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Alcohol is a teratogen known to have deleterious effects on the developing embryo and fetus. Language deficits secondary to central nervous system dysfunction are among the sequelae of Fetal Alcohol Syndrome (FAS). Limited information is available regarding the language deficits associated with FAS, particularly among the population of American Indians in whom FAS is highly prevalent. The TOLD-P and TOLD-I were administered to 27 American Indian children: 10 with FAS and 17 normally developing control subjects. Pure-tone screening, immittance measurement, and vision screening preceded language testing. The older FAS children presented syntactic deficits while the younger FAS subjects presented more global language deficits.
Since early identification of dementia is very important, a simple inexpensive examination for its diagnosis is needed. A naming and recognition test was formulated for: examining factors affecting naming performance, comparing naming and recognition performance, and sampling spontaneous speech. The results were compared with those of the mini-mental test. Subjects were 7 men and 14 women (mean age 80 +/- 4.7) in the early stages of dementia, living in a senior citizen's home. The short mini-mental test differentiated between the groups, as did the newly formulated test. Language tests were shown to be of value in the accurate detection of dementia in its early stages.
Diagnosis of developmental speech and language disorders in accordance with the ICD-10 is to be based on the psychometric assessment of speech and language performance. In the present study the clinical validity of the Heidelberger Sprachentwicklungstest (HSET) for diagnosing expressive language disorders was assessed by comparing HSET subtest results for 92 children aged 4 to 10 years who had various speech and language disorders with the children's scores on another language test, a cognitive test and clinical findings. The HSET scores differed considerably from the clinical ratings of the severity of the language disturbance. The correlations between the HSET scores and the score on the other language test was also low. Although the correlations of the HSET scores with the performance IQ was low, the correlations with the verbal IQ were high. The implications of these findings for the use of the HSET in diagnosing children with language impairments are discussed.
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BACKGROUND: Several procedures for testing language lateralization and memory function exist during the intracarotid amobarbital test (IAT). The use of functional magnetic resonance imaging (fMRI) gives the opportunity to assess the validity of some of these procedures, or at least to inspect the neuronal correlates. A comprehensive fMRI protocol was tested, aimed at addressing aspects of lateralization of language, as well as testing memory in relation to activation of mesiotemporal regions. Here we report observations with possible consequences for the current IAT procedures. MATERIALS AND METHODS: The protocol consisted of three language tasks (overt naming, semantic decision and silent word generation) and two memory tasks (encoding and retrieving visual scenes). The paradigms used a block-related procedure in nine right-handed normal volunteers. During the procedure dynamic weighted full brain images were acquired which are sensitive to the blood oxygenation activation effect. RESULTS: Encoding showed symmetrical bilateral activation in the mesiotemporal regions, specifically the hippocampus, parahippocampal gyrus and fusiform gyrus. With a retrieval task activation of the mesiotemporal areas was restricted to the posterior hippocampal area. Overt object naming showed results, similar to encoding tasks with bilateral activation of hippocampal areas. Silent word generation showed much stronger ability to lateralize than the other two language-related tasks and especially object naming. CONCLUSION: Activation revealed by fMRI activation shows that IAT procedures, using active semantic language processing or comprehensive procedures with multiple language tasks have the highest guarantee for individual activation lateralization. Simple object naming does not guarantee a lateralized language fMRI activation pattern. Of the different memory procedures during IAT, the procedures (Interview and the Montreal) demanding encoding processing will be related to larger areas of bilateral hippocampal activation than procedures (Seattle) exclusively requiring retrieval. Moreover, tasks using recognition of previously presented language items (naming objects) are equally effective for assessing hippocampal activation compared with presenting separate memory items.
Animal word list generation (ANWLG) was administered to 47 first-episode schizophrenia (FES) participants and 31 controls. Fifty-nine left temporal lobe epilepsy (LTLE) participants were included as a comparison group with known temporal lobe damage and expected semantic deficits. Semantic knowledge was assessed with the Association Index (AI), a measure of the semantic relatedness of all consecutive ANWLG responses. Neuropsychological tests of language and executive functioning were also administered. Results showed that both FES and LTLE groups generated fewer ANWLG responses than controls, but only the LTLE participants obtained a lower AI relative to controls. FES participants did not differ from controls on the AI. FES and LTLE groups produced fewer semantic subcategories (clusters), however, only the LTLE group produced fewer words per subcategory compared to controls (cluster size). FES participants produced a higher rate of perseverative responses compared to the other groups. Finally, correlation analyses showed that for FES participants both executive and language tests significantly correlated with ANWLG total responses, while the correlation between ANWLG and only 1 language test was significant for LTLE participants. Taken together, the results suggest that reduced ANWLG output in FES participants may be best conceptualized as a deficit in the executive component of word list generation (i.e., semantic search/access, response monitoring) or global cognitive impairment.
Language hemispheric dominance can be assessed by the Wada test before temporal lobectomy, in patients with refractory epilepsy of the mesial temporal lobe. Functional MR is a less invasive technique which recently demonstrated the ability to localize some language areas. The aim of this study was to determine if functional MR can be substituted to the Wada test in the determination of language dominance. Seven patients with a refractory epilepsy of the mesial temporal lobe were included. The MR protocol was carried out using a 1.5 T system including 12 axial gradient echo BOLD EPI images. A semantic fluency task, interspersed with rest periods, was used as activation paradigm. An activation of middle and inferior frontal region was found in all patients. It predominated in the left hemisphere in 6 cases and in the right hemisphere in 1 case. The hemispheric and frontal lobe lateralization of the functional MR activation was correlated with the hemispheric language dominance as assessed by the Wada test. In conclusion, functional MR is a promising technique in the determination of language dominance.
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Infants (321) who had been screened for language delay and auditory perceptual problems at 9 months of age were evaluated 1 year later. Of these infants 88.6% were correctly classified as at-risk or not-at-risk of delayed linguistic development. The correlation between performance on the screen and on a language scale was 0.49. The great majority of those with receptive and expressive delay continued to show problems at 2 years of age, whereas half of those with expressive delay alone were within normal limits. No evidence was found that a history of fluctuating hearing loss contributed to the development of either language delay or auditory perceptual problems.
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The language abilities of a group of 22 children (aged between 5 years and 17 years, 9 months) treated for acute lymphoblastic leukaemia (ALL) were investigated and compared with those of a group of non-neurologically impaired, age- and sex-matched controls. The language test battery included an age-appropriate measure from the Test of Language Development (TOLD) series, consisting of either the Test of Adolescent Language (TOAL--2), or the Test of Language Development--Intermediate or --Primary (TOLD--I or --P); the timed subtests of the Clinical Evaluation of Language Function (CELF); the Boston Naming Test; and one of either the Token Test or the Token Test for Children, depending on the age of the subject. As a group, the leukaemia subjects performed significantly worse than the controls on the TOAL--2, TOLD--I, TOLD--P, Token Test, and Boston Naming Test. The need for post-treatment monitoring of the language abilities of children treated for ALL to enable early remediation of areas of deficit is highlighted.
A comprehensive language test battery (Aachen Aphasia Test) was administered to 45 patients in the early, middle or later stages of Huntington's disease (HD) and to 20 control subjects. In spontaneous speech, many HD patients exhibited a loss of conversational initiative. Dysarthria was a common finding. Reading skills were found to be impaired mainly as a consequence of dysarthria; some HD patients displayed visual dyslexia. In addition to the characteristic disturbances of writing skills due to the choreiform movement disorder, the writing of HD patients with advanced dementia indicated constructional dysgraphia, characterized by frequent omissions, perseverations and substitutions. HD patients exhibited no evidence of word-finding difficulty or other semantic deficits in spontaneous speech. There was, however, a marked impairment in visual confrontation naming, with a significant rise in naming error rate as the disease progressed in severity. In most instances, the inappropriate names referred to an object visually similar to the target object, suggesting that visual misperception is the major cause of the naming disorder in HD. Syntactical structure of spontaneous speech was typically reduced to short, simple sentence construction. Verbal stereotypes were only rarely encountered and occurred late in the course of the disease. Tests of language comprehension reflected the general degree of dementia. It is concluded that there are no primary language changes in HD. Instead, a variety of language impairments develop secondary to other neurological and neuropsychological changes.
BACKGROUND: We investigated the aetiology of language impairment in 579 four-year-old twins with low language performance and their co-twins, members of 160 MZ twin pairs, 131 same-sex DZ pairs and 102 opposite-sex DZ pairs. METHODS: Language impairment in 4-year-olds was defined by scores below the 15th percentile on a general factor derived from an extensive language test battery. Language impairment of different degrees of severity was investigated by using multiple cut-offs below the 15th percentile. RESULTS: DeFries-Fulker extremes analysis indicated that language impairment as measured by the general language scale is under strong genetic influence. In addition, group differences heritability showed an increasing trend (from 38% to 76%) as a function of severity of language impairment. Although more boys are impaired than girls, incorporating opposite-sex DZ pairs into the analysis found neither quantitative nor qualitative differences between boys and girls in genetic and environmental aetiologies. CONCLUSIONS: Language impairment at four years is heritable. This finding replicates previous research on language impairment and extends it by showing that language impairment is heritable in twins selected from a representative community sample. Despite the mean difference between boys and girls, genetic and environmental influences are quantitatively and qualitatively similar for language impairment for boys and girls. For both boys and girls, heritability appears to be greater for more severe language impairment, indicating stronger influence of genes at the lower end of language ability.