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Perceptual and linguistic factors in the language impairment of developmental dysphasics: an experimental investigation with the token test.

Twelve developmental dysphasics and twelve control children were tested on De Renzi and Vignolo's Token Test. The performance of the dysphasics, though significantly poorer than that of the controls on Parts 2-5 of the test, seemed to follow a similar pattern. Both groups were errorless on the initial parts of the test. As the demand on auditory retention increased on subsequent parts of the test, the performance of both groups progressively deteriorated. However, the addition of grammatical complexity on Part 5, rather than causing even further deterioration in performance, actually served to improve the performance of both groups, though not significantly. Although the pattern of errors made by the two groups was similar, the quantity of errors made by the dysphasics, as compared to the normal control children, demonstrated the magnitude of the dysphasic children's receptive language impairment. Analysis of errors indicated that dysphasic children have greater difficulty with auditory retention and verbal memory than they do with the grammatical or structural complexity of language. It is suggested that the observed gross language impairment of developmentally dysphasic children does not result, at least primarily, from a specific inability to analyze the linguistic components of language. Rather, the language impairment of these children appears to reflect their primary inability to analyze the rapid stream of acoustic information which characterizes speech and is essential to normal speech perception and language development.

Aphasia↗

Otitis media, hearing sensitivity, and maternal responsiveness in relation to language during infancy.

The relation of otitis media with effusion (OME) and associated hearing loss to language and cognitive skills at 1 year of age was studied to determine whether OME-related hearing loss had a direct association with language and cognitive outcomes at 1 year of age or an indirect association with these outcomes, as mediated by the child-rearing environment. Subjects were 61 black infants attending community-based child care programs. The presence of OME was assessed biweekly from 6 to 12 months of age by otoscopy and tympanometry. Hearing was assessed with visual reinforcement audiometry when children were well and when ill with OME. Language and cognitive skills and the child-rearing environment at home and in child care were examined. The results indicated a modest correlation between hearing loss associated with OME and receptive language. However, the direct association between OME-related hearing loss and all the language and cognitive measures was negligible. Hearing loss had an indirect association with receptive and expressive language, cognitive development, and overall communication as mediated by child-rearing factors. That is, children with more frequent hearing loss tended to have less responsive mothers and home environments, and this association was linked to lower performance on the infant assessments.

Adult↗

Aetiology of hearing loss and other related factors versus language outcome after cochlear implantation in children.

OBJECTIVE: Cochlear implantation outcome in prelingually deafened children is highly variable. The objective of this study was to examine the relationship between the yearly improvements in speech and language scores after cochlear implantation in children, with the aetiology of the hearing loss and other related factors. METHODS: We reviewed the case notes of children with early onset (0-2 years) of hearing loss, who were implanted in their first decade of life between 1992 and 2000 in Great Ormond Street Children Hospital. We assessed the relationship between the improvement of the receptive language and speech scores, on each year after implantation, with the aetiology of hearing loss and with the presence of additional medical problems. RESULTS: Children with a syndromic diagnosis had lower speech and language improvement scores at years 4 and 5 after implantation than children with a hereditary-non syndromic or unknown diagnosis. Vision and vestibular problems were significant negative predictors for speech and language improvement scores. The disability score, i.e. an overall index of additional to the hearing loss problems, had a negative correlation with the speech and language improvement scores. CONCLUSIONS: The presence of a syndromic diagnosis, vision or vestibular problems, and the overall level of additional to the hearing loss problems, may be negative prognostic indicators for speech and language improvement after implantation.

Child, Preschool↗

The neurobiology of language and verbal memory: observations from awake neurosurgery.

Neurosurgical operations under local anesthesia provide a unique opportunity to investigate the neurobiology of human cognition. We have studied the cortical organization of language and verbal memory in this setting, using two different techniques: electrical stimulation mapping and extracellular microelectrode recording of activity of individual neurons. The two techniques provide very different perspectives. Stimulation mapping identifies brain areas that are essential for a behavior, while changes in neuronal activity can occur in non-essential regions. Stimulation mapping identifies multiple discrete areas in perisylvian cortex of the dominant hemisphere as essential for a function, with separation of areas for different aspects of language including naming in two languages, different semantic classes, naming compared to reading, and language from verbal memory. There is substantial individual variation in the location of these essential areas, variability that in part relates to subjects age, gender and verbal abilities. Neurons changing activity with language or verbal memory are widely distributed, in both hemispheres. However, individual neurons usually change activity with only one function, including naming in only one of two languages, only naming or reading, or with recent verbal memory encoding but not identification of similar items. A few lateralized changes in neuronal activity have been identified, including a predominance of inhibition in dominant hemisphere with naming, and polymodal memory responses in dominant hemisphere, unimodal in nondominant. Specific neuronal populations have been identified that are related to different aspects of memory, that differentiate correct from incorrect identification or memory performance and differentiate learned from unlearned associations, with some evidence of differences in neuronal activity related to subjects' ability.

Animals↗

Language following functional left hemispherectomy in a bilingual teenager.

A detailed language assessment was conducted with MM, a 17-year-old bilingual teenager with Rasmussen syndrome who had undergone a left functional hemispherectomy. Results revealed important deficits in French and English, affecting expressive and receptive language in both the written and the oral modality. MM's linguistic profile was coherent with previous description of language function following left hemispherectomy, and what is known of the linguistic potential of the right hemisphere (RH). The impairment pattern showed overall similarities between French and English, thus supporting the existence of a common underlying system for these two languages. However, the profiles in each language were not identical, implying that distinct subsystems may also be at play. These findings support previous descriptions of acquired language impairments and recovery in bilingual individuals.

Adolescent↗

Language therapy for pure word deafness in children.--A case report.

A follow-up study has been made on a girl with pure word deafness, the onset of which was surmised to be when she was nearly four years old. In the present paper, a course of language therapy for the patient during the period from five years and three months to seven years and five months was presented and the advantage of the training program using written language as a communicaiton modality was described. The program has been employed for language training of deaf children in the authors' hospital. During the course of the training, improvement in comprehension and expression was noted as far as the cards with written words were concerned, but the patient continued to have limited ability in auditory perception even at the end of the training period and never regained usable language ability by speech. It was suggested that the language difficulty in this particular case was due to the lesions in the bilateral temporal lobes. We discuss the relation between prognosis of this disability and language therapy.

Aphasia↗

What contributions do languages other than English make on the results of meta-analyses?

Including only a portion of all available evidence may introduce systematic errors into the meta-analytic process and threaten its validity. We set out to examine whether language restricted meta-analyses, compared to language inclusive meta-analyses, provide different estimates of the effectiveness of interventions evaluated in randomized trials. We identified and retrieved all 79 meta-analyses from several disease areas in which explicit eligibility criteria regarding trial selection were reported. General characteristics and quality of reporting of the meta-analyses were assessed using a validated instrument. We explored the effects of language of publication of the randomized trials on the quantitative results using logistic regression analyses. Language restricted meta-analyses, compared to language inclusive meta-analyses, did not differ with respect to the estimate of benefit of the effectiveness of an intervention (ROR = 0.98; 95% CI: 0.81-1.17). These results were also robust after a series of sensitivity analyses. This study provides no evidence that language restricted meta-analyses lead to biased estimates of intervention effectiveness. We encourage others to replicate this study using different sampling frames, clinical topics and interventions.

Humans↗

The GRAIL concept modelling language for medical terminology.

The GALEN representation and integration language (GRAIL) has been developed to support effective clinical user interfaces and extensible re-usable models of medical terminology. It has been used successfully to develop the prototype GALEN common reference (CORE) model for medical terminology and for a series of projects in clinical user interfaces within the GALEN and PEN&PAD projects. GRAIL is a description logic or frame language with novel features to support part-whole and other transitive relations and to support the GALEN modelling style aimed at re-use and application independence. GRAIL began as an experimental language. However, it has clarified many requirements for an effective knowledge representation language for clinical concepts. It still has numerous limitations despite its practical successes. The GRAIL experience is expected to form the basis for future languages which meet the same requirements but have greater expressiveness and more soundly based semantics. This paper provides a description and motivation for the GRAIL language and gives examples of the modelling paradigm which it supports.

Artificial Intelligence↗

Neural organization and plasticity of language.

Powerful advances in neuroimaging techniques have added to and refined classical descriptions of the neurobiology of language in adults. Recent studies have employed these methodologies to study the nature and extent of plasticity of language-relevant aspects of cerebral organization in adults, in early and late bilinguals and in people who have acquired language through different modalities. Studies of children have documented dynamic shifts in cerebral organization over the course of language acquisition. Each of these different approaches has revealed constraints on the identity of the neural systems that mediate language; these studies have also described the marked and specific effects of language experience on the organization of these systems.

Adult↗

Language lateralization in patients with temporal lobe epilepsy: a comparison of functional transcranial Doppler sonography and the Wada test.

This study prospectively investigates whether noninvasive functional transcranial Doppler sonography (fTCD) is a useful tool to determine hemispheric language lateralization in the presurgical evaluation of patients with medically intractable temporal lobe epilepsy (TLE). fTCD results were compared with the Wada test as the gold standard. Wada test and fTCD were performed in 13 patients suffering from TLE. fTCD continuously measured blood flow velocities in both middle cerebral arteries, while the patient was performing a cued word generation task. During the Wada test, spontaneous speech, comprehension, reading, naming, and repetition were investigated. A laterality index (LI) was obtained by both procedures. Due to a lack of an acoustic temporal bone window, fTCD could not be performed in two patients (15%). In 9 of the remaining 11 patients hemispheric language dominance was found on the left side, in 1 patient on the right side, and 1 patient showed bihemispheric language representation. In all patients fTCD and the Wada test were in good agreement regarding hemispheric language lateralization, and the LI of both techniques were highly correlated (r = 0.776, P = 0.005). fTCD gives predictions of hemispheric language dominance consistent with the Wada test results even in children, patients with low IQ, and nonnative speakers. It is an alternative to the Wada test in determining language lateralization in patients with temporal lobe epilepsy.

Adolescent↗

Severe falciparum malaria and acquired childhood language disorder.

Language disorders have been reported after severe falciparum malaria but the deficits have not been described in detail. We assessed language outcome in three groups of children aged 6 to 9 years (n=487): those previously admitted to Kilifi District Hospital, Kenya, with cerebral malaria (CM; n=152; mean age 7y 4 mo [SD 1y 1mo]; 77 males, 75 females); or those with malaria and complicated seizures (M/S; n=156; mean age 7y 4mo [SD 1y 2mo]; 72 males, 84 females); and those unexposed to either condition (n=179; mean age 7y 6mo [SD 1y 1mo]; 93 males, 86 females). Median age at hospital admission was 28 months (interquartile range [IQR] 19 to 44 mo) among children with a history of CM and 23 months (IQR 12 to 35mo) among children with a history of M/S. A battery of eight assessments covering the major facets of speech and language was used to measure language performance. Cognitive performance, neurological/motor skills, behaviour, hearing, and vision were also measured. Eighteen (11.8%) of the CM group, 14 (9%) of the M/S group, and four (2.2%) of the unexposed group were found to have a language impairment. CM (odds ratio 3.68, 95% confidence interval 1.09 to 12.4, p=0.04) was associated with significantly increased odds of an impairment-level score relative to the unexposed group. The results suggest that falciparum malaria is one of the most common causes of acquired language disorders in the tropics.

Child↗

Processes in language acquisition: the roles of gender, attention, and maternal encouragement of attention over time.

This longitudinal study including 87 infant-mother dyads examined the relation between infant temperamental attention, maternal encouragement of attention, language, and the effects of gender. At ages 0;4, 0;8, and 1;0, global attention was assessed from Rothbart's (1981) IBQ; manipulative exploration was assessed with the Bayley (1969) IBR; and maternal verbal, visual and physical encouragement of attention were coded from 5 minutes of mother-infant free-play. At 1;0, language was measured using language items from the Bayley Mental Scale and parent-report items from Hendrick, Prather & Tobin's (1984) SICD-Revised. Multiple regressions indicated that gender, infants' manipulative exploration and maternal physical encouragement of attention at 0;4, and maternal verbal encouragement of attention at 1;0, were all positively related to language at 1;0. Interactions indicated that girls high in 0;8 or 1;0 manipulative exploration had more advanced language skills than girls low in manipulative exploration or than boys, regardless of their attention level. Additionally, maternal verbal encouragement of attention appears to be particularly salient in the development of language for boys.

Attention↗

The dissolution of language in Alzheimer's disease.

Language impairment in Alzheimer's disease has become an important clinical issue. It has been recognized for some time that the disease may begin with aphasia and even before frank aphasia develops, some of the earliest changes in a large number of individuals consist of impairment of word fluency and semantic access manifesting itself in word finding difficulty. The second major issue concerning language in Alzheimer's disease is that the cases which have early severe language impairment may represent a more progressive familial variety of disease as it has been suggested in the literature. This is still subject to controversy. Finally, it will be documented that the later stage of the disease shows language invariably impaired and goes through stages of dissolution that resemble anomic, transcortical sensory. Wernicke's and global aphasias. Accurate assessment of language may turn out to be one of the most reliable predictors of the stages of Alzheimer's disease and provides important insights into the cerebral organization of language, semantic access, relationship of semantic and episodic memory and the pathophysiology of the disease.

Alzheimer Disease↗

Conceptual clusters in figurative language production.

Although most prior research on figurative language examines comprehension, several recent studies on the production of such language have proved to be informative. One of the most noticeable traits of figurative language production is that it is produced at a somewhat random rate with occasional bursts of highly figurative speech (e.g., Corts & Pollio, 1999). The present article seeks to extend these findings by observing production during speech that involves a very high base rate of figurative language, making statistically defined bursts difficult to detect. In an analysis of three Baptist sermons, burst-like clusters of figurative language were identified. Further study indicated that these clusters largely involve a central root metaphor that represents the topic under consideration. An interaction of the coherence, along with a conceptual understanding of a topic and the relative importance of the topic to the purpose of the speech, is offered as the most likely explanation for the clustering of figurative language in natural speech.

Cluster Analysis↗

[The cochlear implant--evolution of hearing and language with an artificial inner ear].

One of the most spectacular progresses in modern medicine is the possibility to replace a deaf ear, a sensory organ in total by an implantable electronic prosthesis, a so-called cochlear implant (CI). The CI stimulates the auditory nerve by electrical pulses and thus generates the sensation of hearing along the auditory pathway. One of the most impressive aspects of cochlear implantation is the fact that small children with profound deafness who were able a few years ago to learn spoken language only to very limited extent may achieve nowadays an almost normal language development. Duration and intensity of the training of listening and spoken language vary considerably as a function of etiology and time of deafness. Most important for the development of language is sufficient stimulation of the auditory pathway during early childhood. Early diagnosis of a severe to profound deafness is most important in order to fit hearing aids or a cochlear implant without a time delay. Affected children need intensive training by professionals specialized in education and speech therapy. Adults and adolescents who lost their hearing when language acquisition was established may understand spoken language only a few weeks after receiving a cochlear implant. Several individuals are able to use the telephone. Preliminary results after bilateral cochlear implantation of children and adults show advantages. Not only do these subjects report "better hearing with two CI as compared to hearing with one CI," but some of them developed directional hearing in a rather short time lag after fitting the second implant. And in addition they achieve better speech discrimination in environmental noise.

Adolescent↗

Language-naive chimpanzees (Pan troglodytes) judge relations between relations in a conceptual matching-to-sample task.

Three chimpanzees with a history of conditional and numeric token training spontaneously matched relations between relations under conditions of nondifferential reinforcement. Heretofore, this conceptual ability was demonstrated only in language-trained chimpanzees. The performance levels of the language-naive animals in this study, however, were equivalent to those of a 4th animal--Sarah--whose history included language training and analogical problem solving. There was no evidence that associative factors mediated successful performance in any of the animals. Prior claims of a profound disparity between language-trained and language-naive chimpanzees apparently can be attributed to prior experience with arbitrary tokens consistently associated with abstract relations and not language per se.

Animals↗

Lexical selection in bilingual speech production does not involve language suppression.

The "hard problem" in bilingual lexical access arises when translation-equivalent lexical representations are activated to roughly equal levels and, thus, compete equally for lexical selection. The language suppression hypothesis (D. W. Green, 1998) solves this hard problem through the suppression of lexical representations in the nontarget language. Following from this proposal is the prediction that lexical selection should take longer on a language switch trial because the to-be-selected representation was just suppressed on the previous trial. Inconsistent with this prediction, participants took no longer to name pictures in their dominant language on language switch trials than they did on nonswitch trials. These findings indicate that nontarget lexical representations are not suppressed. The authors suggest that these results undermine the viability of the language suppression hypothesis as a possible solution to the hard problem in bilingual lexical access.

Adolescent↗

Language trees support the express-train sequence of Austronesian expansion.

Languages, like molecules, document evolutionary history. Darwin observed that evolutionary change in languages greatly resembled the processes of biological evolution: inheritance from a common ancestor and convergent evolution operate in both. Despite many suggestions, few attempts have been made to apply the phylogenetic methods used in biology to linguistic data. Here we report a parsimony analysis of a large language data set. We use this analysis to test competing hypotheses--the "express-train" and the "entangled-bank" models--for the colonization of the Pacific by Austronesian-speaking peoples. The parsimony analysis of a matrix of 77 Austronesian languages with 5,185 lexical items produced a single most-parsimonious tree. The express-train model was converted into an ordered geographical character and mapped onto the language tree. We found that the topology of the language tree was highly compatible with the express-train model.

Archaeology↗