functioning, 74 long-term survivors of childhood cancer were examined. A comprehensive battery of tests was administered to two CNS treatment groups (irradiated and nonirradiated leukemia and lymphoma patients) and a control group (solid tumor and Hodgkin disease patients receiving no CNS treatment). The CNS-irradiated group obtained lower scores than the other two groups, with significant differences in visual-motor and fine motor skills, spatial memory, and arithmetic achievement resulting in significant differences in IQ scores (VIQ, PIQ, FSIQ). The results are discussed in relation to: (1) the effects of CNS irradiation on cognitive development; (2) the specificity of these effects; and (3) the relationship of age at diagnosis to treatment effects. It is concluded that although there is a general lowering of scores after CNS irradiation, the effect is most pronounced for nonlanguage skills. Age at diagnosis was less important than the type of treatment, with CNS irradiation reducing performance regardless of when cancer was diagnosed. There were indications that children with any type of cancer diagnosed before age 5 years are more likely to have some cognitive difficulties.

Age Factors↗
PubMed1979

[Intelligence testing in early old age. The correlation between the multiple-choice vocabulary test (MCVT-B) and the progressive matrices test (PMT) in a patient cohort in early old age].

Taking a random sample of 147 patients a substantial correlation of 0.54 between the "Mehrfachwahl-Wortschatz-Test (MWT-B)" by Lehrl and the "Progressiver Matrizen-Test" by Raven could be found. The MWT-B did not show significant differences between the age groups of 34-44 years, 45-54 years and 55-64 years. In the PMT differences between the age groups only showed up when the raw-scores were converted to IQ-scores (reffering to the corresponding age groups). Using the raw-scores no significant differences could be determined. Investigating an average IQ of 109 in the PMT, we found an average IQ of 97 in the MWT-B for the same patients. A main reason for the superelevated IQ-scores in PMT seems to be the reference to different age groups. A new standardization of the test should be undertaken.

Adult↗