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PubMed1997

Boys with Asperger's disorder, exceptional verbal intelligence, tics, and clumsiness.

Five boys with both Asperger's disorder and Tourette syndrome, exceptional verbal intelligence, and clumsiness are reported. Each presented at early elementary school age with a prominent complaint of social difficulties with peers. History was notable for a flapping stereotypy and the neurological examination revealed motor and/or vocal tics and numerous motor soft signs. Highly specialized interests were characteristics. Language prosody and/or pragmatics was impaired. Despite exceptional verbal intelligence, the children were not, according to their teachers and parents, faring well either socially or academically. Motor difficulties, manifested psychometrically as a significant performance IQ disadvantage, interfered with school performance and social adjustment. Tics, although not noted by parents in the clinical history, compounded their social difficulties. Asperger's disorder in these highly verbal children overlaps with pervasive developmental disorder (PDD) on account of the socioemotional difficulties and stereotypies seen in both. Asperger's disorder and Tourette syndrome overlap in these children on account of the tics. Finally, Asperger's disorder and the right-hemisphere-based learning disorders overlap on account of the visuoperceptual and attentional deficits that can occur in both.

Child, Preschool↗
PubMedDate not supplied

Cognitive discriminants of wandering among nursing home residents.

Dimensions of cognitive impairment that best discriminated between wandering and nonwandering ambulatory subjects were studied. Cognitive impairment was measured along four dimensions: abstract thinking, language, judgement, and spatial skills. Wanderers had higher overall levels of cognitive impairment and poorer performance on all cognitive dimensions. The dimension of language was the most important higher order cognitive skill differentiating wanderers from nonwanderers; basic cognitive skill deficits (memory, orientation, concentration) and medical bases of cognitive impairment also contributed to the distinction between the groups. Overall classification rates obtained by linear classification function (LCF) analyses were only slightly better than chance rates. However, LCF rates for nonwanderers ranged from 93% to 95%, suggesting greater homogeneity in the cognitive impairments specific to this group.

Aged↗
PubMed1985

Developmental and behavioural disturbances in 13 boys with fragile X syndrome.

Developmental and behavioural aspects were studied in 13 boys aged 2.6-12.5 years from three families with the fragile X syndrome. The following observations were made. Moderate to severe retardation was present in all boys; non-verbal IQs ranged between 25 and 67 (mean 46 +/- 14); IQ and age were negatively correlated (P less than 0.01). Language development was grossly delayed in all boys; most had severe articulation problems. Imitative and symbolic play (e.g. doll play) were strikingly retarded as compared to abstract play (e.g. block design). Autistic features such as no use of eye contact, stereotyped movements and echolalia were found in 9/13 boys; the same number showed aggressive behaviour. General activity was reduced during the 1st year of life; most boys became very hyperactive during the second year; and short attention span and increased distractability were observed in all. Motor development was mildly delayed; all boys were clumsy and moderately hypotonic. The fragile X syndrome ought to be considered in retarded boys with a dissociated developmental pattern, in particular a striking delay in language and play development, and autistic features.

Child↗
PubMedDate not supplied

The interaction of bilingualism and stuttering in an adult.

The relation between bilingualism and stuttering was examined in a bilingual adult who stutters. Language ability in English and Afrikaans was assessed through the use of cloze and language proficiency tests. Anticipation, adaptation and consistency of stuttering were investigated. Frequency, distribution and nature of disfluencies on narrative and procedural tasks were analyzed according to a modified version of the Systematic Disfluency Analysis (SDA) (Campbell & Hill, 1987). Results indicated that language ability influenced frequency, distribution and nature of disfluencies. The subject was more proficient and stuttered less in his predominant language. Implications for the interaction of language and stuttering were discussed. Clinical strategies for dealing with bilingual stutterers were considered.

Humans↗
PubMed1996

Word frequency effects on recall, recognition, and word fragment completion tests.

In 3 experiments, the effect of word frequency on an indirect word fragment completion test and on direct free-recall and Yes-no recognition tests was investigated. In Experiment 1, priming in word fragment completion was substantially greater for low-frequency words than for high-frequency words, but free recall was unaffected. Experiment 2 replicated the word fragment completion result and showed a corresponding effect in recognition. Experiment 3 replicated the low-frequency priming advantage in word fragment completion with the set of words that P.L. Tenpenny and E.J. Shoben (1992) had used in reporting the opposite pattern in word fragment completion. Using G. Mandler's (1980) dual-process theory, the authors argue that recognition and word fragment completion tests both rely on within-item integration that influences familiarity, whereas recall hinges on elaboration that influences retrievability.

Humans↗
PubMed1999

Sex differences in material-specific cognitive functions related to language dominance: an intracarotid amobarbital study in left temporal lobe epilepsy.

Population-based studies of material-specific cognitive functions yield evidence of sex differences: women are superior on verbal tasks whereas men are superior on figural and visuo-spatial tasks. Although there is still no direct evidence, these sex differences have been assumed to be related to a different cerebral organisation of language and nonlanguage functions, i.e. language in women is suggested to be more bilaterally organised than in men. We investigated this issue with respect to verbal/nonverbal memory functions in 42 men and 43 women with left temporal lobe epilepsies who all underwent intracarotid amobarbital testing for language dominance. The results indicate that atypical language dominance is not significantly more frequent in women than in men (44% vs 33%). Atypical dominance was related to an onset of epilepsy before puberty and appeared to be a consequence of the left hemisphere pathology rather than being naturally predisposed. Furthermore, women indeed showed the expected advantage with respect to verbal memory, and men showed an advantage in figural memory. With consideration of language dominance, however, the sex difference in verbal memory was observed particularly with atypical dominance, whereas the sex difference in figural memory was observed with left dominance.

Journal Article↗
PubMed1986

Statistical models for predicting Edgerton-Danhauer NST scores from pure-tone thresholds.

Pure-tone thresholds (PTTs) and phonemic-scored responses to the Edgerton and Danhauer (1979) Nonsense Syllable Test (NST) at 25, 35, 45, and 55 db SL re each S's SRT, were taken from 97 Ss of 4 earlier studies of Danhauer and colleagues. All studies had used the same stimuli and procedures. Among the 97 Ss were heterogeneous subpopulations of normally-hearing and sensorineural hearing-impaired Ss, aged 6-81 yrs. PTTs at octaves from .25-8 kc/s, singly and in various weighted combinations, were explored by step-wise multiple linear regression analyses for the best equation to predict an individual's NST score at each SL. Included were the two weighted PTT averages (over .5, 1, and 2 kc/s) proposed by Butts, Schoney and Ruth (Asha, 1984, 26, 64). PTT2 kc/s was the single most predictive datum. The most predictive equation at one NST SL was not necessarily the best at another SL. At each NST SL, the most predictive equation was always one or other of the equations of Butts et al, and at the higher levels the best equations incorporated in addition certain weighted PTTs at .5 and 1 kc/s. The results indicated that it is possible to predict a S's NST scores from PTTs with reasonable accuracy: from 86-91% of Ss' NST scores were predicted within +/- 10%. Further validation and refinement of these models on larger and different subject samples may result in equations predicting NST scores from PTTs with those difficult-to-test patients in whom speech recognition capacity cannot well be tested directly.

Acoustic Stimulation↗
PubMed2006

Neurocognitive sequelae of a giant arachnoid cyst: case study.

We conducted a comprehensive neuropsychological evaluation of a normally functioning man with a giant arachnoid cyst encompassing much of the space normally occupied by the left hemisphere. Although of solidly average intellectual ability, the patient demonstrated neurocognitive deficits only revealed upon neuropsychological assessment. Despite the remarkable left hemisphere lesion, the pattern of cognitive dysfunction suggested right hemisphere pathology. We review the arachnoid cyst literature and discuss the possibility of a crowding phenomenon by which language function relocates to the more viable hemisphere. This case illustrates striking preservation of higher cognition in the presence of substantial structural abnormality.

Adult↗
PubMed1989

Functional communication in Alzheimer's disease.

This study investigated functional communication skills in subjects with mild (n = 26) and moderate (n = 22) Alzheimer's disease (AD) and compared their performance with that of normal elderly (n = 26), Wernicke's aphasic (n = 26), and elderly depressed (n = 15) subjects. Communicative Abilities in Daily Living (CADL) (Holland, 1980), a formal test of functional communication, was administered to all subjects. Subjects with mild and moderate AD were impaired on the CADL, and the impairment was more severe in the moderately demented group than in the mildly demented group. In addition, functional language skills were impaired in elderly depressed subjects as compared with normal elderly control subjects; however, the elderly depressed subjects were less impaired than were the mild AD subjects. The depressed subjects responded incompletely rather than in the irrelevant, vague, rambling style that characterized the AD subjects. Finally, although performance of the moderate AD and Wernicke's aphasic subjects did not differ in terms of total CADL score, the performance of these groups across pragmatic categories and types of error responses were markedly different.

Aged↗
PubMed1998

Is speech arrest during wada testing a valid method for determining hemispheric representation of language?

BACKGROUND AND OBJECTIVE: The intracarotid amobarbital procedure, or Wada test, is the method of choice to determine hemispheric representation of language, and is routinely used in the presurgical evaluation for intractable epilepsy. Some investigators perform comprehensive language assessments, but others base language lateralization solely on speech arrest. This study sought to determine whether speech arrest alone during Wada testing provides valid data regarding language lateralization. METHODS: The subjects (previously reported) were 21 patients evaluated for intractable epilepsy, who underwent language lateralization by Wada testing and functional MRI (FMRI). For each patient, language representation was determined by calculating: (1) a Wada laterality index based exclusively on speech arrest; (2) a Wada laterality index based on comprehensive language assessment; and (3) an FMRI laterality quotient. Correlation coefficients and categorical classifications were analyzed. RESULTS: There was no significant correlation between the Wada laterality quotient derived from duration of speech arrest and either the comprehensive Wada language laterality score (r =.35, p =.12) or FMRI language laterality score (r =.32, p =.16). Categorical classification as left, right or bilateral language also showed marked discordance between speech arrest and the other two methods. CONCLUSION: Duration of speech arrest during Wada testing is not a valid measure of language dominance.

Amobarbital↗
PubMed2006

[Stability of phoneme discrimination in preschool children].

BACKGROUND: Several tests have been developed to probe phoneme discrimination. However, little is known about the stability of discrimination abilities in preschool children. We investigated the test-retest reliability of a newly developed test material. METHODS: In a prospective study, 30 preschool children (5.1-6.3 years old) were tested with a time lag between test 1 and test 2 of 1 month. Correlational analysis was carried out using 60 minimal pairs consisting of real words and nonsense syllables. The choice of items took into consideration their frequency in the basic vocabulary as well as phoneme properties such as contrast and position. RESULTS: High Cronbach's alpha were found for all subscales. For the whole item list, Cronbach's alpha was 0.994. No significant gender specific differences were found. DISCUSSION: These data indicate a high stability of phoneme discrimination abilities in preschool children. Based on these results, the test material can be reliably used to evaluate therapeutic strategies to improve discrimination ability.

Child↗
PubMed1988

Stability of the Peabody Picture Vocabulary Test--revised for emotionally handicapped middle-school-age children.

In this pilot study, 20 middle-school-age children classified as emotionally handicapped were administered Forms L and M of the Peabody Picture Vocabulary Test--Revised in test-retest fashion. Pearson correlations for Form L were .90, for Form M, .69, and these dependent correlations were significantly different from each other. As triennial school psychological evaluations typically contain tests which have been administered previously, e.g., WISC-R, WRAT-R, we suggest that psychologists use caution when using Form M to test or retest the receptive vocabulary of emotionally handicapped or disturbed middle-school-age children.

Adolescent↗
PubMedDate not supplied

The effect of unilateral carotid endarterectomy on neuropsychological test performance in 53 patients.

Six psychomotor tests (Ravens matrices, finger tapping, spatial orientation, arithmetic, vocabulary, and short-term memory) were administered preoperatively, at 3-7 days and 3 months postoperatively to 53 patients undergoing unilateral carotid endarterectomy between 1978 and 1982. Standard operative technique included general anesthesia and Javid shunt. None of the patients experienced postoperative neurological deficit or significant complications. Individual and cumulative test scores were correlated with prior CVA, neurological examination, cerebral angiography, pre and postoperative computerized cerebral tomograms and intraoperative carotid flow measurements. Psychometric scores did not change postoperatively in 18 patients with prior CVA's. Forty-five patients operated upon for high grade stenosis (75% reduction in cross sectional diameter) had a significant increase in early post-endarterectomy test scores which returned to preoperative levels by three months postoperatively. Increase in intra-operative carotid artery blood flow correlated with improved test performance. We conclude that carotid endarterectomy of flow restrictive stenosis initially augments psychometric test performance but the improvement is not sustained at the third postoperative month.

Endarterectomy↗
PubMed1981

Problems with contingency theory: testing assumptions hidden within the language of contingency "theory.".

This paper suggests that there are five problems with contingency theory, ranging from a simple lack of clarity in its theoretical statements to more subtle issues such as the embedding of symmetrical and nonmonotonic assumptions in the theoretical arguments. Starting from Galbraith's (1973) contingency theory about organizing for effectiveness, several traditional contingency hypothesis were tested along with more precise hypotheses developed from knowledge of the five problems with contingency theory. Data were drawn from a study of organizational effectiveness in acute care hospital operating room suites. Although traditional contingency notions were not supported by the data, the more precise hypotheses received stronger empirical support. The study data suggest that relationships between technology, structure, and organizational effectiveness are more complicated than contingency theory now assumes. The paper concludes by suggesting formulation of a contingency theory of organizational effectiveness that includes interactive, nonmonotonic, and symmetrical arguments.

Analysis of Variance↗
PubMed2000

[Testing, estimating, "significance"--concept and language of medical biometry].

The justification for the application of medical treatments and diagnostic methods has gained importance during the last decades. Together with scientific argumentations also the concepts of medical statistics have found a widespread use and are nowadays indispensible tools for clinical research. In publications of clinical trials, epidemiological investigations and animal experiments p-values, statistical tests and confidence intervals help the reader to evaluate the significance and relevance of the provided results. A prerequisite is a clear understanding of the concepts underlying these methodological terms. This paper presents the basic concepts of medical statistics and demonstrates the conclusions that can be drawn with the aid of these concepts.

Biometry↗
PubMed2000

Acute oxygen deprivation: neuropsychological profiles and implications for rehabilitation.

OBJECTIVE: To investigate areas of neuropsychological functioning in severe anoxia survivors that have received little prior attention but that have significant implications for rehabilitation. DESIGN: Residents of a long-term neurobehavioural rehabilitation facility were administered comprehensive neuropsychological protocols. Areas assessed were arousal and attention, executive abilities, reasoning, language, visuospatial abilities, motor, praxis, memory, affective regulation, and insight into deficits. RESULTS: Subjects were impaired in all areas except in performing automatized tasks. Areas of dysfunction not previously emphasized included praxis, affective regulation, and verbal fluency. CONCLUSION: Areas of compromise not previously emphasized were identified. Their routine assessment can assist rehabilitation professionals in better serving anoxic encephalopathy survivors, particularly those with profound behavioural dysregulation.

Adolescent↗
PubMed1991

A cross-linguistic perspective on the development of temporal systems.

The purpose of this research was to evaluate the development of temporal location within a cross-linguistic experimental design. The research focused on the transition from a temporal system based on absolute temporal relation involving speech time and event time to a more complex system involving relative temporal relationships and reference time. A comprehension test was constructed with problems which were diagnostic of two salient distinctions within each of three temporal systems. The procedure was based on a two-choice sentence-picture matching task. The children who participated were from Poland, the USA and Finland, and there were 12 children at each of the following age levels: 2;6, 3;6, 4;6, 5;6, and 6;6. The Polish and American children solved problems requiring absolute temporal location at 2;6, and the older children eventually solved most of the problems requiring relative location. The Finnish children followed a different pattern taking longer to comprehend both types of problems. A second experiment confirmed the Finnish pattern of development. The results of the comprehension test were compared to observations of conversational and narrative discourse which were the product of two elicitation procedures. The research demonstrates the way in which conceptual development places a universal constraint on the developmental process and how the specific properties of individual languages also have an effect.

Child↗