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PubMedDate not supplied

Issues in perceptual speech analysis in cleft palate and related disorders: a review.

BACKGROUND: Perceptual speech assessment is central to the evaluation of speech outcomes associated with cleft palate and velopharyngeal dysfunction. However, the complexity of this process is perhaps sometimes underestimated. AIMS: To draw together the many different strands in the complex process of perceptual speech assessment and analysis, and make recommendations for practice. MAIN CONTRIBUTION: This review examines issues such as data sampling, data collection/recording, archiving, the advantages and disadvantages of lay and specialist listeners, approaches to data analysis, reliability, and data interpretation. CONCLUSIONS: The need to capture meaningfully the sound of speech based on detailed phonetic analysis is argued. Also described are some of the differences in measuring speech for clinical, audit and research activities. Blind independent analysis of speech data by specialist therapists is recommended as the gold standard methodological approach when reporting audit and research outcomes. The requirement for ongoing training in listening skills for specialist therapists is advocated. The limitations of an impairment-based-only approach to measurement are also illustrated, indicating the need to develop outcome measures that incorporate more functional issues that affect quality of life.

Cleft Palate↗
PubMed1990

Identification of visual scanning deficits in adults after cerebrovascular accident.

Visual scanning deficits can result in the inefficient acquisition of information about one's environment. For adults who have had cerebrovascular accidents (CVAs), such deficits can interfere with the independent performance of many daily activities. The present study examined five tests designed to measure visual scanning deficits in post-CVA adults. Subjects with right and left hemisphere lesions were matched with control subjects by age and sex, and their performances on the tests were compared. The difference between the matched groups was statistically significant for all tests, with the hemiplegic subjects achieving lower scores than their normal counterparts. Deficits in visual scanning speed, identification of visual stimuli in the hemifield on the involved side, use of a systematic scanning pattern, and the ability to reproduce accurate visual designs were identified in the hemiplegic group. Statistically significant correlations were obtained on test-retest and interrater data, which indicates that the tests are reliable measures. The results of this study show that visual scanning deficits are present in post-CVA patients and can be measured with simple clinical evaluations. The presence of scanning deficits may significantly interfere with performance on tests measuring higher level visual-perceptual skills such as visual closure, figure-ground perception, and visual memory. An accurate assessment of visual-perceptual skills cannot be made without prior evaluation of such basic oculomotor functions as scanning. This approach is consistent with the developmental framework applied to most areas of treatment with brain-injured adults but is one that traditionally has not been applied in the evaluation of visual-perceptual skills.

Activities of Daily Living↗
PubMed1991

[The syndromes of oculogyric crisis and paroxysmal perceptual alteration in chronic schizophrenic patients--a clinical inquiry into their pathophysiology].

The syndromes of oculogyric crisis (OGC) and paroxysmal perceptual alteration (PPA) in chronic schizophrenics have been investigated. The perceptual symptoms of PPA are characterized by hypersensitivity of perception, psychedelic experience (brightening of colors, sharpening of contrast, visual distortion, etc.) and a disorder of somatic schema (one feels that one is floating, one's extremities are pulled and elongated, etc.). PPA in chronic schizophrenics occurs abruptly mainly in the evening, often precipitated by fatigue. During the attack patients also suffer from mood and thought alteration (anxiety, agitation, depressive mood and inability to distract their thought from one thing), but they are aware that symptoms of PPA are not real and apprehensive about them. The attack ceases gradually and spontaneously while the patient rests or sleeps. The syndrome of OGC occurs in a similar fashion as in PPA; the attack occurs mainly in the evening and is also associated with a variety of transient mood and thought disturbances similar to those in PPA. Four cases have been described in this study, who experienced both PPA and OGC simultaneously. Among 223 schizophrenic patients admitted to our hospital between April 1987 and September 1988, 18 cases with OGC, 5 cases with PPA, and 4 cases with both PPA and OGC were found. The mean +/- SD dose of neuroleptics (chlorpromazine equivalent) at the latest occurrence of these syndromes was 761 +/- 470 mg (N = 22, ranging from 195 to 2010 mg) for OGC and 773 +/- 587 mg (N = 9, ranging from 227 to 2010 mg) for PPA. The appearance of OGC in cases with 195 mg or more dose (chlorpromazine equivalent) of neuroleptics of OGC in cases with with 195 mg or more dose (chlorpromazine equivalent) of neuroleptics (NLP) is significantly higher (p less than 0.05) than that in cases with less than 195 mg of NLP. Similarly, the appearance of PPA in cases with 277 mg or more dose of NLP was higher (p less than 0.1) than that in cases with less than 277 mg of NLP. In paranoid schizophrenic patients the incidences of OGC and PPA were significantly lower (p less than 0.001 and p less than 0.05, respectively) than those in other types of schizophrenics. In disorganized schizophrenic patients the incidence of PPA was significantly lower (p less than 0.01) than those in undifferentiated, residual and schizoaffective types.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1983

Late language development in a child unable to recognize or produce speech sounds.

A boy with severe quadriplegia who neither recognized nor uttered speech sounds acquired language. Until the age of 6 years he was considered to be of severely subnormal intelligence. At age 6 years 9 months he was introduced to a manual sign system. Subsequently he was able to read, write, converse, and produce imaginative stories. Attention and memory were unimpaired and affective and social responsiveness developed appropriately. The case history demonstrates the selective effects of brain lesions that, despite extensive damage, may spare functional systems necessary for cognitive and linguistic development. It highlights the difficulty in diagnosing and evaluating the intellectual and affective potential of a multihandicapped child without functional hearing or speech and emphasizes the importance of sign language as a communication channel and prerequisite for the acquisition of reading and writing skills.

Aphasia↗
PubMed1980

CSF monoamine metabolites in child and adult psychiatric patients. A developmental perspective.

Concentrations of acid metabolites of dopamine and serotonin were measured in lumbar CSF of a diagnostically heterogeneous group of 154 psychiatric patients following oral probenecid loading. The patients ranged in age from 2 to 67 years old. No patients had received psychoactive medications for at least two weeks prior to the lumbar puncture. Children had higher mean CSF homovenillic acid (HVA) levels, higher mean CSF HVA-probenecid ratios, higher CSF HVA-log probenecid ratios, and lower mean CSF probenecid levels than adults. Age was negatively correlated with CSF HVA level and with CSF HVA-probenecid ratio. These correlations were more pronounced in male patients than in female patients.

Adolescent↗
PubMed1975

A factorial approach to neuropsychological assessment.

A factorial structure approach is examined in the assessment of test behaviors related to brain damage. A factor analysis performed on data from an extensive battery of psychological tests administered to 292 adult brain-damaged patients yielded five clearly defined factors. Multiple regression analysis was employed to predict performance on a second set of criterion tests that used, first, actual test scores, and second, factor scores. Formulae are presented to predict factor scores from the few best contributing variables. These estimated factor scores applied on independent patients indicate predictability through the use of raw test scores as good as that derived through the use of estimated factor scores. Results reveal an economical and comprehensive method to assess brain functioning through the use of factor categories rather than isolated test scores.

Achievement↗
PubMed2006

Emotional processing in eating disorders: specific impairment or general distress related deficiency?

The literature on eating disorders emphasizes the relationship between alexithymia and anorexia nervosa on the one hand, and between bulimia nervosa and affect dysregulation on the other. In our study, two questions are addressed: (1) Are there different patterns of emotional processing deficiencies in anorexia and bulimia? and (2) Is there a unique contribution of eating disorders to emotional processing deficiencies? Participants were women with anorexia nervosa (ANs, n=20), bulimia nervosa (BNs, n=20), and normal controls (NCs, n=20). Three hypotheses were examined: (1) Women with eating disorders will exhibit lower emotional awareness and more deficient emotional regulation than will NCs (emotional deficiency); (2) ANs will be less emotionally aware than BNs, whereas BNs will be less capable of effective emotional regulation than ANs (disorder specificity); and (3) emotional distress will mediate the relationships between emotional processing and eating disorders (emotional distress mediation). Results supported the emotional deficiency and distress mediation hypotheses, and partially supported the disorder specificity hypothesis. The need to move beyond alexithymia in understanding the pattern of emotional processing deficiencies in eating disorders is discussed.

Adolescent↗
PubMed1999

Spatial working memory in Asperger's syndrome and in patients with focal frontal and temporal lobe lesions.

Spatial working memory (SWM) was investigated in 15 patients with Asperger's syndrome (AS) comparing their performance to 18 age- and IQ-matched control subjects. An additional comparison was made with 20 unilateral frontal excision patients [9 right (RFL); 11 left (LFL)] and with 38 unilateral temporal lobectomy patients [18 right (RTL); 18 left (LTL)], the frontal and temporal lobe patients having separate matched control groups. SWM was tested using the Executive Golf Task, a test that also measures spatial strategy formation. The AS group showed a substantial deficit on SWM, but no impairment in strategy formation. The LFL showed the same pattern of impairment, but with a less substantial deficit. The RFL group showed a large deficit, but some of this was accounted for by a strategy formation impairment. Of the temporal lobe lesions groups, only the RTL group was impaired on SWM, but this group showed normal strategy formation. It was concluded that the SWM deficit in AS may reflect a more general difficulty in accessing different types of representations in order to guide voluntary behavior, providing at least a partial explanation for the executive deficits found in AS.

Adolescent↗
PubMed1999

Hippocampal involvement in spatial and working memory: a structural MRI analysis of patients with unilateral mesial temporal lobe sclerosis.

Forty-seven patients with unilateral temporal lobe epilepsy (TLE) were investigated on the Nine-Box Maze. The task was designed to compare working memory and spatial mapping theories of the functions of the hippocampus and provide measures of spatial, object, working, and reference memory. The results extended our previous findings in a larger group of patients. Spatial memory deficits across both working and reference memory conditions were found in patients with a right epileptogenic focus. There was no evidence of an object working memory deficit, but a nonlateralized impairment in object reference memory was revealed, which is consistent with our previous findings. The pattern of results was confirmed in a subgroup of 33 patients with unilateral atrophy localized to the hippocampus and parahippocampal gyrus, as verified by volumetric analysis of magnetic resonance images. In addition spatial memory errors significantly correlated with volumetric measures of mesial temporal lobe structures and not with measures of the remaining temporal cortex. In contrast, object reference memory errors correlated with volumetric measures of the temporal cortex and not with mesial temporal lobe structures. These findings support a specialized role for the right hippocampal region in spatial memory.

Adult↗
PubMed1979

Transformational deficits in cognition of schizophrenic children.

This study examined schizophrenic children for cognitive deficits in logical thinking, symbolic imagery, and conservation. Evaluation revealed persistent failure of the aberrant subjects to achieve at the level of age expectancy. Comparison with nonpsychotic, institutionalized children demonstrated no effect due to institutionalization. By mid-teens not one of the subjects had accomplished formal operations and very few were able to master concrete operations. Implications for development and treatment were discussed.

Adolescent↗
PubMed2005

Neuropsychological differences between frontotemporal dementia and Alzheimer's disease: a review.

This paper surveys the similarities and differences between frontotemporal dementia (FTD) and Alzheimer's disease (AD). The review covers findings primarily from neuropsychological studies on memory, language, attention/executive function, and visuospatial abilities. However, neuropsychiatric and neuroimaging data are also briefly discussed. Distinguishing features of both FTD and AD are described in order to present a comprehensive clinical picture of these dementing diseases, which is essential for the process of differential diagnosis. The cause of specific cognitive deficits is also considered. Our comprehensive review of the empirical literature reveals that AD is characterized by early memory loss and visuospatial problems, while among the main features of FTD are behavioral abnormalities and executive dysfunctions.

Alzheimer Disease↗
PubMed1987

Intravenous procaine as a probe of limbic system activity in psychiatric patients and normal controls.

Evidence from animal and human studies suggests that procaine hydrochloride may selectively activate limbic system structures and suppress neocortical structures. We administered a series of intravenous bolus doses of procaine hydrochloride to 31 subjects (7 with affective disorders, 17 with borderline personality disorder, and 7 healthy normal volunteers). Dose-related cognitive and sensory distortions and illusions were observed; affective experiences ranged widely from euphoric to dysphoric. Topographic electroencephalogram (EEG) analysis indicated selective increases in fast activity (26-45 Hz) over the temporal lobes; the degree of increase in this activity correlated with degree of dysphoria experienced. Procaine was associated with increases in secretion of cortisol, adrenocorticotrophic hormone (ACTH), and prolactin, but not with growth hormone. These preliminary data are consistent with the possibility that procaine might serve as a clinically useful probe of psychosensory, affective, electrophysiological, and endocrine effects referable to the limbic system.

Adrenocorticotropic Hormone↗