Statistical and normative studies of the Halstead Neuropsychological Test Battery relevant to a neuropsychiatric hospital setting.
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This study examined IQ change over a 2-year period in 291 young children (mean age 39 months) referred to a pediatric developmental clinic for evaluation of developmental problems. Although correlation between initial and follow-up IQ was very high (0.78), there was also a significant increase in mean IQ score, from 67.12 to 74.06. Moreover, 26% of the subjects showed IQ increase of 16 points or more. Variables making some contribution to IQ change were initial clinical diagnosis, etiology, and intervention. Children diagnosed with a developmental language disorder made significantly greater gains than those diagnosed as mentally retarded. Sex, family status, initial age, and test interval were not significantly correlated with IQ change. We concluded that prediction for individual children is difficult, but that initial diagnosis may be useful in differentially predicting IQ change in young children with developmental delays.
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Neonatal screening of congenital hypothyroidism has been recently extended to the most of North America, Australia, Europe, and to several Italian areas. Before screening programs, several Authors reported neurological defects and behavioral disturbances also in patients whose treatment has been precocious, thus stressing the importance of an antenatal thyroidal defect. We have therefore setted up a follow-up program to evaluate the prevalence and to treat such disturbances in hypothyroid children. In this report we describe the program, present the most significant preliminary data and discuss the prognosis of hypothyroid patients detected by screening programs.
OBJECTIVE: To examine the generation effect, the observation that items generated by subjects are better remembered than items provided, as a means of maximizing new learning in multiple sclerosis (MS). DESIGN: Prospective between-group design. SETTING: Private, nonprofit research facility. PARTICIPANTS: Population-based sample of 31 subjects with MS (MS group) and 17 healthy controls (control group), matched for age and education. INTERVENTION: Immediate, thirty-minute and 1-week assessments. MAIN OUTCOME MEASURES: Neuropsychologic tests assessing language, executive functioning, working memory, long-term memory, and the generation effect were administered. Recall and recognition of generation effect stimuli was tested immediately, 30 minutes, and 1-week after presentation. RESULTS: Recall and recognition of generated stimuli were significantly higher than provided stimuli across testing sessions. This effect was observed equally across the control and MS groups. Recall performance for generated stimuli correlated significantly with indices of episodic memory, information processing, and language but not executive control. Memory for the source of the information was deficient for generated words compared with provided words. CONCLUSIONS: The generation effect was present in MS and control subjects and may be a viable way of maximizing new learning in MS.
The intracarotid amobarbital procedure (IAP) is frequently used to determine hemispheric language dominance and memory competence in individuals with intractable epilepsy before surgical intervention. The present study focused on outcome results concerning use of this technique in children. The IAP was an effective tool in determining their hemispheric language dominance. Seven characteristics, including age, gender, dose level of sodium amobarbital, Full-Scale I.Q., hemispheric side of injection (left or right), language dominance of hemisphere injected, and order of injection (first or second) were examined as possible factors predictive of memory performance on the IAP. Results suggest that after injection of the hemisphere suspected of containing the primary seizure origin, children aged < 13 years who had the left language-dominant hemisphere injected were significantly less likely to pass IAP memory tasks than were older children or younger children who had the nondominant hemisphere injected. These findings suggest that the IAP is a reliable indicator of hemispheric memory competence in children aged > 13 years or younger children whose suspected seizure focus is located in the nondominant language hemisphere.
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Time-of-day related changes on four tests used by speech therapists and four other performance tests, in addition to oral temperature, were documented in 16 school children (7-9 years of age). Six of them had language disorders and were receiving speech therapy. Children were synchronized with diurnal activity from around 0730 to around 2100 and nocturnal rest. For each child, at each test time point (e.g. 0900, 1100, 1530 and 1930) tests were performed three times, with two different speech therapists, in a random order, with only one session per day. Conventional methods (t-tested mean differences; ANOVA; correlation tests) were used for statistical analyses. Among 29 parameters (items) which were analyzed, only nine exhibited time-of-day related changes, mainly in speed to-perform measures. In most detected rhythms best performance occurred either at 1100 or at 1530 with no difference in subgroups except for the fastest performance of the sentence repetition test. With regard to the daily mean M, controls performed better than children with language disorders for the word (syllabic) repetition test (P less than 0.0004) but this was reversed for both computing and colouring skill tests (P less than 0.04 and less than 0.002). A difference related to sex (but not to language disorders) was observed in the Ms of speed in sign reproduction (P less than 0.0000) and sorting cards (P less than 0.01), with boys being faster than girls. In children, as in adults, time-of-day effects should be considered when the quantification of performance is desired.
An outline of the paediatric assessment needs of children with delayed or deviant language development has been given based on the experience and findings of the research language team at the Wolfson Centre.
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Recent interest in the biological basis of schizophrenia has led to a reexamination of many symptomatic aspects of the disorder in terms of brain-behavioral models. Schizophrenic speech disturbances have traditionally been described in terms of a model of acquired aphasia. We review some of the limitations of this model and provide an alternative model for the study of some characteristics of schizophrenic speech based on neuropsychological theories of frontal lobe dysfunction in schizophrenia. The emphasis is placed on the study of productive errors noted in schizophrenic speech, most notably verbal perseverations. In a study of errors observed during a sample of 15 schizophrenics performance on a confrontation naming test, we were able to reliably identify and classify hierarchic categories of verbal perseverations occurring at both semantic and phonemic levels. These perseverations constituted 20% of the total errors. We argue that these perseverations represent a special case of executive dysfunction resulting from a disturbance of language monitoring mechanisms. We examine the implications of these findings for a hypothesis of schizophrenic speech disturbances in terms of frontal lobe dysfunction and the developmental neuropathological processes involved in the illness.
Despite the surge of interest in borderline psychopathology in psychiatric quarters, contributions from the perspective of psychological testing have been few. A brief delineation of the range of borderline psychopathology is offered. Broad trends in the test performance of patients within the borderline range are described with regard to: intelligence and cognitive operations, thought and language, reality testing, organization of affect, configuration of defenses, structure of the object world, dynamics and the interpersonal aspects of the test process.
The performance of children who receive a cochlear implant may be dependent on both age of the child at implantation and the amount of experience with the implant. In the present study, changes in auditory perception and speech identification were investigated with experience of 71 children who had received a cochlear implant. The children were divided into three groups, those above and those below the age of 7 years at the time of implantation, and those aged 3 years or younger deafened by meningitis. The children received either the Nucleus 22, the Nucleus 24 or the Med El C40+ implant. The test material was a reduced form of the EARS evaluation protocol developed by Med El into a multi-language format. Tests were performed pre-operatively, within 2-5 days of first fitting of the speech processor, then at 1, 3 and 6 months and every 6 months thereafter, for a total period of 24 months. The results indicated that all children showed improvement after 6-12 months. The rate of improvement differed between age groups. Children over 7 years of age had pre-operatively higher test scores than younger children, presumably because of their previous experience with hearing aids. These children showed an immediate post-operative drop in performance that recovered 1-3 months later. The children aged under 7 years started at lower performance levels but approached those of the older children after 12 months' cochlear implant use because their post-operative drop was less significant and their performance improved faster. Children who had been deafened by meningitis and implanted at the age of 3 or less made little progress over the first 6 months but approached test levels of the under-7-year-olds by 18 months or later. All three components of the evaluation protocol employed the Listening Progress Profile (LiP), the Monosyllabic-Trochee-Polysyllabic Test (MTP) and the Meaningful Auditory Integration Scale (MAIS) and proved to be valuable in demonstrating improvement in performance of cochlear implant children in all age groups once the immediate post-operative drop had been overcome.
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