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PubMed2004

Medical and cognitive outcome in children with traumatic brain injury.

BACKGROUND: Head injury is an important cause of morbidity and mortality in pediatrics. Comprehensive studies on outcome are scarce despite significant clinical concern that multiple areas of functioning may be impaired following moderate to severe head injury. The literature suggests that sequelae include not only medical problems but also impairments in cognitive functioning. METHODS: A retrospective medical and psychology chart review of patients, age 1-18 years, admitted to the Children's Hospital of Eastern Ontario with moderate (Glasgow Coma Scale [GCS] 9-12) or severe head injury (GCS < or = 8) from November 1, 1993 until December 31, 1998 was conducted. Correlations were performed between medical variables (i.e., GCS, Pediatric Risk of Mortality [PRISM] III score, duration of ICU and hospital stay) and measures of intelligence and memory functioning. RESULTS: Eighty-three children age 1 to 18 were included. Seventy percent of the children were classified as having a severe head injury. There was a mortality rate of thirteen percent. Younger age at injury, lower GCS, and higher PRISM III scores predicted higher mortality. Medical complications were documented systematically. Forty-four patients underwent at least one cognitive assessment and 17 of these children had intelligence testing at three points in time: baseline (< four months), early recovery (five to 15 months) and follow-up (16 to 38 months). The mean intelligence and memory scores fell within the average range at the latest point in follow-up. For those children who underwent three serial assessments, the mean verbal and performance IQ fell within the low average range at baseline improving significantly to fall within the average range by early recovery. Continued improvements were apparent in verbal memory beyond early recovery, with the mean obtained at follow-up falling within 1 SD of the normative mean. Despite the return to normal ranges for the group means the proportion of scores falling below 1.5 standard deviations from the mean was greater than population norms for verbal IQ, performance IQ and verbal memory. Lower GCS scores and longer duration of stay in ICU or hospital were predictive of lower nonverbal intelligence. Lower GCS was also predictive of lower visual memory scores. CONCLUSIONS: This study describes a population of Canadian children who suffered moderate or severe traumatic brain injury. Initial GCS was the best predictor of mortality and cognitive outcome. These children demonstrated a temporal improvement in intelligence and memory functioning, with their mean performance on these cognitive measures falling within the average range at 16 to 38 months postinjury, although there was considerable variability in the outcomes between individuals.

Adolescent↗
PubMed1998

Talker-specific learning in speech perception.

The effects of perceptual learning of talker identity on the recognition of spoken words and sentences were investigated in three experiments. In each experiment, listeners were trained to learn a set of 10 talkers' voices and were then given an intelligibility test to assess the influence of learning the voices on the processing of the linguistic content of speech. In the first experiment, listeners learned voices from isolated words and were then tested with novel isolated words mixed in noise. The results showed that listeners who were given words produced by familiar talkers at test showed better identification performance than did listeners who were given words produced by unfamiliar talkers. In the second experiment, listeners learned novel voices from sentence-length utterances and were then presented with isolated words. The results showed that learning a talker's voice from sentences did not generalize well to identification of novel isolated words. In the third experiment, listeners learned voices from sentence-length utterances and were then given sentence-length utterances produced by familiar and unfamiliar talkers at test. We found that perceptual learning of novel voices from sentence-length utterances improved speech intelligibility for words in sentences. Generalization and transfer from voice learning to linguistic processing was found to be sensitive to the talker-specific information available during learning and test. These findings demonstrate that increased sensitivity to talker-specific information affects the perception of the linguistic properties of speech in isolated words and sentences.

Humans↗
PubMed1987

Neuropsychological performance of children with Duchenne muscular dystrophy and spinal muscle atrophy.

Neuropsychological examinations were conducted on 39 boys with Duchenne muscular dystrophy (DMD) and 12 children with spinal muscular atrophy (SMA). There were no significant group differences in the pattern or level of test-score profiles, indicating that the performances of the two patient groups were very similar. However, pattern analysis indicated that while scores on verbal and non-verbal intelligence tests were within the average range for the children with DMD, there were deficits on tests of immediate memory.

Adolescent↗
PubMed2003

Oral creatine monohydrate supplementation improves brain performance: a double-blind, placebo-controlled, cross-over trial.

Creatine supplementation is in widespread use to enhance sports-fitness performance, and has been trialled successfully in the treatment of neurological, neuromuscular and atherosclerotic disease. Creatine plays a pivotal role in brain energy homeostasis, being a temporal and spatial buffer for cytosolic and mitochondrial pools of the cellular energy currency, adenosine triphosphate and its regulator, adenosine diphosphate. In this work, we tested the hypothesis that oral creatine supplementation (5 g d(-1) for six weeks) would enhance intelligence test scores and working memory performance in 45 young adult, vegetarian subjects in a double-blind, placebo-controlled, cross-over design. Creatine supplementation had a significant positive effect (p < 0.0001) on both working memory (backward digit span) and intelligence (Raven's Advanced Progressive Matrices), both tasks that require speed of processing. These findings underline a dynamic and significant role of brain energy capacity in influencing brain performance.

Adult↗
PubMedDate not supplied

Sensory-motor and cognitive functioning in children who have undergone bone marrow transplantation.

Sensory-motor and cognitive functioning was investigated in a group of 32 children treated with bone marrow transplantation (BMT), 1-6 years after treatment. Twenty-five of the patients had suffered from leukemia. The BMT procedure had involved a regimen of cytostatic drugs and, for leukemia patients, total body irradiation at a dose of 10 Gy, administered in one session. Cytostatic drugs and irradiation are known to be potentially neurotoxic, particularly when combined. The examination involved four neuropsychological tests of sensory-motor and cognitive functioning, as well as an age-appropriate intelligence test. For control the bone marrow donors (n = 32), siblings of the patients, were also investigated. A pronounced delay in motor development was found in four children, who had been treated with BMT including total body irradiation before 3 years of age. Patients between 3 and 11 years of age at BMT were at a slight disadvantage, compared to donors, on tasks involving perceptual and fine motor speed. In older patients no deficits were observed.

Adolescent↗
PubMed1999

Long-term neuropsychological sequelae of early-treated congenital hypothyroidism: effects in adolescence.

A cohort of over 100 children with congenital hypothyroidism (CH) detected via newborn screening was followed regularly throughout childhood and into adolescence. They were studied using a variety of different tests as part of three consecutive research components: semiannual/annual psychological assessments using age-appropriate intelligence tests (phase I), detailed psychoeducational evaluations in grades 3 and 6 (phase II) and a thorough neuropsychological evaluation during adolescence (phase III). Controls for phase I were siblings and for phase II, classmates and siblings. Phase III controls were drawn from a larger control pool and were individually matched with each CH case for age and gender. The results showed that although the CH group was intellectually functioning well within the normal range by adolescence, the children were performing significantly below expectation. Longitudinal analyses showed significant declines in IQ with age, signifying that the CH group was failing to make the same age-related gains as controls. Children with CH showed significantly poorer performance in visuospatial, language and fine motor areas as well as selective attention and memory deficits. At school, they were initially below par in arithmetic but were able to catch up by grade 6; however, their teachers reported that they were not performing as well as controls in the classroom and they demonstrated more difficulty with more complex school subjects such as science and social studies. Correlational analyses indicated different manifestations of early hypothyroidism versus later treatment factors, suggesting that while some effects can be improved by better treatment and management approaches, others caused by prenatal and perinatal thyroid hormone insufficiency may persist.

Adolescent↗
PubMed1975

A check on hypothetical personality structures and their theoretical interpretation at 14-16 years in T-data.

Basing hypotheses on interpretations of 12 personality factors most replicated in 10 past researches with children, this experiment sets up about eight subtests as specific markers for each. Ninety-five tests, taking eight hours in all, were administered to 394 14-16-year olds. A majority of the personality pattern hypotheses were sustained factor analytically by evidence on number of factors, significance of unique simple structure reached, and goodness of identifying match (chi-square test). Concept validities can be obtained for some six of the factors rivalling those for intelligence tests. A brief discussion is given of the bearing of the present results upon theoretical explanations of the given source traits, including extraversion, and it is pointed out that the psychological meaning of most, for personality research, is as important, in variance terms, as for the one or two, such as anxiety and extraversion, which have tended to monopolize discussion.

Adolescent↗
PubMed2005

Early life predictors of childhood intelligence: evidence from the Aberdeen children of the 1950s study.

OBJECTIVE: To identify the early life predictors of childhood intelligence. DESIGN: Cohort study of 10 424 children who were born in Aberdeen (Scotland) between 1950 and 1956. RESULTS: Social class of father around the time of birth, gravidity, maternal age, maternal physical condition, whether the child was born outside of marriage, prematurity, intrauterine growth, and childhood height were all independently associated with childhood intelligence at ages 7, 9, and 11. The effect of social class at birth was particularly pronounced, with a graded linear association across the distribution even with adjustment for all other covariates (p<0.001 for linear trend). Those from the lowest social class (V) had intelligence scores that were on average 0.9-1.0 of a standard deviation lower than those from the higher groups (I and II) at each of the three ages of intelligence testing. Collectively, the early life predictors that were examined explained 16% of the variation in intelligence at each age. CONCLUSIONS: Father's social class around the time of birth was an important predictor of childhood intelligence, even after adjustment for maternal characteristics and perinatal and childhood factors. Studies of the association of childhood intelligence with future adult disease need to ensure that the association is not fully explained by socioeconomic position.

Adult↗
PubMedDate not supplied

[Prevalence of attention deficit hyperactivity disorder in Colombian children and teenagers].

INTRODUCTION: Attention deficit hyperactivity disorder (ADHD) is the most common neurobehavioural disorder among schoolchildren. It may persist into adulthood and affect performance in the academic, social, occupational and familial spheres, and increase the use and abuse of alcohol and psychoactive substances and the risk of having an accident. Its prevalence throughout the world varies widely and further knowledge about this situation would be valuable for the development of policies in the sector of education. AIMS: The aim of this research was to determine the prevalence of ADHD and its distribution according to subtypes in schoolchildren from Sabaneta, Antioquia, Colombia, in 2001. SUBJECTS AND METHODS: The analysis involved a cross-sectional descriptive study using a representative randomised multistage sample (which was proportional to the size of the groups) of schoolchildren between 4 and 17 years old. Measurement was performed in two stages, first by application of a screening form according to DSM IV criteria, and later a structured interview, Conners' and Intelligence tests. RESULTS: Prevalence was found to be 20.4% and 15.8% if only children with an intelligence quotient of 80 or above were considered. The combined subtype was the most frequent, with 9.6%. In public schools it was 16.2%, private 15.3%, age group from 7-11 years 16.9%, 12-17 years old 14.2%, males 20.9%, females 10.1%, low 14.7%, medium 17.4% and high socioeconomic level 10.7%, with a male to female prevalence ratio of 3.88 to 1. CONCLUSIONS: Prevalence of ADHD in the school population in a municipality in the Metropolitan Area of Medellin, Colombia, is high. The most frequent subtype was the combined type, which was predominant in males, had repercussions on academic performance and low proportions of pharmacological interventions for the disorder (15%). Programmes must be developed for the detection of this problem and subsequent intervention in the school population.

Adolescent↗
PubMed1972

The effect on the test behavior of children, as reflected in the I.Q. scores, when reinforced after each correct response.

This experiment studied the effect on intelligence test scores of a probable reinforcer given for correct responses. Eleven pairs of 5- to 7-yr-old children were matched on the basis of a strong liking of candy, no physical problems associated with eating it, parent permission to receive and eat the candy, age, sex, and a revised Stanford-Binet Scale Form L IQ score. The control group was given the revised Stanford-Binet Scale Form M, as prescribed in the test manual. The experimental group was also given Form M according to the manual, except M&M candy was given for each plus or correct response. There was an appreciable, statistically significant difference between the resulting IQ test scores of the two groups.

Journal Article↗
PubMedDate not supplied

[Psychological test procedures for the elderly].

This paper presents our standardized psychometric inventory for the psychological investigation in the elderly patients: exploration, standard intelligence test, standard concentration-test, investigations into questionnaires of neurosis, screening-investigations of organic brain damage. The incorporation of information about the environment and its various effects in the exploration indicates the necessity for paying attention to the individual person-environment-relationship in psycho-diagnostic considerations. The necessity of psychometric methods in the diagnostic and therapeutic intervention in the elderly patients were discussed.

Aged↗
PubMed2002

Quantifying the intelligibility of speech in noise for non-native talkers.

The intelligibility of speech pronounced by non-native talkers is generally lower than speech pronounced by native talkers, especially under adverse conditions, such as high levels of background noise. The effect of foreign accent on speech intelligibility was investigated quantitatively through a series of experiments involving voices of 15 talkers, differing in language background, age of second-language (L2) acquisition and experience with the target language (Dutch). Overall speech intelligibility of L2 talkers in noise is predicted with a reasonable accuracy from accent ratings by native listeners, as well as from the self-ratings for proficiency of L2 talkers. For non-native speech, unlike native speech, the intelligibility of short messages (sentences) cannot be fully predicted by phoneme-based intelligibility tests. Although incorrect recognition of specific phonemes certainly occurs as a result of foreign accent, the effect of reduced phoneme recognition on the intelligibility of sentences may range from severe to virtually absent, depending on (for instance) the speech-to-noise ratio. Objective acoustic-phonetic analyses of accented speech were also carried out, but satisfactory overall predictions of speech intelligibility could not be obtained with relatively simple acoustic-phonetic measures.

Adult↗
PubMed2003

Neuropsychological assessment after microsurgical clipping or endovascular treatment for anterior communicating artery aneurysm.

BACKGROUND: After open surgery for ruptured ACoA aneurysms, several patients who have achieved a favourable neurological outcome still exhibit significant cognitive deficits. The aim of this study was to investigate the cognitive performances in patients with ACoA aneurysms submitted to different therapeutic options such as endovascular treatment and surgical clipping. METHODS: We evaluated 37 consecutive patients in WFNS grade I or II, who underwent an early treatment (within 48 hours) of a bleeding ACoA aneurysm: 20 out of 37 were surgically clipped (group A) and 17 were treated with endovascular coiling (group B). These two groups were compared with 16 patients (group C) with subarachnoid haemorrhage and negative cerebral panangiography and with 18 volunteers (group D) without neurological or psychiatric disorders. All patients were neurologically intact at discharge and were in Glasgow Outcome Scale 1 at 6 months follow-up after SAH. All subjects were tested to assess selective attention, verbal, spatial and logical memory, frontal lobe executive functions, language and intelligence. Depressive symptoms and anxiety were also examined. FINDINGS: Selective attention, verbal and spatial memory, and intelligence tests didn't show any significant difference between the patients and the controls. Surgically treated patients showed a significant worse performance on the logical memory and on the frontal lobe executive functions compared to controls, while the endovascular group and the group C (not treated) showed a significant decrease only in the literal fluency score.Moreover, the surgical group showed a significant impairment in using grammatical and syntactical rules to produce sentences. No significant difference was found between the group B, C and controls. Treated patients were not significantly more depressive or anxious than controls. INTERPRETATION: Investigation of neuropsychological deficits can show an impairment, even in patients classified as good outcome by Glasgow Outcome Scale (GOS). The frontal lobe functions and language are impaired especially in surgically treated in comparison with controls, but no significant difference was found respect to the endovascular and no treated patients (group C).

Attention↗
PubMed1991

Personality correlates of intelligence in a clinical group.

The relationship between personality and intelligence test performance among 84 psychiatric patients was examined using a reduced version of the Wechsler Adult Intelligence Scale together with the Eysenck Personality Questionnaire. Introverts were inclined to do better than extraverts on all WAIS scales, the difference being statistically significant for the verbal subtests of Information and Similarities only. A 2-way multivariate analysis of variance gave a significant main effect for Social Conformity, in which low Lie scorers obtained higher scores on all subscales, particularly Verbal IQ. There was no main effect for Psychoticism but there were two interactions (Psychoticism x Lie) for the verbal subscales. For individuals characterized by high social conformity, the high Psychoticism scorers displayed lower scores on those scales associated with sensory associative intelligence (Information, Similarities, and Picture Completion). The results were discussed with particular reference to two competing theories relating personality and intelligence.

Adolescent↗
PubMed1994

Is 20 years too long?: improving intelligibility in long-standing dysarthria--a single case treatment study.

Resource management decisions by most speech and language therapists would suggest that treatment for a dysarthric client of 20 years' duration should be a low priority. This study describes the therapy of a dystonic client who had been virtually speechless for 20 years because of his severe dysarthria. Assessment of his speech revealed that lip rounding was particularly difficult for him. He was offered eight sessions of general dysarthria therapy and eight sessions of therapy specifically designed to reduce lip tension. The hypotheses driving this therapy plan were that it would be possible to effect changes in his longstanding speech patterns and that therapy focused on reducing lip tension would be more effective than non-specific dysarthria therapy. An intelligibility test was designed to monitor any changes in his speech production. Therapy improved the client's intelligibility and increased his confidence and consequent functional use of speech.

Communication↗
PubMed1995

[Effect of linguistic competence on speech audiometry results using the Basel Sentence Test].

Linguistic competence, such as a mental lexicon knowledge of syntactic rules of the language and the use of semantic constraints, may impact central speech processing and play an important role in speech recognition. The influence of linguistic ability on speech understanding was investigated using the Basel Sentence Understanding Test. The subject's linguistic ability was determined based upon educational background (elementary school, high school and or university) and intelligence quotients (IQ) based on the reduced version of the Hamburg-Wechsler Intelligence Test. Forty normally-hearing subjects listened to five test forms of the Basel Sentence Understanding Test. Each test form comprised a fraction of 15 low-predictable (LP) test items and 15 high-predictable (HP) test items based on the amount of contextual information in the phrases. No effect of educational background and IQ-value could be demonstrated on the scores of LP sentences. However, there was a small but significant influence of educational background and IQ-value on the scores of HP sentences. The implications of these findings on clinical speech audiometry are discussed.

Adult↗