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Comparison of formal language therapy with supportive counseling for aphasia due to acute vascular accident.

A total of 60 right-handed patients with acute aphasia due to left hemispheral stroke were randomly assigned to two modes of therapy for six months, beginning one month after the ictus. Conventional speech therapy provided by professional speech pathologists twice weekly was compared with emotionally supportive counseling therapy, also provided by professional speech pathologists at the same intervals. Language function was tested periodically by the Porch Index of Communicative Ability. Fifty of the subjects were also tested at ten months after the ictus. There was no difference in the amount of improvement between the two groups.

Adult↗

Concept mediation in trilingual translation: evidence from response time and repetition priming patterns.

Translation responses to individual words were elicited from 48 English-Spanish-French trilinguals, who translated in six directions at study and two directions at test. Patterns of translation response times and error rates at study reflected the relative proficiency of the trilinguals in comprehension and production of their three languages. At test, repeated items were translated more quickly than new items, with the strongest priming effects occurring for identical repetitions. Repetition priming was also substantial when only the stimulus language or only the response language matched from study to test, implying that repeated comprehension and production processes contribute to priming in translation. Patterns of response times and repetition priming indicate that translation in all directions involved conceptual access. Additive patterns in response time asymmetries and repetition priming were consistent with the treatment of word comprehension and production processes of translation as independent.

Adult↗

Extending formant transitions may not improve aphasics' perception of stop consonant place of articulation.

Synthetic speech stimuli were used to investigate whether aphasics' ability to perceive stop consonant place of articulation was enhanced by the extension of initial formant transitions in CV syllables. Phoneme identification and discrimination tests were administered to 12 aphasic patients, 5 fluent and 7 nonfluent. There were no significant differences in performance due to the extended transitions, and no systematic pattern of performance due to aphasia type. In both groups, discrimination was generally high and significantly better than identification, demonstrating that auditory capacity was retained, while phonetic perception was impaired; this result is consistent with repeated demonstrations that auditory and phonetic processes may be dissociated in normal listeners. Moreover, significant rank order correlations between performances on the Token Test and on both perceptual tasks suggest that impairment on these tests may reflect a general cognitive rather than a language-specific deficit.

Adult↗

Semantic encoding deficits in a case of traumatic amnesia.

A 33-year-old patient was studied neuropsychologically 19 years after sustaining severe head trauma. A recent CT scan showed lesions in the left frontal and right temporal regions. Performance on standard memory tests, both verbal and visuospatial, was extremely poor, although other intellectual functioning was relatively spared. The patient showed some interesting deficits in semantic processing. In a depth of processing task there was no advantage for words where semantic encoding had been induced. Neither was there any release from proactive interference after shifts in semantic categories. Deficits were also observed in short-term memory distractor tasks as well as in cueing tasks. These findings suggest that the cognitive deficits commonly observed in Korsakoff's disease can also be present in other amnesic disorders and may in part be related to cortical and especially frontal lobe atrophy.

Adult↗

Comparison of morphology and syntax in free narrative and structured tests: fluent vs. nonfluent aphasics.

Seven agrammatic Broca's and seven paragrammatic conduction aphasics were evaluated on a free narrative story elicitation test and on a structured, cross-modal morphology and syntax battery (MSB). The latter permitted comparison of the same set of morphosyntactic forms in both production and comprehension. Results suggests distinctive oral production profiles, with agrammatics inferior to paragrammatics in use of auxiliaries, verb inflection and passive word order. Only agrammatics commonly omitted articles or main verbs. The use of noun plurals and possessives did not discriminate between the groups. The two groups did not differ in level of performance on MSB comprehension subtests, and the order of difficulty among the comprehension subtests was unrelated to their difficulty for production. This suggests that the source of agrammatic production errors is independent of comprehension errors. The production of targeted constructions on the MSB, an easily scored instrument, closely paralleled production in free narrative.

Aged↗

The use of word-reading to estimate "premorbid" ability in cognitive domains other than intelligence.

Diagnostic neuropsychological assessment requires the clinician to estimate a patient's premorbid abilities. Word reading tests, such as the National Adult Reading Test-Revised (NART-R), provide reasonably accurate estimates of premorbid IQ, but their capacity to benchmark other premorbid cognitive abilities remains unclear. In this extension of an earlier report, we administered the NART-R, an abbreviated Wechsler Adult Intelligence Scale (WAIS-R or WAIS-III), and 26 other cognitive measures to 322 reasonably healthy adults. While NART-R performance correlated robustly (rs > or = .72) with concurrent Verbal and Full Scale IQ, its correlation with all other cognitive measures was significantly lower. Thus, while it is appealing to use word reading as a proxy for premorbid functioning in other cognitive domains, the NART-R has limited utility for this because it does not predict current performance on other cognitive tests as well as it predicts IQ in healthy adults.

Adolescent↗

Embedded-explicit emergent literacy intervention I: Background and description of approach.

This article, the first of a two-part series, provides background information and a general description of an emergent literacy intervention model for at-risk preschoolers and kindergartners. The embedded-explicit intervention model emphasizes the dual importance of providing young children with socially embedded opportunities for meaningful, naturalistic literacy experiences throughout the day, in addition to regular structured therapeutic interactions that explicitly target critical emergent literacy goals. The role of the speech-language pathologist (SLP) in the embedded-explicit model encompasses both indirect and direct service delivery: The SLP consults and collaborates with teachers and parents to ensure the highest quality and quantity of socially embedded literacy-focused experiences and serves as a direct provider of explicit interventions using structured curricula and/or lesson plans. The goal of this integrated model is to provide comprehensive emergent literacy interventions across a spectrum of early literacy skills to ensure the successful transition of at-risk children from prereaders to readers.

Dyslexia↗

Speech-language pathologists' beliefs about language assessment of bilingual/bicultural individuals.

A survey of speech/language pathologists, in 5 states across the United States was conducted to determine their beliefs about the language assessment of bilingual/bicultural individuals. Most SLPs reported low efficacy in bilingual assessment for both their own skills (personal efficacy) and those of the field in general (general efficacy). SLPs who learned a second language in the context of cultural experience (the CE group) reported more personal efficacy in bilingual assessment than speech-language pathologists who learned a second language via academic study (the AS group), who in turn felt more competent than monolingual SLPs (the M group). Furthermore, the 3 groups of respondents differed in terms of attributions for their low personal efficacy. The M group was most likely to mention their lack of knowledge about bilingual issues, the AS group commented on their less than optimal language proficiency, and the CE group focused on both proficiency and experience as influences. Over half of all participants (52%) reported that bilingual input in a child's environment would influence their interpretation of that child's language assessment results. Most of these participants (40%) reported that they would be more conservative in recommending language therapy for a bilingual than a monolingual child, particularly due to the respondent's own lack of knowledge of bilingual issues. Implications regarding the relations between language learning experiences and beliefs about the assessment of bilingual/bicultural individuals among SLPs are discussed.

Adolescent↗

Impact of temporal lobe epilepsy on phonological processing and reading: a case study of identical twins.

In order to evaluate the possible consequences of temporal lobe epilepsy on reading acquisition, we first compared the reading skills and phonological awareness abilities in a set of 13-year-old identical twins, one of whom is affected by temporal lobe epilepsy (LB). We then compared their performances to those of an age- and IQ-matched control group. Both siblings have an intellectual quotient above average as well as normal memory and linguistic abilities. Results showed that the reading age of LB (assessed by the Lefabvrais French reading test) was more than two years behind expectations whereas that of her sister was above average. Further, in contrast to her sister and healthy control subjects, LB exhibited specific deficits in elaborate metaphonological awareness abilities (non-word repetition, rhyme production, phonemic segmentation and syllabic inversion). These could be linked to temporal lobe dysfunction, thus confirming the important role of the temporal lobes in reading acquisition.

Adolescent↗

Norrie's disease: a prospective study of development.

Developmental progress, hearing, and dysmorphic features were monitored prospectively in eight babies with Norrie's disease (an X linked form of congenital blindness believed to be associated with mental retardation, regression, sensorineural deafness, and dysmorphic features) and in six congenitally blind peers during their preschool years. No evidence of sensorineural deafness or dysmorphology was found in the group with Norrie's disease. No significant difference in the rate of developmental progress occurred between the two groups. All 14 children showed continuing developmental progress and in 10 this was at a normal or superior rate. Two cases and two controls showed slowing in their rate of progress; in both groups a suboptimal developmental climate had prevailed and may have been contributory. The emphasis on serious and progressive associated disabilities in past reports has led to considerable distress for families of children with this disease. Our study suggests that these anxieties may often be illfounded. Parental depression constrains development, particularly when a baby is blind. More optimistic counselling with developmental guidance is recommended for children who are not overtly retarded in infancy until the long term developmental perspective of this disease is further clarified.

Blindness↗

Language lateralisation and early right ear deafness: was Wernicke right?

The effects of early right ear deafness on lateralisation of auditory language functions are not fully known. A 36 year old right handed man, with a history of perinatal right ear deafness and undergoing evaluation for surgical treatment of seizures that began at age 10 years was studied. Language lateralisation testing by intracarotid sodium amobarbital injection showed receptive and expressive language functions to be strongly lateralised to the left hemisphere. Results with intracarotid sodium amobarbital injection further suggested that transmission of auditory input to the patient's left hemisphere was partially dependent on ipsilateral left ear pathways. Cortical language mapping through implanted subdural electrodes localised auditory language functions to traditional left posterior perisylvian language areas. These results suggest that early right ear deafness does not impede left hemisphere lateralisation and localisation of auditory language functions. Moreover, transmission of auditory information to the patient's left hemisphere seems to be accomplished, in part, by recruitment of ipsilateral left ear pathways.

Adult↗

Levels of cognitive and linguistic development in Angelman syndrome: a study of 20 children.

Angelman syndrome (AS) is a genetic disorder associated with severe developmental delay. The purpose of this study was to investigate cognitive and linguistic development in AS. Piaget's developmental model was used to evaluate the test results. The participants comprised 20 children (14 boys and 6 girls) aged 2-14 years (median age 7.4 years). AS was diagnosed either according to typical clinical criteria or confirmatory genetic testing. Cognitive functioning was evaluated with Griffiths' Mental Development Scale. Language development was also evaluated with Receptive-Expressive Emergent Language Scale 2 (REEL-2). Cognitive functioning, based on results on the Performance Scale, never exceeded Piaget's sensorimotor stage, 0-2 years. The median mental age for language development was 9 months. Expressive verbal vocabulary consisted of less than 2 words (n = 11), 2-3 words (n = 7) and 4-5 words (n = 2). Analyses according to REEL-2 did not indicate a consistent discrepancy between impressive and expressive language.

Adolescent↗

Further analyses of clock drawings among demented and nondemented older subjects.

In a previous article we described a 10-point scoring system (i.e., scale 1) to grade clock drawings to command and copy with hands set for "ten after 11" among demented patients. Alzheimer's subjects (AD) improved from the command to copy conditions, whereas subjects with ischaemic vascular dementia (IVD) did not. To investigate the underlying cognitive deficits responsible for this profile, an additional scale was developed (scale 2) that tallied errors in graphomotor functioning, hand/number placement, and executive control. On an independent sample of subjects, AD subjects, again, made significant improvement on scale 1 from the command to copy condition, whereas no such improvement occurred among the IVD subjects. On scale 2, IVD subjects made more graphomotor errors in the command condition, and more executive control and more total errors in the copy conditions than AD subjects. A number of positive correlations were noted between tests of language and memory on scale 1. By contrast, scores on tests of executive control declined as scale 2 errors increased. In addition, a principal component analysis indicated that scale 2 test performance loaded on a factor with other tests related to executive control. These results suggest that impairment in frontal systems functioning may explain why IVD subjects do not improve from the command to copy conditions on scale 1. Such a pattern of performance in clock drawing may also be helpful in making a differential diagnosis between AD and IVD.

Journal Article↗

Verbal dichotic listening in developmental stuttering: subgroups with atypical auditory processing.

OBJECTIVE: The major aim of this study was to determine whether adults with persistent developmental stuttering have atypical auditory processing. BACKGROUND: Stuttering has been attributed to aberrant hemispheric dominance, and auditory processing deficits have been found in some adults who stutter. Dichotic listening, an indirect measure of auditory processing, has not been used to study auditory laterality in right- and left-handers who stutter. Because left-handers and people who stutter may have aberrant hemispheric dominance, it is important to examine auditory neural systems in right- and left-handed people who do and do not stutter. METHODS: Adults with persistent developmental stuttering (n = 18) and matched controls (n = 28) were studied by simultaneous binaural (dichotic) presentation of consonant-vowel stimuli in three attention conditions: nondirected attention, attention directed right, and attention directed left. Sex-handedness groups (stutter and control) included right-handed men and women and left-handed men, but not left-handed women because this stutter subgroup could not be recruited. To study ear advantage and auditory laterality, two dependent measures were examined: percent left and right ear responses and lateralization shift magnitude. Potential relationships between degree of handedness and dichotic listening measures were also examined. RESULTS: Matched controls and right-handed men who stutter had the expected right-ear advantage (REA) in the nondirected attention condition. In contrast, left-handed men who stutter had a left-ear advantage (LEA), and right-handed women who stutter did not have a lateral ear bias in the nondirected attention condition. Right-handed women who stutter had the greatest tendency to hear a sound that was not presented to either ear, and were relatively unable to selectively direct attention left or right. In contrast, left-handed men who stutter were able to shift attention to the left and right ear better than any other group. For the fluent control group, there were no significant relationships among degree of handedness and dichotic-listening variables. For the stutter group, degree of handedness was significantly related to percentage left and right ear response and to the lateralization shift magnitude. CONCLUSIONS: Left-handed men who stutter and right-handed women who stutter have atypical auditory processing but differ in important ways. The left-ear bias found in left-handed men who stutter in the nondirected attention condition suggests that their right temporal lobe may be important in perceiving speech, and, therefore, they have mixed dominance. These subjects were also better at shifting attention in both directions in comparison to all other groups; thus, the right hemisphere, which is dominant for shifting attention to both right and left space, may be activated. In contrast, the right-handed women who stutter had no ear bias in the nondirected attention condition, made more perceptual errors, and had difficulty shifting attention to the left and right. Although these results suggest that right-handed women who stutter have attentional deficits, the relationship between attentional disorders and stuttering remains to be elucidated. Because right-handed men who stutter were not different from controls, aberrant hemispheric dominance cannot fully account for stuttering. Unfortunately, left-handed women were not examined in this study. Therefore, these interesting sex-handedness effects found in left-handed men and right-handed women who stutter must be interpreted with caution.

Adult↗