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PubMedDate not supplied

Development of the Grammar and Phonology Screening (GAPS) test to assess key markers of specific language and literacy difficulties in young children.

BACKGROUND: Despite a large body of evidence regarding reliable indicators of language deficits in young children, there has not been a standardized, quick screen for language impairment. The Grammar and Phonology Screening (GAPS) test was therefore designed as a short, reliable assessment of young children's language abilities. AIMS: GAPS was designed to provide a quick screening test to assess whether pre- and early school entry children have the necessary grammar and pre-reading phonological skills needed for education and social development. This paper reports the theoretical background to the test, the pilot study and reliability, and the standardization. METHODS: This 10-min test comprises 11 test sentences and eight test nonsense words for direct imitation and is designed to highlight significant markers of language impairment and reading difficulties. To standardize the GAPS, 668 children aged 3.4-6.6 were tested across the UK, taking into account population distribution and socio-economic status. The test was carried out by a range of health and education professionals as well as by students and carers using only simple, written instructions. RESULTS: GAPS is effective in detecting a range of children in need of further in-depth assessment or monitoring for language difficulties. The results concur with those from much larger epidemiological studies using lengthy testing procedures. CONCLUSIONS: The GAPS test (1) provides a successful screening tool; (2) is designed to be administered by professionals and non-professionals alike; and (3) facilitates identification of language impairment or at-risk factors of reading impairment in the early educational years. Thus, the test affords a first step in a process of assessment and targeted intervention to enable children to reach their potential.

Age Distribution↗
PubMed1994

Linguistic impairment in early psychosis.

Twenty-four, first-admission, psychotic subjects and 24 control subjects were administered a linguistic instrument to elicit impairments in syntax, semantics, cohesion, and use of metaphors. In the same session, the subjects were also rated on the Scale for Thought, Language, and Communication Disorders (TLC). Results indicated a significant impairment of all four linguistic categories in psychotic subjects. The impairment in semantics, however, was differentiated the most between the patient and control groups. The psychotic patients scored significantly higher on the TLC. Scores of impairment on the linguistic tasks did not correlate with scores on the TLC.

Adolescent↗
PubMed1980

5-hydroxytryptophan and pyridoxine. Their effects in young children with Down's syndrome.

In a double-blind study, 89 children with Down's syndrome were given 5-hydroxytryptophan or pyridoxine hydrochloride in the first three years of life. The analysis of 5-hydroxyindole blood levels revealed that 5-hydroxytryptophan, pyridoxine, and the combination of 5-hydroxytryptophan and pyridoxine raised blood levels of 5-hydroxyindole equally well in 40% of the children. The assessment of muscle-tone ratings showed no significant difference among the study groups once children with moderate and severe congenital heart disease were excluded. Detailed studies of cognitive-adaptive function of children in the various groups found a significant difference ont the Vineland Social Maturity Scale at ages 6, 12, 18, and 36 months; yet the source of significance was a negative interaction affecting children whose parents were able to comply with furnished guidance; these children showed consistently higher levels of accomplishment.

Child, Preschool↗
PubMed1975

Prognostic antecedents and outcome in a follow-up study of children with a diagnosis of childhood psychosis.

Records of the initial period of observation and the early history of 59 children with a diagnosis of childhood psychosis during the preschool years were examined for possible predictive variables. The children, now age 10 years or older, were divided into two groups--those that are presently successful and those that are presently unsuccessful, according to the criteria of this study. A cluster of 23 items was found significantly to differentiate the two groups.

Adaptation, Psychological↗
PubMed1994

Can we differentially diagnose an attention deficit disorder without hyperactivity from a central auditory processing problem?

This article examines the dilemma involved in properly diagnosing children with Central Auditory Processing Deficits (CAPD) and children with Attention Deficit Disorders (without hyperactivity) (ADD) as they may not be mutually exclusive. With the help of a case illustration, the diagnostic difficulties are highlighted. There is a strong need for professionals in the speech/language and psychiatric communities to communicate to differentially diagnose a child who exhibits characteristics of both CAPD and ADD.

Auditory Perceptual Disorders↗
PubMed2004

Repetitive transcranial magnetic stimulation as treatment of poststroke depression: a preliminary study.

BACKGROUND: Depression has a significant impact on poststroke recovery and mortality. There are a proportion of patients with poststroke depression (PSD) who do not respond to antidepressants. Repetitive Transcranial Magnetic Stimulation (rTMS) might be a safe and effective alternative in these refractory cases. METHODS: We conducted a randomized, parallel, double-blind study of active versus sham left prefrontal rTMS in patients with refractory PSD. After discontinuing antidepressants, patients were randomly assigned to receive 10 sessions of active (10 Hz, 110% of the motor threshold, 20 trains of 5 seconds duration) or sham left prefrontal rTMS. Efficacy measures included HAM-D scores, response and remission rates. Patients completed a neuropsychological battery at baseline and after completing the protocol. RESULTS: When compared with sham stimulation, 10 sessions of active rTMS of the left dorsolateral prefrontal cortex were associated with a significant reduction of depressive symptoms. This reduction was not influenced by patient's age, type or location of stroke, volume of left frontal leukoaraiosis or by the distance of the stimulating coil to the prefrontal cortex. However, there was a significant positive correlation between the percentage of reduction of Ham-D scores and frontal gray and white matter volumes. There were no significant changes in cognitive functioning between the active and the sham stimulation groups. In addition, there were few and mild adverse effects that were equally distributed among groups. CONCLUSIONS: Taken together, these preliminary findings suggest that rTMS may be an effective and safe treatment alternative for patients with refractory depression and stroke.

Aged↗
PubMed2004

Understanding 'not': neuropsychological dissociations between hand and head markers of negation in BSL.

Simple negation in natural languages represents a complex interrelationship of syntax, prosody, semantics and pragmatics, and may be realised in various ways: lexically, morphologically and prosodically. In almost all spoken languages, the first two of these are the primary realisations of syntactic negation. In contrast, in many signed languages negation can occur without lexical or morphological marking. Thus, in British Sign Language (BSL), negation is obligatorily expressed using face-head actions alone (facial negation) with the option of articulating a manual form alongside the required face-head actions (lexical negation). What are the processes underlying facial negation? Here, we explore this question neuropsychologically. If facial negation reflects lexico-syntactic processing in BSL, it may be relatively spared in people with unilateral right hemisphere (RH) lesions, as has been suggested for other 'grammatical facial actions' [Language and Speech 42 (1999) 307; Emmorey, K. (2002). Language, cognition and the brain: Insights from sign language research. Mahwah, NJ: Erlbaum (Lawrence)]. Three BSL users with RH lesions were specifically impaired in perceiving facial compared with manual (lexical and morphological) negation. This dissociation was absent in three users of BSL with left hemisphere lesions and different degrees of language disorder, who also showed relative sparing of negation comprehension. We conclude that, in contrast to some analyses [Applied Psycholinguistics 18 (1997) 411; Emmorey, K. (2002). Language, cognition and the brain: Insights from sign language research. Mahwah, NJ: Erlbaum (Lawrence); Archives of Neurology 36 (1979) 837], non-manual negation in sign may not be a direct surface realisation of syntax [Language and Speech 42 (1999) 143; Language and Speech 42 (1999) 127]. Difficulties with facial negation in the RH-lesion group were associated with specific impairments in processing facial images, including facial expressions. However, they did not reflect generalised 'face-blindness', since the reading of (English) speech patterns from faces was spared in this group. We propose that some aspects of the linguistic analysis of sign language are achieved by prosodic analysis systems (analysis of face and head gestures), which are lateralised to the minor hemisphere.

Aged↗
PubMed2003

The neuropsychological profiles of mild Alzheimer's disease and questionable dementia as compared to age-related cognitive decline.

Test scores from a comprehensive neuropsychological battery administered to 1602 subjects consisting of 1347 subjects with probable Alzheimer's disease (AD), 100 subjects with questionable dementia (QD) and 155 non-demented elderly control subjects were cross-sectionally analyzed. Subjects with probable AD were categorized as mild (n = 244), moderate (n = 480), severe (n = 376), and very severe (n = 247) according to modified mini mental status exam (mMMSE) scores. Mean scores on individual neuropsychological tests are provided for each group of subjects. Stratified random sampling was performed to select a sample of mild AD subjects who were matched in age and education to non-demented elderly controls, and analyses focused on the performance of QD subjects and mild AD subjects, whose scores were compared to those of the elderly control subjects. Selected scores were organized by cognitive domain and logistic regressions were used to determine the domains and individual tests within each that were most predictive of group status. Results suggested a profile of scores associated with QD and mild AD including impaired recall of verbal information for both groups. Areas of lower functioning in QD subjects as compared to elderly controls included category fluency and visuospatial ability.

Aged↗
PubMed2006

Overdependence on degraded gist memory in Alzheimer's disease.

Alzheimer's disease (AD) reduces associative effects on false recognition in the Deese-Roediger-McDermott task, either due to impaired memory for gist or impaired use of gist in memory decisions. Gist processes were manipulated by blocking or mixing studied words according to their associations and by varying the associative strength between studied and nonstudied words at test. Both associative blocking and associative strength had smaller effects on false recognition in AD patients than in control participants, consistent with gist memory impairments. However, unlike the case with control participants, blocking influenced true and false recognition equally in AD patients, demonstrating an overdependence on gist when making memory decisions. AD also impaired item-specific recollections, relative to control participants, as true recognition of studied words was reduced even when the two groups were equated on gist-based false recognition. We propose that the overdependence on degraded gist memory in AD is caused by even larger impairments in item-specific recollections.

Aged↗
PubMed1993

Two approaches to the facilitation of grammar in children with language impairment: an experimental evaluation.

Two approaches to grammar facilitation in preschool-age children with language impairment were evaluated. One approach was administered by a speech-language pathologist and the other was presented by the subjects' parents, who were trained by the speech-language pathologist. Both treatment packages ran for 4 1/2 months and made use of focused stimulation procedures and a cyclical goal-attack strategy. Subjects were 30 children between the ages of 3:8 and 5:10 (years:months) who had marked delays in grammatical development. Children who served in a delayed-treatment control group averaged no gains over their no-treatment period. In contrast, large treatment effects were observed for both treatment groups on three of four measures of grammatical expression. However, closer inspection of the data revealed that the effects for the clinician treatment were more consistent across treatment administrations than were those for the parent treatment. Although the specific contributions of the focused stimulation procedures and the cyclical goal attack strategy were not evaluated, the results support the viability of these components as parts of larger treatment packages. The results also support the participation of parents as primary intervention agents in grammar facilitation programs. When parents take such a large role in the intervention process, however, it is imperative that the children's progress be monitored carefully and that program adjustments be made whenever gains are smaller than expected.

Child↗
PubMed1997

Variable presentation of cerebrovascular disease in monovular twins.

We describe twin girls with bilateral cerebrovascular disease. In one child, a diagnosis of moyamoya disease was made after presentation in infancy with an acute hemiparesis; her asymptomatic sibling was found to have significant bilateral cerebrovascular disease after neuropsychological evaluation and assessment with transcranial Doppler ultrasound. Both subjects showed a discrepancy between verbal and performance IQ and deficits on a test of frontal-lobe function suggesting that these domains should be targeted in cognitive assessment. Family members of subjects with moyamoya are at risk of cerebrovascular disease. Clinical symptoms do not reliably predict disease and those at risk should be offered screening with non-invasive vascular imaging.

Cerebral Angiography↗
PubMed2006

Sex differences in language dysfunction in schizophrenia.

OBJECTIVE: Normal sex differences in language functions are disrupted in schizophrenia. However, identification of specific language components most vulnerable in schizophrenia and how they may differ by sex remain unexamined. The current study investigated this issue in the domains of phonology, semantics, and grammar, which have been closely linked with neuroanatomic regions for which sex differences have been identified. METHOD: Thirty-one outpatients with DSM-III-R schizophrenia and 27 healthy subjects comparable within sex on age, handedness, parental socioeconomic status, and ethnicity were systematically ascertained from a Boston catchment area. The subjects were administered an extensive language battery in the context of a comprehensive neuropsychological battery that included measures of phonology, semantics, and grammar. RESULTS: Male patients performed significantly worse than their healthy counterparts on all three domains, with phonology least affected. In contrast, language function was relatively preserved in the female patients, compared to their healthy counterparts, with phonology most affected. Across domains, the effect sizes in comparisons of male patients and healthy male subjects had a twofold difference, whereas the difference in effect sizes in comparisons of female patients and healthy female subjects was less in all areas. CONCLUSIONS: Findings were consistent with prior evidence of overall language dysfunction in schizophrenia and may have implications for understanding sex differences in neuroanatomic abnormalities in regions associated with phonological processing.

Adult↗