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Neuropsychological functioning of siblings of children with autism, siblings of children with developmental language delay, and siblings of children with mental retardation of unknown genetic etiology.

Neuropsychological functioning of 30 siblings of children with autism (AU-S), 28 siblings of children with mental retardation of (MR-S), and 30 siblings of children with developmental language delay (DLD-S) was compared. Two siblings, both AU-S, received diagnoses of pervasive developmental disorder (PDD). More siblings with cognitive disabilities were found in DLD-S than in AU-S. However, these differences disappeared after excluding diagnosed siblings or after accounting for family membership. In sum, despite the elevated incidence of PDD among AU-S, the neuropsychological functioning of the remaining siblings did not convey specific characteristics related to the genetic risk associated with autism, in contrast to the cognitive functioning of the DLD-S, which did reflect a genetic risk.

Adolescent↗

Alternate form reliability and equivalency of the Rey Auditory Verbal Learning Test.

Assessed alternate form reliability and equivalency for the Rey Auditory Verbal Learning Test (AVLT) in a clinical sample. A test-retest, counterbalanced design was utilized with a diagnostically heterogenous group of 85 VA Medical Center patients. The mean test-retest interval was 140 min. Alternate form reliability coefficients were highly significant, all p less than .001, and ranged from .60 to .77. The forms yielded comparable means with differences of less than 1 point on each of the five learning trails and the postinterference (VI) and recognition trials. Total words recalled on trials I through V differed by less than 3 points across forms. From a statistical point of view, when the alternate form was administered second it was slightly more difficult than the original. In the reverse order, the two measures were comparable. Overall, differences between forms lacked clinical significance and the tests were judged to be equivalent measures.

Adult↗

Neuropsychological detection and characterization of preclinical Alzheimer's disease.

We attempted to characterize the changes in cognition associated with the earliest, or preclinical, stages of Alzheimer's disease (AD) by administering a comprehensive neuropsychological test battery to a group of initially nondemented older adults participating in a prospective epidemiologic study of dementia. Using Cox regression analyses, we examined the associations between baseline neuropsychological test scores and subsequent development of AD. Results confirmed preliminary findings that baseline scores on the Boston Naming Test, Immediate Recall on the Selective Reminding Test, and the Similarities subtest of the Wechsler Adult Intelligence Scale-Revised were significantly and independently associated with later diagnosis of AD. Analyses controlled for the effects of age, education, sex, and language of test administration. These results lend support to the notion of a preclinical phase of AD and indicate that this very early stage of AD is characterized by poor word-finding ability, abstract reasoning, and memory.

Aged↗

Preliminary adaptation into Portuguese of a standardised picture set for the use in research and neuropsychological assessment.

Pictorial stimuli and words have been widely used to evaluate mnemonic processes in clinical settings, neuropsychological investigations, as well as in studies on the mechanisms underlying the phenomena of memory. However, there seem to be few studies of standardisation of pictures for research in this field. The present paper aimed at adapting the use of a set of pictures standardised for English speaking subjects for Portuguese speakers. Name agreement of 150 pictures was assessed in 100 high-school students. Ninety pictures were found to present the same name for over 90 subjects. Results yield data that may help create more controlled tests for the study of memory for pictorial stimuli in Brazil.

Adolescent↗

Equivalence classes in individuals with minimal verbal repertoires.

Studies from two different laboratories tested for equivalence classes in individuals with severe mental retardation and minimal verbal repertoires. In the first study, 3 individuals learned several matching-to-sample performances: matching picture comparison stimuli to dictated-word sample stimuli (AB), matching those same pictures to printed letter samples (CB), and also matching the pictures to nonrepresentative forms (DB). On subsequent tests, all individuals immediately displayed Emergent Relations AC, AD, BC, BD, CD, and DC, together constituting a positive demonstration of equivalence (as defined by Sidman). The second study obtained a positive equivalence test outcome in 1 of 2 individuals with similarly minimal verbal repertoires. Taken together, these studies call into question previous assertions that equivalence classes are demonstrable only in individuals with well-developed language repertoires.

Adolescent↗

Responsiveness to repeated speech stimuli persists in left but not right auditory cortex.

Activation of the auditory cortex habituates with repeated stimulation. While behaviorally adaptive in most circumstances, decreasing auditory responsiveness could interfere with speech perception. We therefore tested whether auditory habituation differs for speech and non-speech stimuli and for left and right auditory cortex. We examined seven right-handed subjects in whom we had determined left-hemispheric language dominance by event-related blood flow assessment. We recorded magnetoencephalographic-evoked responses to trains of four sine tones or vowels and measured the decrement from the first to the last stimulus of the response component about 100 ms after stimulus onset (N1). For the sine tones there was a decrement in both hemispheres. Conversely, for vowels there was significant attenuation of the auditory decrement in the left compared with the right hemisphere (p=0.017). This left-hemisphere persistence in auditory responsiveness to vowels demonstrates that the human brain processes speech stimuli differently than non-speech stimuli and that the left-hemisphere plays a dominant role in this speech-specific auditory processing.

Acoustic Stimulation↗

Neuroanatomy of language processing studied with functional MRI.

This article discusses recent data from functional magnetic resonance imaging (FMRI) studies of language. Although preliminary, these data suggest activation of the left prefrontal cortex across a variety of tasks, with less activation of posterior cortical areas known to play a role in language. Potential sources of error in functional imaging studies related to task subtraction techniques are briefly discussed. The semantic decision task used by the author and colleagues, which produces left lateralized activation of both prefrontal and temporoparietal areas, is presented in detail, and the activation pattern observed in these studies is discussed in the context of converging neuropsychological and positron emission tomography data. It is argued that superior temporal responses evoked by listening to speech represent sensory rather than language processes. The data bring into question the classical disconnection model of transcortical aphasia and confirm the participation of left prefrontal areas in comprehension. FMRI shows promise as an alternative to the intracarotid amobarbital test for language dominance.

Brain↗

Face encoding and psychometric testing in healthy dextrals with right hemisphere language.

OBJECTIVE: To document how right hemisphere language dominance in neurologically normal right-handed individuals affects lateralization of face encoding and level of performance in neuropsychological tests. METHODS: Three healthy right-handed adults with predominantly right hemisphere language activation during single-word or sentence-level processing were identified from 210 consecutive right-handed subjects studied using blood oxygenation level-dependent contrast fMRI. These three study subjects (S1 to S3) underwent a second scanning session where they performed word and face encoding. Their functional scans were contrasted with those obtained from six healthy control subjects (C1 to C6) with left hemisphere language dominance. Psychometric tests were performed on the study subjects. RESULTS: Right hemisphere-dominant language activation was reproduced in the second scanning session in the three study subjects. The extent to which the lateralization of face encoding was reversed varied. Right hemisphere language was associated with lower (but within normal) verbal IQ compared with performance IQ in two of three volunteers. Verbal and nonverbal memory scores were normal and did not differ appreciably. CONCLUSION: Right hemisphere-dominant language in healthy dextrals exists but is rare. The extent to which face encoding is reversed in these individuals is variable. Cognitive function does not appear to be significantly compromised even though some psychometric test scores are asymmetric in favor of nonverbal performance when the reversal of lateralization of face and word memory is not complete.

Adult↗

Reading skills and auditory processing ability in children with chronic otitis media in early childhood.

The effect of recurrent middle ear disease during the first 2 years of life on auditory perceptual skills and reading ability was examined in two groups of 6- and 7-year-old children who were pair-matched by age, gender, socioeconomic status, and receptive vocabulary. Group 1 consisted of children with documented chronic otitis media at an early age, and group 2 had no history of middle ear problems. Tests of auditory perceptual skills and reading ability were administered. Significant differences in performance on all tests of auditory processing ability and reading ability were noted.

Auditory Perception↗

Provision of a language index for severely and profoundly retarded individuals.

The development of habilitative language programming for severely and profoundly retarded individuals requires detailed knowledge of their current levels of competence. Specific information is needed regarding the particular language skills characteristically displayed, the frequency with which such skills are used, and the proportion of severely retarded individuals who evidence linguistic abilities at the various levels. An index of language proficiency has been developed utilizing a standardized system of direct observation of subjects in their usual, familiar environment. Data on a group of ambulant, institutionalized, severely and profoundly retarded individuals were described. Some type of vocal or gestural communication was observed for about 75 percent of the subjects; almost 60 percent evidenced some vocal or verbal expression. One in four subjects demonstrated meaningful, articulate speech. Associations between language and factors such as sex, chronological and mental age, diagnosis, and biosocial history were investigated. Implications of these findings were discussed in relation to programs for language development.

Adaptation, Psychological↗

[Formal and semantic lexical evocation in normal subjects. Performance and dynamics of production as a function of sex, age and educational level].

A protocol of formal lexical evocation (words beginning with a letter) and semantic evocation was applied to 168 normal subjects evenly distributed on the basis of three factors (sex, three age classes and two levels of education). Correct answers, their distribution within the allotted time (proportions of correct answers in four thirty-second periods) and errors were analysed globally and in relation to the said factors. Level of education had a decisive influence in all tests; age had no influence on performance in formal evocation, whereas the subjects in the middle age class presented the best performance in semantic evocation. Distribution of the answers over time was unrelated to any of the factors considered. Errors were related to age in half the test.

Adult↗

Diagnosing cognitive dysfunction in the elderly: primary screening tests.

The recognition of cognitive disturbances in geriatric patients has important clinical implications for the primary care physician. Commonly seen cognitive dysfunctions include dementia, pseudodementia, delirium, and frontal lobe syndrome; these may be confounded by overlapping depression. The cognitive examination covers such intellectual and behavioral functions as attention, memory, and language. As many psychiatric disorders result from neurologic brain disease, a psychiatric examination is essential. Mental status questionnaires are useful for screening of high-risk populations for dementia and to quantify the degree of cognitive dysfunction for purposes of management planning and surveillance.

Aged↗