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PubMed2007

Performance on MMSE sub-items and education level in presenilin-1 mutation carriers without dementia.

BACKGROUND: Spanish-language screening tests that are sensitive to the early cognitive changes of Alzheimer's disease (AD) are needed. Persons known to be at 50% risk for young-onset AD due to presenilin-1 (PSEN1) mutations provide the opportunity to assess which measures on the Mini-mental State Examination (MMSE) are most sensitive to these early changes. METHODS: We performed genetic and Spanish-language cognitive testing on 50 Mexican persons without dementia at risk for inheriting PSEN1 mutations. We then compared the performance on sub-items of the MMSE between PSEN1 mutation carriers (MCs) and non-carriers (NCs) using t-tests and Fisher's exact tests. Exploratory multiple logistic regression analyses were also performed. RESULTS: Twenty-nine persons were MCs and 21 NCs. NCs tended to achieve higher levels of education (p = 0.039) than did MCs. MCs tended to perform more poorly when spelling "MUNDO" backwards and on Orientation, particularly regarding the date. In multiple regression analyses the ability of backwards spelling to predict PSEN1 mutation status was reduced when education was included as an independent variable. CONCLUSION: Subjects in the earliest stage of PSEN1-related AD showed deficits on orientation to date and in divided attention when spelling backwards. It is unclear if educational level should be considered an associated feature or a con-founding variable in this population although it should be taken into account when considering performance on the MMSE task of divided attention. The relative lack of deficits on delayed recall of three words probably represents the insensitivity of this measure in early AD. This study supports the utility of autosomal dominant AD as a model of the more common sporadic form of the disorder.

Aged↗
PubMed1990

Syntax comprehension deficits in Parkinson's disease.

The comprehension of 100 different spoken English sentences was studied in 39 patients with mild to moderate Parkinson's disease (PD) using the Rhode Island Test of Language Structure. Eight of the PD patients were mildly demented, and the remaining 31 showed no cognitive deficits. Seven of the eight mildly demented patients had high comprehension error rates for sentences that had moderately complex syntax. The error rates of 28 of the 31 other, nondemented patients were low, similar to those of normal control subjects. The difference between the error rates of the demented and nondemented patients was significant (p less than .02, two-tailed t-test). The data argue against some current "modular" theories that segregate linguistic from other cognitive behavior. The destruction by PD of the midbrain regions that stimulate the frontal cortex may be responsible for both cognitive and syntactic comprehension deficits.

Aged↗
PubMed1987

Acquired aphasia in childhood: clinical and CT investigations.

We studied eight children with acquired aphasia. All had left hemisphere lesions. In most, the correlation between the CT lesion site and the resulting aphasic syndrome duplicated an anatomic-clinical correlation described in adults. Rapid recovery of language fluency distinguished the children from reported adults. Late follow-up indicated poor scholastic achievements, reflecting an acquired handicap in new learning. Anatomic-clinical correlates and recovery patterns suggest that brain organization for language is similar but not identical in children and adults.

Adolescent↗
PubMed2002

FMRI-determined language lateralization in patients with unilateral or mixed language dominance according to the Wada test.

Due to the reported variability of the language laterality index (LI) across fMRI studies, reliable distinction between patients with unilateral and mixed language dominance is currently not possible, preventing clinical implementation of fMRI as a replacement for the invasive Wada test. Variability of the LI may be related to differences in experimental and control tasks, and statistical methodology. The goal of this study was to improve detection power of fMRI for hemispheric language dominance by using a combined analysis of four different language tasks (CTA), that has previously shown more reliable and robust Lls in groups of normal volunteers than individual task analyses (see Ramsey et al). The CTA targets brain areas that are common to different language tasks, thereby focusing on areas that are critical for language processing. Further advantage of the CTA is that it is relatively independent of specific task and control conditions. 18 patients with typical (i.e., left-sided, n = 11) and atypical (i.e., right-sided or mixed, respectively, n = 3 and n = 4) language dominance according to the Wada test underwent fMRI (groups respectively denoted as WadaL, WadaR, and WadaM patients). Statistical methodology (including thresholding of activity maps) was fixed to assure a user-independent approach. CTA yielded better results than any of the individual task analyses: it was more robust (on average 2.5 times more brain activity was detected due to its higher statistical power) and more reliable (concordance for WadaL, WadaM and WadaR patients was respectively 10/11 (91%), 3/4 (75%), and 2/3 patients (67%)). Overall, a significant correlation was observed between frontal and temporoparietal LIs. Remarkably, brain activity for WadaM patients was significantly lower than for WadaL or WadaR patients, and a dissociation in lateralization was observed between frontal (right-sided) and temporoparietal (left-sided) activity in three of four patients. Of the individual task analyses, the verb generation task yielded best results for patients with unilateral language dominance (same concordance as CTA). However, in contrast to CTA results, the verb generation task was unable to identify WadaM patients (concordance in one of four patients). In conclusion, the CTA is a promising approach for clinical implementation of fMRI for the prediction of hemispheric language dominance.

Adult↗
PubMed2003

Age, working memory, figurative language type, and reading ability: influencing factors in African American adults' comprehension of figurative language.

This study investigated the cognitive and linguistic factors presumed to be associated with adult comprehension of figurative language, including age, working memory (WM), figurative language type, and reading comprehension (RC). Forty younger (M = 22 years) and 40 older (M = 63 years) healthy African American adults completed WM and reading tasks, and the 60-item forced-choice multiple-category (20 idioms, 20 metaphors, and 20 metonyms) Figurative Language Comprehension Test. After controlling for WM and RC, the older adults outperformed the younger adults on idioms and metonyms. Metaphor comprehension was comparable between the groups. Findings demonstrate that WM and RC underlie adults' comprehension of figurative language and should be considered when interpreting performance on tests assessing figurative language competence in this population.

Adolescent↗
PubMed2006

Theory of mind abilities in young siblings of children with autism.

Deficits in theory of mind (ToM), evident in most individuals with autism, have been suggested as a core deficit of autism. ToM difficulties in young siblings of children with autism (SIBS-A) compared to siblings of typically developing children (SIBS-TD) would place the former within the broad phenotype. We examined ToM's possible associations with measures of language, cognition, and daily living skills. Participants comprised 24 SIBS-A and 24 matched SIBSTD aged 4.6 years. They completed the false belief and the strange stories tasks. We also collected measures of verbal and cognitive ability and daily living skills. Non-significant differences emerged between the groups on both ToM tasks. Differences did emerge in within-group associations between ToM ability and receptive language. The conclusion is that SIBS-A show resilience in ToM abilities. Possibly, these deficits are not genetically transferred to siblings, at least as measured in laboratory-based ToM tasks.

Autistic Disorder↗
PubMed1999

Early speech and language development in children with velocardiofacial syndrome.

Speech-language impairment is one of the most common clinical features in velocardiofacial syndrome (VCFS). This report describes the speech and language development of four children with VCFS studied longitudinally from 6 to 30 months of age and compares their performance with three groups of children: (1) normally developing children, (2) children with cleft lip and palate, and (3) children with isolated cleft palate. The data show that young children with VCFS show a receptive-expressive language impairment from the onset of language. Further, speech and expressive language development were severely delayed beyond a level predicted by their other developmental or receptive language performance. The children with VCFS showed severe limitations in speech sound inventories and early vocabulary development that far exceeded those shown by the children with cleft lip and palate and children with isolated cleft palate. This study indicates that young children with VCFS emerge from a critical speech and language learning period with severe limitations in their communicative abilities. Further studies are required to describe the later course of these early speech and language impairments and to explore the relationship to learning disabilities described for older children with VCFS. Am. J. Med. Genet. (Neuropsychiatr. Genet.) 88:714-723, 1999.

Abnormalities, Multiple↗
PubMed2005

Are specific language impairment and dyslexia distinct disorders?

PURPOSE: The purpose of this study was to determine whether specific language impairment (SLI) and dyslexia are distinct developmental disorders. METHOD: Study 1 investigated the overlap between SLI identified in kindergarten and dyslexia identified in 2nd, 4th, or 8th grades in a representative sample of 527 children. Study 2 examined phonological processing in a subsample of participants, including 21 children with dyslexia only, 43 children with SLI only, 18 children with SLI and dyslexia, and 165 children with typical language/reading development. Measures of phonological awareness and nonword repetition were considered. RESULTS: Study 1 showed limited but statistically significant overlap between SLI and dyslexia. Study 2 found that children with dyslexia or a combination of dyslexia and SLI performed significantly less well on measures of phonological processing than did children with SLI only and those with typical development. Children with SLI only showed only mild deficits in phonological processing compared with typical children. CONCLUSIONS: These results support the view that SLI and dyslexia are distinct but potentially comorbid developmental language disorders. A deficit in phonological processing is closely associated with dyslexia but not with SLI when it occurs in the absence of dyslexia.

Adolescent↗
PubMed1984

Effects of methylphenidate on reading in children with attention deficit disorder.

Effects of methylphenidate on measures related to reading were studied in a group of nine boys who had attention deficit disorder with hyperactivity; a double-blind crossover design using active drug and placebo was used. Administration of methylphenidate improved subjects' performance on language processing tests but not their performance on oral reading measures. The findings provide evidence in support of a two-factor theory of attention deficit disorder.

Adolescent↗
PubMed2003

Brain imaging of language plasticity in adopted adults: can a second language replace the first?

Do the neural circuits that subserve language acquisition lose plasticity as they become tuned to the maternal language? We tested adult subjects born in Korea and adopted by French families in childhood; they have become fluent in their second language and report no conscious recollection of their native language. In behavioral tests assessing their memory for Korean, we found that they do not perform better than a control group of native French subjects who have never been exposed to Korean. We also used event-related functional magnetic resonance imaging to monitor cortical activations while the Korean adoptees and native French listened to sentences spoken in Korean, French and other, unknown, foreign languages. The adopted subjects did not show any specific activations to Korean stimuli relative to unknown languages. The areas activated more by French stimuli than by foreign stimuli were similar in the Korean adoptees and in the French native subjects, but with relatively larger extents of activation in the latter group. We discuss these data in light of the critical period hypothesis for language acquisition.

Adoption↗
PubMed1996

The relation of medical risk and maternal stimulation with preterm infants' development of cognitive, language and daily living skills.

High-risk (HR) and low-risk (LR) preterm infants (N = 212) and full-term infants (FT, N = 128) from low socio-economic homes were studied with their mothers in the home at 6 and 12 months of age. Infants' cognitive, language and daily living skills were evaluated in relation to mothers' warm sensitivity, use of strategies which maintained the infants' attention and directiveness. Higher levels of maternal attention-maintaining were positively related to infant development for all groups. During toy play, attention-maintaining was most strongly related to expressive language skills for the HR infants; during toy play and daily activities, this maternal behavior was more strongly related to cognitive and language skills for both preterm groups than for the FT infants.

Activities of Daily Living↗
PubMed1985

Otitis media and language performance in a cohort of Apache Indian children.

Language performance was evaluated in 167 healthy Apache Indian children aged 6 to 8 years, who had contrasting histories of otitis media and who had been followed since birth. All children received pneumatic otoscopy, tympanometry, pure tone audiometry, and a battery of language measures. Groups were similar with respect to age, sex, school experience, family income, housing, primary language spoken, and nonverbal intelligence. No statistically or clinically significant differences in language performance were observed between groups of children with frequent episodes of otitis media and those from the same cohort with infrequent otitis. While frequent otitis media was associated with abnormalities on tympanometry and otoscopy, bilateral hearing loss (greater than 25 dB) was observed in only 1% of the children.

Acoustic Impedance Tests↗
PubMed1996

Preschool speech and language screening: further validation of the sentence repetition screening test.

A recent review indicated that only one speech and language screening test (the Sentence Repetition Screening Test; SRST) designed for preschoolers has been successfully validated in a representative population. This study sought to replicate the SRST validation study using a somewhat younger age group and to compare predictive indices to typical measures of parent concern and teacher judgment. A sample of (N = 343) prekindergarten children (ages 54 to 66 months) attending school registration in the spring before kindergarten entry was tested with the SRST. A stratified sample of 76 returned for criteria testing within 2 months. Teacher ratings were obtained 5 months later. Outcome measures were standard language (Bankson and Illinois Test of Psycholinguistic Abilities) and speech articulation (Arizona) tests. With a prevalence of 11%, SRST prediction of language outcomes resulted in the following indices: sensitivity, .62; specificity, .91; predictive validity, .44; overreferral, 8.4%; and underreferral, 4%. Prediction of the articulation outcome with a prevalence of 11% resulted in indices as follows: sensitivity, .57; specificity, .95; predictive validity, .75; overreferral, 3.7%; and underreferral, 8.3%. Teacher ratings and a parent questionnaire (Speech and Language Screening Questionnaire) approached the same rate of prediction of articulation but with a higher overreferral rate. The predictive indices from the SRST exceeded the comparison measures for language outcomes.

Articulation Disorders↗
PubMed2001

Differences between conduction aphasia and Wernicke's aphasia.

Conduction aphasia and Wernike's aphasia have been differentiated by the degree of auditory language comprehension. We quantitatively compared the speech sound errors of two conduction aphasia patients and three Wernicke's aphasia patients on various language modality tests. All of the patients were Japanese. The two conduction aphasia patients had "conduites d'approche" errors and phonological paraphasia. The patient with mild Wernicke's aphasia made various errors. In the patient with severe Wernicke's aphasia, neologism was observed. Phonological paraphasia in the two conduction aphasia patients seemed to occur when the examinee searched for the target word. They made more errors in vowels than in consonants of target words on the naming and repetition tests. They seemed to search the target word by the correct consonant phoneme and incorrect vocalic phoneme in the table of the Japanese alphabet. The Wernicke's aphasia patients who had severe impairment of auditory comprehension, made more errors in consonants than in vowels of target words. In conclusion, utterance of conduction aphasia and that of Wernicke's aphasia are qualitatively distinct.

Aged↗
PubMed2026

BMT4me En Español: Multisite Feasibility and Usability Testing of a Spanish-Language mHealth Adherence Support App for Spanish-Speaking Caregivers of Children After Hematopoietic Stem Cell Transplantation and Cancer Treatment.

BACKGROUND: Medication nonadherence during the first 100 days after pediatric hematopoietic stem cell transplantation (HSCT) and during oncology treatment increases risk for complications. BMT4me is a caregiver-facing mobile health (mHealth) application providing medication reminders, symptom tracking, and note-taking features to support medication management. Spanish-speaking caregivers are frequently excluded from digital adherence interventions due to the lack of language-accessible tools. PROCEDURE: We conducted a multisite, mixed-methods usability testing of a Spanish-language version of BMT4me ("BMT4me en Español") with Spanish-speaking caregivers of children (ages 2-17 years) post-HSCT or with an oncology diagnosis on active treatment. Caregivers completed a facilitated, three-step usability session (unobtrusive observation, interactive observation, and debriefing), followed by a semi-structured interview, and then completed the system usability scale (SUS). Quantitative outcomes were summarized descriptively; qualitative data were analyzed using content analysis with constant comparison. RESULTS: Fifteen participants enrolled at each site for a total of 30 participants. Across both sites, the recruitment rate was 91%. All participants completed all parts of the study. The SUS score (M = 80.09; SD = 17.35) was above average (>68). Two key qualitative themes emerged: (1) the perceived positive impact of BMT4me on managing a serious illness and (2) the acceptance and sociocultural relevance of BMT4me for Spanish-speaking families. Caregivers also shared suggestions to add educational content and multiuser functionalities to BMT4me. CONCLUSIONS: The acceptance and perceived positive impact of the Spanish BMT4me app indicates that socioculturally relevant, Spanish mHealth interventions have strong potential to support Spanish-speaking caregivers in pediatric oncology and HSCT settings. CLINICAL TRIALS NCT: NCT06361173.

Adolescent↗
PubMed1996

Evidence for multiple routes of speech production in a case of fluent aphasia.

A case study is reported of a 24-year old woman who developed fluent aphasia with superior reading relative to auditory comprehension following herpes simplex encephalitis. Her language disturbance showed exceptional features: oral reading, repetition and naming to confrontation were severely impaired and yet her spontaneous speech recovered to be relatively intact. These features are not consistent with Wernicke's aphasia, pure word deafness or any classic aphasic syndromes. These findings indicate the presence of several routes for phonological output that may be differentially impaired.

Adult↗