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PubMed2004

Diagnostic utility of abbreviated fluency measures in Alzheimer disease and vascular dementia.

BACKGROUND: Several studies indicate semantic fluency more sensitively discriminates patients with Alzheimer disease (AD) from normal elderly persons, with disproportionate impairment of semantic over phonemic fluency. OBJECTIVE: To determine the ability of abbreviated fluency measures in the clinic setting (1-minute letter F and animal fluency tests) to detect AD, and to assess whether difference scores between these measures discriminate patients with AD and vascular dementia (VaD) from normal elderly persons. METHODS: The authors studied patients with AD (n = 98) meeting National Institute of Neurological Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association criteria, VaD patients (n = 18) meeting National Institute of Neurological Disorders and Stroke-Association Internationale pour la Recherche et l'Enseignement en Neurosciences criteria, cognitively impaired but not demented patients (CIND; n = 25), vascular CIND patients (VCIND; n = 24), and normal control subjects (NCs; n = 46). RESULTS: Analysis of covariance controlling for age, education, and overall impairment indicated all groups generated fewer animal names compared with NCs, whereas only VaD patients generated fewer letter F words compared with NCs. On standardized scores, patients with AD and CIND, unlike those with VCIND and VaD, scored significantly worse on the animal fluency test than on the letter F fluency test. The animal fluency test was superior in discriminating all patient groups from NCs. Positive likelihood ratios (PLRs) revealed animal fluency scores <15 were 20 times more likely in a patient with AD than in an NC (sensitivity = 0.88; specificity = 0.96). Letter F scores <4 discriminated VaD from AD patients (PLR = 4.0; sensitivity = 0.44; specificity = 0.90). Difference scores <0 (i.e., fewer animal than letter F words) discriminated patients with VCIND from those with CIND (PLR = 2.5; sensitivity = 0.32; specificity = 1.00). CONCLUSIONS: A 1-minute semantic fluency test can assist in early detection of dementia in the memory clinic setting.

Aged↗
PubMed1992

[Recall of the proper names of persons: effect of age and the modality of access].

Aging is associated with phenomena of slowing down of cognitive processes and impairment of neuropsychological performances. Elderly people also report difficulty in the retrieval of proper names. Verbal fluency (VF) tests are particularly effective for the identification of even slight mental impairments. In this experiment we utilized the usual tests of VF for semantic categories and letters of the alphabet together with three new tests of VF for first names, differing in mode of access. The first mode was free recall, the second mode was semantic (first names beginning with a particular letter), and the third mode was autobiographical (first names of relatives). There were 3 experimental groups: young people with high education level, elderly people with high education level and elderly people with low education level. The aim of our work was to verify whether aging modifies the performance in the VF tests, particularly in the three first name VF tests. No difference was found between the groups of young and elderly people with high education level. The comparison between the two groups of elderly people, with high and low education level, showed that significant differences were present in some but not in all of the VF tests. While the two groups clearly differed in semantically oriented tests, no difference could be detected in the test oriented to episodic memory. This result seems to be inconsistent with the hypothesis that aging affects mainly episodic memory.

Adult↗
PubMed1989

A profile analysis approach to interpretation of the Carrow Auditory-Visual Abilities Test.

This paper describes a profile analysis procedure for use with the Carrow Auditory-Visual Abilities Test (CAVAT). The visual-auditory dichotomy, supported by factor analysis, is examined at one level of analysis. Critical values derived from the standard error of measurement of the difference (Sem/D) for each battery are provided allowing the identification of reliable and abnormal visual-auditory discrepancies. At another level of analysis, a procedure for profile analysis is outlined and critical values are included to facilitate the identification of relative strengths and weaknesses at the subtest level. Test results from 2 preschool children are examined and contrasted to illustrate the utility of the CAVAT in the identification of systematic modality preferences.

Auditory Perception↗
PubMed1998

Perceptual and conceptual priming of individual words in coherent texts.

This study explores implicit memory within the domain of text processing. Three experiments were designed to study priming in word-fragment completion, word-stem completion, and free association tests following presentation of target words in the context of a coherent text. In order to examine the time course of perceptual and conceptual processes we investigated the priming effects by manipulating the perceptual context in which the target words had been read and the time given to the subjects for each test-cue. Three main results emerged. First, we found a significant priming effect in the three implicit tests for words previously studied in a text. Second, the magnitude of the priming effect only varied when the task demands required perceptual and conceptual processing, as was the case with the completion tests. Third, priming effects did not depend on subjects' comprehension of the text read. These results are discussed in the framework of the transfer-appropriate processing view proposed by Roediger, Weldon, and Challis (1989).

Concept Formation↗
PubMed1999

Exploration of implicit artificial grammar learning in Parkinson's disease.

Parkinson's disease (PD) patients and matched control subjects were compared in an artificial grammar learning task, one of the main paradigms of implicit learning. The evaluation material was constructed in such a way that grammaticality judgements (classification task) made on the test strings could not be based on some superficial features of the learning strings: the grammatical and nongrammatical test strings did not differ according to different measures of chunk strength (based on the frequency with which their bigram and trigram components appear in the learning strings). Unknown to participants, two successive presentations of the set of test strings were allowed during the classification task. Results show that PD patients and controls performed at the same level during the first presentation of the test strings series, which suggests that the striatum is not (crucially) implicated in the ability to learn implicitly the complex conditional associations between elements present in a set of examples generated by a finite-state grammar. However, and contrary to control subjects, the classification performance of PD patients was at chance during the second presentation of the test strings. We argue that this latter result could be the consequence of the attentional deficit of PD patients.

Association Learning↗
PubMed2001

What test should I use?

Appropriate assessment of Hispanic children requires clinicians to have knowledge of the cultural and linguistic factors that influence the communication skills of these children. This knowledge base includes an understanding of variations in the social and linguistic characteristics of Hispanic subgroups. Knowledge of these characteristics provides clinicians with the framework necessary to conduct less biased assessments. Clinicians possessing this framework would be able to conduct assessments that take into consideration the child's social ecology and the impact of dialect, first and second language acquisition, and language loss on the child's communication skills.

Child↗
PubMed2002

Comorbidity in children with severe developmental language disability.

UNLABELLED: In a cohort of 2359 children, screened for severe developmental language disability (DLD) at 3 y of age, 45 children were identified as true positives. The development, concerning DLD and comorbidity of 41 of these children still living in the municipality of Uppsala was followed up to school start. Criteria for comorbidity were: (a) suspected or diagnosed neuropsychiatric/neurodevelopmental disability according to information from the Child Habilitation Centre and the Child Psychiatric Centre or (b) low performance IQ, signs of activity/distractibility problems according to a psychologist's examination. By school start, 61% of the children with severe DLD were identified with comorbidity. CONCLUSION: Severe DLD is often combined with other disabilities within the neuropsychiatric/neurodevelopmental spectra. The comorbidity might not be obvious at 3 y of age--the age at which severe DLD is effectively identified by the 3-y screening programme. This in turn stresses the necessity of multidisciplinary teamwork both at the referral level and during the therapy work.

Age Factors↗
PubMed1993

[Verbal fluency and EEG coherence in Alzheimer's disease].

EEG coherence of 16 derivations and a verbal fluency test were evaluated on 25 ambulatory patients suffering from Alzheimer's disease (age: 74 +/- 5.7). The aim of the study was to analyze coherence rate variations from different cortical areas in relation to the performance in the test. Coherence rates of each derivation with the other ones were calculated for four frequency bands from 0.5 to 13.5 Hz. Arithmetic averages of these rates were then calculated to obtain scalp averaged coherence rates. The patients were submitted to a verbal fluency test and divided into two groups according to their test score as compared to normative data: impaired (n = 10) and not impaired (n = 15). Results showed that averaged coherence rates of theta and alpha 1 frequency bands were significantly depressed in the impaired group in comparison with those of the not impaired group. Two cortical areas were concerned with this difference, the left temporo-occipital and frontal zones, in an independent way for the same subject. Moreover, we observed that the patients who where impaired in the verbal fluency test, also presented a significantly greater ancientness of the clinical symptoms as compared to the not impaired patients.

Aged↗
PubMed1986

Content relevance and content coverage in tests of grammatical ability.

Three widely used tests of grammatical ability were evaluated for content-oriented test construction using two procedures. First, a decision-making model was developed to assist in judging the content relevance and coverage of each test using information provided by respective test authors. Second, a comprehensive model of the grammatical domain was applied to individual items on the tests so that descriptions and comparisons of their content domains could be made. Both evaluations showed inadequate content relevance and coverage for all three tests. The content domains of these tests were found deficient when judged against an external standard as well as when examined according to their own content specifications. The influence of inadequate content relevance and coverage on assessment and remediation is discussed.

Humans↗
PubMed2003

[Distinctness and discrimination of phonemes in children with cochlear implants--preliminary report].

There are many tests prepared for speech evaluation for different age groups and with any disabilities. The percent of correct repeated mono- or bisyllabes words create the final result. Sometimes this score is lower than real oral communication skill of CI patient. In the years 1994-2002 in Poznań 158 cochlear implantations were performed. Since few months the evaluation of the distinctness and discrimination of phonems of cochlear implants children are being conducted. It was found some differences between distinctness and discrimination of phonems and discrimination of words. It means that scores achieved by children in standarized words--tests do not reflect the real level of speech development of each child.

Child↗
PubMed1979

[Verbal comprehension with objects and its comparison with the token test in children].

This study analyzes the results obtained in the child from an application of the Token Test of the De Renzi and Vignolo and compares them with those obtained from the application of a similar Test, in which objects of more familiar semantic field were employed. Normal children ranking from 4 years 0 month to 8 years 11 months were studied for this purpose.

Child↗
PubMed1994

Adaptations for administering the Peabody Picture Vocabulary Test-Revised to individuals with severe communication and motor dysfunctions.

A method for administering the Peabody Picture Vocabulary Test-Revised to individuals unable to make oral or fine-motor responses was presented. The method involved binary communication and active interrogation by the examiner utilizing a random strategy. The test was administered in both standard and adapted forms to a group of 25 individuals with a wide range of physical and intellectual disabilities. Results from the two versions were correlated at a level comparable to that reported in the test manual between alternate forms. Viability of the binary format administration was discussed in terms of its use in evaluating cognitive ability of those with the most severe communication and physical limitations.

Adult↗
PubMed1998

Barriers to cancer screening in Mexican-American women.

OBJECTIVE: To test the simultaneous effect of various established predictors of breast and cervical cancer screening (breast self-examination, clinical breast examination by a physician, Papanicolaou [Pap] smear, and pelvic examination) in a low-income, Mexican-American sample. MATERIAL AND METHODS: A total of 188 Mexican-American women participated in a face-to-face structured interview in their preferred language. We tested a model with four established predictors of breast and cervical cancer screening--communication skills, knowledge of cancer, access to health care (finances and availability of care), and anxiety about cancer. Simultaneous structural equations analysis was used to form latent variables and to control for the effect of all predictors concurrently. RESULTS: Screening behavior was inversely associated with anxiety about cancer when all other predictors were statistically controlled. In addition, anxiety substantially affected the relationship between communication skills and screening behavior. Unexpectedly, knowledge of cancer was positively, rather than negatively, associated with anxiety about cancer. Predictors in the model demonstrated an excellent fit of the proposed model to the data. CONCLUSION: Successful cancer screening programs for Mexican-American women must address not only access barriers but also communication skills, knowledge, and, perhaps most importantly, anxiety.

Anxiety↗
PubMed1995

Neuropsychological functioning in detoxified alcoholics between 18 and 35 years of age.

OBJECTIVE: The authors determined 1) cognitive functioning in detoxified alcoholics who had alcohol-related problems for a relatively brief time and 2) relationships between neuropsychological test scores and recent and chronic alcohol consumption patterns, childhood symptoms of hyperactivity/minimal brain dysfunction, and extent of familial alcoholism. METHOD: The subjects were 101 detoxified, drug-free alcoholics between 18 and 35 years of age who had consumed excessive amounts of alcohol (average of 114 g four to five times per week) for an average of 6 years. An average of 39 days after the last drink each alcoholic was given an extensive battery of neuropsychological tests assessing language skills, attention, motor skills, intelligence, memory, and cognitive functioning related to the frontal regions of the brain. RESULTS: Only four individuals evidenced mild cognitive dysfunction. Current psychiatric condition, anxiety and depressive states, and liver dysfunction were not related to cognition. Relationships of cognition of lifetime estimates of alcohol consumption (average of 189 kg) and number of days from last drink to testing were determined to be nonlinear and suggested that greater lifetime consumption predicted worse performance and that longer abstinence predicted better performance. Neither extent of familial alcoholism nor number of childhood signs and symptoms of hyperactivity/minimal brain dysfunction was predictive of cognition except that more antisocial behavior predicted poorer cognitive functioning. CONCLUSIONS: Cognition in young alcoholics, averaging 6 years of excessive alcohol consumption, was within normal limits, even though greater lifetime consumption predicted lower test scores and longer abstinence predicted higher scores.

Adolescent↗
PubMed2004

Longitudinal changes in cognition and behavior in asymptomatic carriers of the APOE e4 allele.

OBJECTIVE: To determine whether memory loss is detectable before the symptomatic presentation of mild cognitive impairment (MCI) in those at greater genetic risk for Alzheimer disease (AD) based upon presence or absence of the e4 allele of APOE. METHODS: Participants were age 50 years or older who responded to newspaper advertisements. A total of 212 cognitively normal individuals of known APOE genotype were initially enrolled in a match paradigm that included e4 homozygotes, e3/4 heterozygotes, and e4 noncarriers in a 1:1:2 ratio (53 sets). Of the original 212 individually matched participants, 180 completed at least two epochs of testing including 45 APOE e4/4 homozygotes, 42 APOE e3/4 heterozygotes, and 93 APOE e4 noncarriers, mean age 60 (+/-6.2) years. Of these, four developed MCI or AD during the follow-up period and were excluded from analysis. Longitudinal neuropsychological study included two verbal (Auditory Verbal Learning Test [AVLT], Selective Reminding Test [SRT]) and two visual (Complex Figure Test [CFT], Visual Retention Test) memory tests. RESULTS: Multiple measures on both verbal memory tests showed poorer performance over a mean interval of 33 months in e4 carriers than noncarriers: AVLT total learning, long term delayed recall; SRT free and cued recall. Among those age 50 to 59 years, AVLT long term delayed recall, SRT free and cued recall, and CFT recall declined more in APOE e4 carriers. No differences were found in the domains of language, spatial skills, or executive function. CONCLUSIONS: Memory declined in APOE e4 carriers before the symptomatic presentation of MCI in a cohort whose mean age was 60 years over a median period of 33 months. The decline began prior to age 60.

Aged↗
PubMed1991

Cleft palate. Diagnosis.

The necessary information for diagnosis of "cleft palate speech" is available from clinical speech pathology tests and observations for the majority of patients. Test findings about error type and stimulability often give direction to our decisions about speech therapy. Other kinds of tests are useful for confirming these findings or for other purposes. Trial speech therapy is a very useful diagnostic procedure. Problem patients (those who fail to make suitable progress) should be referred without hesitation to a cleft palate team, or to a colleague who is an SLP on that team. Referrals to other specialists should be made appropriately, using careful, clear referral language.

Child↗
PubMed1994

Speech perception training can facilitate sound production learning.

This study examined the role of speech perception training in the correction of phonological errors. Twenty-seven preschoolers with phonological impairment who misarticulated /integral of/ were randomly assigned to one of three groups: Group 1 children listened to a variety of correctly and incorrectly produced versions of the word "shoe"; Group 2 children listened to the words "shoe" and "moo"; Group 3 children listened to the words "cat" and "Pete." A computer game was used to provide reinforcement for correct identification of the words. All children received the same traditional sound production training program for correction of their /integral of/ error, concurrently with speech perception training, during six weekly treatment sessions. On post-testing, Group 1 and 2 children demonstrated a superior ability to articulate the target sound in comparison to Group 3 children. The results are interpreted in relation to previous research on this topic.

Articulation Disorders↗
PubMed2005

Phonological skills of children adopted from China: implications for assessment.

Little is known about the acquisition of English phonology by children adopted from China. Data are summarized from three recent studies with a focus on the phonological skills of children adopted from China as infants or toddlers. Two longitudinal studies (combined n = 8) described early phonological behaviors (e.g., babbling, phonetic inventories), and found substantial individual variation. In spite of this variation by 3 years of age, nearly all of the children were performing at a level comparable to nonadopted monolingual English-speaking peers. No clear relationship between the early behaviors and outcome at age 3 was found. The third study provided descriptions of the phonological skills of preschoolers ( n = 25) who had been adopted 2 or more years earlier, and found that only a few had persistent phonological delays. Errors were predominantly common developmental errors frequently observed in nonadopted monolingual English-speaking children. These findings suggest that tests and measures developed for monolingual English-speaking children may be used cautiously with children adopted as infants or toddlers who have been in their permanent homes for 2 or more years. Prior to that time, assessment should focus on independent analyses of phonological behaviors with consideration of the child's chronological age, length of exposure to English, and development in other language domains.

Adoption↗