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Contributions of memory circuits to language: the declarative/procedural model.

The structure of the brain and the nature of evolution suggest that, despite its uniqueness, language likely depends on brain systems that also subserve other functions. The declarative/procedural (DP) model claims that the mental lexicon of memorized word-specific knowledge depends on the largely temporal-lobe substrates of declarative memory, which underlies the storage and use of knowledge of facts and events. The mental grammar, which subserves the rule-governed combination of lexical items into complex representations, depends on a distinct neural system. This system, which is composed of a network of specific frontal, basal-ganglia, parietal and cerebellar structures, underlies procedural memory, which supports the learning and execution of motor and cognitive skills, especially those involving sequences. The functions of the two brain systems, together with their anatomical, physiological and biochemical substrates, lead to specific claims and predictions regarding their roles in language. These predictions are compared with those of other neurocognitive models of language. Empirical evidence is presented from neuroimaging studies of normal language processing, and from developmental and adult-onset disorders. It is argued that this evidence supports the DP model. It is additionally proposed that "language" disorders, such as specific language impairment and non-fluent and fluent aphasia, may be profitably viewed as impairments primarily affecting one or the other brain system. Overall, the data suggest a new neurocognitive framework for the study of lexicon and grammar.

Humans↗

The evolution of the language faculty: clarifications and implications.

In this response to Pinker and Jackendoff's critique, we extend our previous framework for discussion of language evolution, clarifying certain distinctions and elaborating on a number of points. In the first half of the paper, we reiterate that profitable research into the biology and evolution of language requires fractionation of "language" into component mechanisms and interfaces, a non-trivial endeavor whose results are unlikely to map onto traditional disciplinary boundaries. Our terminological distinction between FLN and FLB is intended to help clarify misunderstandings and aid interdisciplinary rapprochement. By blurring this distinction, Pinker and Jackendoff mischaracterize our hypothesis 3 which concerns only FLN, not "language" as a whole. Many of their arguments and examples are thus irrelevant to this hypothesis. Their critique of the minimalist program is for the most part equally irrelevant, because very few of the arguments in our original paper were tied to this program; in an online appendix we detail the deep inaccuracies in their characterization of this program. Concerning evolution, we believe that Pinker and Jackendoff's emphasis on the past adaptive history of the language faculty is misplaced. Such questions are unlikely to be resolved empirically due to a lack of relevant data, and invite speculation rather than research. Preoccupation with the issue has retarded progress in the field by diverting research away from empirical questions, many of which can be addressed with comparative data. Moreover, offering an adaptive hypothesis as an alternative to our hypothesis concerning mechanisms is a logical error, as questions of function are independent of those concerning mechanism. The second half of our paper consists of a detailed response to the specific data discussed by Pinker and Jackendoff. Although many of their examples are irrelevant to our original paper and arguments, we find several areas of substantive disagreement that could be resolved by future empirical research. We conclude that progress in understanding the evolution of language will require much more empirical research, grounded in modern comparative biology, more interdisciplinary collaboration, and much less of the adaptive storytelling and phylogenetic speculation that has traditionally characterized the field.

Biological Evolution↗

Language activation distributions revealed by fMRI in post-operative epilepsy patients: differences between left- and right-sided resections.

OBJECTIVE: To reveal differences of cerebral activation related to language functions in post-operative temporal lobe epilepsy (TLE) patients. METHODS: Right (RTL) and left temporal lobe (LTL) resected patients, and healthy controls were studied using functional magnetic resonance imaging (fMRI). Only patients with complete left-hemispheric language dominance according to the intracarotid amytal procedure (IAP) were included. Language-related activations were evoked by performing word generation and text reading language tasks. Activation lateralization and temporo-frontal distribution effects were analysed. RESULTS: For word generation, only LTL patients showed reduced left lateralized activation compared to controls, due to a decrease in activation in the left prefrontal cortex and an increase in the right prefrontal cortex. For reading, the left-hemispheric lateralization in RTL patients increased because of enhanced activity in the left prefrontal cortex, whereas for LTL patients the activation became bilaterally distributed over the temporal lobes. Lateralization results between pre-operative IAP and post-operative fMRI were highly discordant. Significant temporo-frontal distribution changes manifested from the reading but not from the word generation task. CONCLUSION: The cerebral language representation in post-operative LTL epilepsy patients is more bi-hemispherically lateralized than in controls and RTL patients. Post-operative temporo-frontal and interhemispheric redistribution effects, involving contralateral homologous brain areas, are suggested to contribute to the cerebral reorganisation of language function.

Adult↗

Content validity and the language of breathing.

OBJECTIVE: The study objective was to validate the content validity of natural language words and phrases selected from participant logs as breathing-intensity descriptors. DESIGN AND SETTING: A descriptive design was implemented using data collected in a prior study in which the breathing-intensity descriptors had been identified. METHODS: Content validity was used to rate natural language breathing-intensity descriptors. Six seasoned nurses with a minimum of master's preparation served as the expert panel. On the basis of a 4-point (0-3) scale, mean scores were calculated for natural language breathing-intensity descriptors. Content validity was established for mean scores greater than 1.0. RESULTS: A total of 66 (89%) natural language breathing-intensity descriptors were validated. The experts did not validate eight descriptors that described the lower end of breathing intensity. CONCLUSIONS: Natural language breathing-intensity descriptors were validated. The highest validation scores were achieved with breathing-intensity descriptors at the upper end of the breathing-intensity spectrum. However, words and phrases that aligned with the lower end of the spectrum generated lower content validity scores. This was an unexpected finding on the full spectrum of breathing intensity that raised questions about differences in language, meaning, and significance between participants and experts.

Humans↗

Five children--vignettes of language disorders.

The pediatric otolaryngologist cares for children who have abnormal language as a primary or secondary deficiency. Five children, each with a different form of language disorder, are presented. These are children with specific language impairment (SLI) expressive, pervasive developmental delay (autism), expressive language delay associated with severe to profound hearing loss early in life, language delay secondary to a moderate to severe hearing loss diagnosed late and not cared for, and language delay secondary delay secondary to social deprivation and otitis media with effusion.

Autistic Disorder↗

Using assessment of higher brain functions of children with GJB2-associated deafness and cochlear implants as a procedure to evaluate language development.

OBJECTIVE: While investigators have reported that patients with GJB2-associated deafness and cochlear implants have preferable language development, the mechanisms of this phenomenon remains unknown. The goal of the present study was to assess higher brain functions of patients with GJB2-related and GJB2-unrelated deafness as a method of evaluating language development. METHODS: Eight children with cochlear implants were subjected to genetic testing for GJB2 and underwent the Raven colored progressive matrices test, Rey's auditory verbal learning test, Rey's complex figure test, the standardized language test for aphasia, the picture vocabulary test, and the standardized comprehension test for abstract words. RESULTS: Three children were diagnosed with GJB2-related deafness, and five children were diagnosed with GJB2-unrelated deafness. All three GJB2-related cases demonstrated normal range higher brain functions and fair language development. By contrast, one GJB2-unrelated case showed a semantic disorder, another demonstrated a visual cognitive disorder with dyslexia, and another had attention deficit-hyperactivity disorder. CONCLUSIONS: Children with GJB2-unrelated deafness showed a high frequency of heterogeneous disorders that can affect proper language development. This difference between children with GJB2-related and GJB2-unrelated deafness may account for the improved language development in children with GJB2-related deafness and cochlear implants. Further, genetic diagnosis of the non-syndromic hearing loss represents a useful tool for the preoperative prediction of outcomes following a cochlear implant procedure.

Audiometry↗

Pediatricians' opinions about otitis media and speech-language-hearing development.

UNLABELLED: Twenty-five pediatricians responded to a confidential survey about their opinions on the relationship between otitis media and children's speech-language-hearing status. Results found that pediatricians did not necessarily agree that otitis media has an impact on speech-language-hearing development. Pediatricians reported that an early otitis media onset (birth to age 2) affects speech-language development, but they also reported that parents and daycare environments could mitigate any otitis media effect. Pediatricians reported a possible otitis media impact on hearing status, but they did not necessarily agree that an otitis media history required referral for audiological testing. Clinical implications are discussed for collaboration among pediatricians, speech-language pathologists, and audiologists. LEARNING OUTCOMES: (1) The reader will become familiar with pediatricians' opinions about the impact of otitis media on speech-language development. (2) The reader will become familiar with strategies to support interdisciplinary collaboration between pediatricians, speech-language pathologists, and audiologists.

Attitude to Health↗

Language-learning disorders and youth incarceration.

UNLABELLED: Many speech-language pathologists are serving delinquent boys with language-learning disorders who are both current and former residents of correctional institutions. These youngsters demonstrate personal maladjustments that have a negative impact on school performance and socialization. Those boys within chaotic families are at risk of poverty, institutionalization, and substance abuse. Boys with language-learning disorders, who have encountered the law, need to be provided with services through collaborative and individualized efforts toward improving language skills, learning, and re-incorporating them into society. Further investigations are needed in order to clarify how the elements of personal, family, neighborhood, school and service conditions serve as either protective or risk factors for a life of incarceration in these individuals. LEARNING OUTCOMES: As a result of this presentation, the reader will understand the complex relationship among language-learning disorders, poverty, poor school performance, and delinquency in boys. The reader will become aware of the elements that should be present in school and correctional services in order to prevent recidivism in boys with language-learning disorders who have had problems with the law.

Humans↗

The effects of variation on learning word order rules by adults with and without language-based learning disabilities.

UNLABELLED: Non-adjacent dependencies characterize numerous features of English syntax, including certain verb tense structures and subject-verb agreement. This study utilized an artificial language paradigm to examine the contribution of item variability to the learning of these types of dependencies. Adult subjects with and without language-based learning disabilities listened to strings of three non-words for which the first and third elements had a dependent relationship. In the low variability condition, 12 non-words occurred in the middle position, and in the high variability condition, 24 non-words occurred in this position. Non-disabled adults were able to learn the non-adjacent contingencies and generalize the underlying structure to new strings, but only when variability was high. Adults with language-based learning disabilities did not perform above chance levels under either variability condition. Thus, this group showed poor sensitivity to statistical information in speech input that both infants and non-disabled adults are known to track. LEARNING OUTCOMES: As a result of this activity, the reader will: (1) understand the advantages of using an artificial language to investigate language learning; (2) become familiar with a paradigm for studying the rapid learning of syntactic contingencies; (3) comprehend how the ability to map language structure differs for non-disabled adults and adults with a history of language/learning disability as a function of variability in the input the listener receives.

Adolescent↗

Primary language of parent is associated with disparities in pediatric preventive care.

OBJECTIVES: To determine whether infants of parents whose primary language is not English are less likely to receive recommended preventive care than infants of parents whose primary language is English. STUDY DESIGN: We conducted a retrospective cohort study of all 38,793 1-year-old Medicaid-enrolled infants born in Washington state between January 1, 1999 and September 30, 2000. The main exposure was self-reported primary language of parents. Using multivariate regression, we estimated the relative risk of receiving appropriate and timely receipt of preventive care visits in the first year as recommended by the American Academy of Pediatrics and Washington state Medicaid. RESULTS: Fewer than 1 in 6 (15.4%) infants received all 6 recommended preventive care visits in their first year of life. Infants of parents whose primary language was not English were half as likely to receive all recommended preventive care visits compared with infants of parents whose primary language was English (adjusted relative risk = 0.53; 95% confidence interval = 0.49 to 0.58). This disparity was seen in white, Hispanic, and African-American infants, but not in Asian-American infants. CONCLUSIONS: Disparities based on primary language exist in receipt of recommended pediatric preventive care in white, Hispanic, and African-American infants enrolled in Medicaid.

Child Health Services↗

Determination of language dominance with synthetic aperture magnetometry: comparison with the Wada test.

Cerebral dominance for language function was investigated with synthetic aperture magnetometry (SAM). The results were compared with those of the Wada test. SAM is a spatial filtering technique that enables demonstration of the spatiotemporal distribution of oscillatory changes (synchronization and desynchronization) in magnetoencephalography (MEG) signals elicited by specific brain activation. MEG was conducted during a silent reading task in 20 consecutive preoperative neurosurgical patients who also underwent a Wada test. The spatial distribution of oscillatory changes related to silent reading was shown tomographically with SAM as statistical images. Language dominance was estimated by the laterality index, which scales the lateralization of the beta (13-25 Hz) and low gamma (25-50 Hz) band desynchronizations in the inferior frontal gyrus (IFG) or middle frontal gyrus (MFG). Oscillatory changes were distributed multifocally and bilaterally in the occipital cortex, IFG or MFG, and temporo-parieto-occipital border regions. In 19 patients (95%), language lateralization estimated by the laterality index was congruent with the result of the Wada test. In left-handed patients, SAM analysis clearly differentiated language dominance (left, right, or bilateral), and the findings were confirmed by the Wada test. Lateralization of beta or low gamma band desynchronizations in the IFG or MFG is a good indicator of the side of language dominance. Reliability of MEG imaging with SAM is sufficient to evaluate language dominance preoperatively in neurosurgical patients.

Adolescent↗

Combining fMRI and MEG increases the reliability of presurgical language localization: a clinical study on the difference between and congruence of both modalities.

To avoid neurological impairment during surgery near language-related eloquent brain areas, we performed presurgical functional brain mapping with functional magnetic resonance imaging (fMRI) and magnetoencephalography (MEG) in 172 patients using language tasks. For MEG localizations, we used either a moving equivalent-current dipole fit or a current-density reconstruction using a minimum variance beamformer with a spatial filter algorithm. We localized the Wernicke and Broca language areas for every patient. We integrated the results into a frameless stereotaxy system. To visualize the results in the navigation microscope during surgery, we superimposed the fMRI and MEG findings on the brain surface. MEG and fMRI results differed in 4% of cases, and in 19%, one modality showed activation but not the other. In the vicinity of large gliomas, the BOLD (blood oxygenation level-dependent) effect was suppressed in 53% of our patients. Of the 124 patients who had surgery, only 7 patients (5.6%) experienced a transient language deterioration, which resolved in all cases. We used MEG and fMRI to show different aspects of brain activity and to establish validation between MEG and fMRI. We conclude that measurement by both MEG and fMRI increases the degree of reliability of language area localization and that the combination of fMRI and MEG is useful for presurgical localization of language-related eloquent cortex.

Brain↗

Language reactivity and work functioning in schizophrenia.

Some studies have found that the speech of certain schizophrenia patients becomes more disordered in stressful laboratory situations. It is unknown, however, whether affective reactivity of speech is associated with stress responsiveness of symptoms in the real world. This study examines whether language-reactive patients report more stress-related impairments in work functioning than language-nonreactive patients. Forty-six patients provided speech samples and completed a work history interview. It was found that the language-reactive patients were more likely than the language-nonreactive patients to endorse items pertaining to social anxiety and difficulty relating to others as reasons for their work difficulties. This suggests that language-reactive patients are more sensitive to social stressors than language-nonreactive patients.

Adult↗

Language laterality determined by MEG mapping with MR-FOCUSS.

Magnetoencephalography recordings were made on 27 patients with localization related epilepsy during two different language tasks involving semantic and phonological processing (verb generation and picture naming). These patients underwent the semi-invasive intracarotid amobarbital procedure (IAP), also referred to as the Wada test, to determine the language-dominant hemisphere. Magnetoencephalography (MEG) data were analyzed by MR-FOCUSS, a current density imaging technique. A laterality index (LI) was calculated from this solution to determine which hemisphere had more neural activation during these language tasks. The LIs for three separate latencies, within each language task, were calculated to determine the latency that correlated best with each patient's IAP result. The LI for all language processing was calculated for the interval 150-550 ms, the second LI was calculated for the interval 230-290 ms (Wernicke's activation), and the third LI was calculated for the interval 396-460 ms (Broca's activation). In 23 of 24 epilepsy patients with a successful IAP, the LIs for Broca's activation, during the picture naming task, were in agreement with the results of the IAP (96% agreement). One of three patients who had an undetermined or bilateral IAP had an LI calculated for Broca's activation (396-460 ms) that agreed with intracranial mapping and clinical testing. These results indicate an 89% agreement rate (24 of 27) for magnetoencephalographic LI determination of the hemisphere of language dominance.

Adolescent↗

Right hemispheric language dominance in a right-handed male with a right frontal tumor shown by functional transcranial Doppler sonography.

BACKGROUND: A 38-year-old, right-handed man with late-onset right frontal epilepsy due to a ganglioglioma and atypical right hemispheric language dominance is described. METHODS: Language dominance was investigated with functional transcranial Doppler sonography (fTCD), and language localization with functional magnetic resonance imaging (fMRI). RESULTS: During a word generation task, fTCD showed atypical right hemispheric language dominance, which was confirmed by fMRI using a semantic word comparison and a word stem completion task. This information helped to guide the resective procedure, which left the patient seizure-free and did not induce new deficits. CONCLUSION: Functional TCD appears to be a useful and reliable screening tool for determining hemispheric language dominance, even in patients with atypical language representation. Functional MRI may be used to confirm fTCD results and further localize eloquent cortex.

Adult↗

Standardized language--making nursing practice count.

Language in nursing has never communicated the same clinical problems in a clear, precise, or consistent manner. Clinical information systems require standardized terms and definitions to help clinicians with electronic documentation. The future of nursing depends on systematic efforts to label and define nursing contributions to health care. Standardized nursing languages provide a structure to manage nursing data in a computerized patient record. Learning about and working with standardized nursing languages will ensure that nursing contributions are an integral component of any medical record. This article defines standardized language, explores standardized languages in nursing, and outlines the various nursing languages for clinical practice that have been recognized by the American Nurses Association.

Databases as Topic↗

Turning the tables: language and spatial reasoning.

This paper investigates possible influences of the lexical resources of individual languages on the spatial organization and reasoning styles of their users. That there are such powerful and pervasive influences of language on thought is the thesis of the Whorf-Sapir linguistic relativity hypothesis which, after a lengthy period in intellectual limbo, has recently returned to prominence in the anthropological, linguistic, and psycholinguistic literatures. Our point of departure is an influential group of cross-linguistic studies that appear to show that spatial reasoning is strongly affected by the spatial lexicon in everyday use in a community (e.g. Brown, P., & Levinson, S. C. (1993). Linguistic and nonlinguistic coding of spatial arrays: explorations in Mayan cognition (Working Paper No. 24). Nijmegen: Cognitive Anthropology Research Group, Max Planck Institute for Psycholinguistics; Cognitive Linguistics 6 (1995) 33). Specifically, certain groups customarily use an externally referenced spatial-coordinate system to refer to nearby directions and positions ("to the north") whereas English speakers usually employ a viewer-perspective system ("to the left"). Prior findings and interpretations have been to the effect that users of these two types of spatial system solve rotation problems in different ways, reasoning strategies imposed by habitual use of the language-particular lexicons themselves. The present studies reproduce these different problem-solving strategies in speakers of a single language (English) by manipulating landmark cues, suggesting that language itself may not be the key causal factor in choice of spatial perspective. Prior evidence on rotation problem solution from infants (e.g. Acredolo, L.P. (1979). Laboratory versus home: the effect of environment on the 9-month-old infant's choice of spatial reference system. Developmental Psychology, 15 (6), 666-667) and from laboratory animals (e.g. Restle, F. (1975). Discrimination of cues in mazes: a resolution of the place-vs.-response question. Psychological Review, 64, 217-228) suggests a unified interpretation of the findings: creatures approach spatial problems differently depending on the availability and suitability of local landmark cues. The results are discussed in terms of the current debate on the relation of language to thought, with particular emphasis on the question of why different cultural communities favor different perspectives in talking about space.

Adult↗

Plasticity and reorganization during language development in children with early brain injury.

Although some studies have reported subtle language deficits following early focal brain lesions (EFBL), most studies find no evidence for differential language outcomes as a function of lesion side or lesion type in children with congenital injuries to one side of the brain. However, recent prospective studies of the first stages of language development in English-speaking children with EFBL have reported greater delays in expressive vocabulary in children with left-hemisphere damage, particularly if the lesion involves left temporal cortex. In the present study, first stages in the development of word production were studied in 43 Italian children with congenital EFBL, between 13 and 46 months of age. As a group, the EFBL children were markedly delayed in expressive vocabulary. Among children who were in the first stage of language learning, delays were significantly greater with left-hemisphere injury. However, this left-right difference was not evident in children who had moved on to the next stage of language development, producing at least some sentences. Discussion centers on the role of developmental plasticity in determining the outcomes of early focal brain injury, suggesting that recovery from initial delays may take place in the early stages of language development, at least for some children.

Brain↗