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PubMed2004

The impact of sex and language dominance on material-specific memory before and after left temporal lobe surgery.

Recent findings raised evidence that in early-onset left temporal lobe epilepsy, women show greater functional plasticity for verbal memory than men. In particular, women with lesion- or epilepsy-driven atypical language dominance show an advantage over men. The question asked in this study was whether there is evidence of sex- and language dominance-dependent late, i.e. adult age, plasticity for verbal memory when epilepsy surgery is performed in these patients. Pre- and 1-year postoperative memory performance was evaluated in 169 patients (94 males and 75 females) who underwent left temporal lobe surgery and who had WADA testing of hemispheric language dominance prior to surgery. Verbal memory and figural memory were assessed by list-learning paradigms. According to the Bonn intracarotid amobarbital test (IAT) protocol, patients were categorized into left dominant or atypically dominant (right, incomplete left or right, and bilateral dominant) groups. Results were controlled for the hypothesized sex differences. Thirty-four percent of men and 47% of women displayed patterns of atypical language dominance. Atypical dominance was related to an early onset of epilepsy. Men showed a larger time window for development of atypical dominance but, differently from women, the pattern of atypical dominance was more strictly determined by the age at onset of epilepsy. Atypically dominant women showed better verbal memory than typically dominant women or men. After surgery, right dominant patients had better verbal memory outcome than patients with bilateral or left language dominance who showed significant memory loss. No effect of sex on verbal memory change was found. Figural memory deteriorated in men and improved in women, when they were not left dominant. Seizure outcome had no effect on performance changes. It was concluded that better preserved verbal memory in atypically dominant women before surgery indicates greater benefit from atypical dominance in women than men with regard to the initial damage associated with left hemisphere epilepsy. Later in life, when epilepsy surgery causes additional damage, no such sex difference is observed, indicating that the women's advantage over men is fixed to an early time window in life. Postoperative changes in figural memory suggest dynamics in crowding and suppression patterns. Whether this reflects late plasticity and compensation needs further demonstration. For clinical practice, it is important to note that incomplete right hemisphere and bilateral language dominance do not protect against verbal memory loss after left-sided temporal lobe surgery.

Adult↗
PubMed2006

When language meets action: the neural integration of gesture and speech.

Although generally studied in isolation, language and action often co-occur in everyday life. Here we investigated one particular form of simultaneous language and action, namely speech and gestures that speakers use in everyday communication. In a functional magnetic resonance imaging study, we identified the neural networks involved in the integration of semantic information from speech and gestures. Verbal and/or gestural content could be integrated easily or less easily with the content of the preceding part of speech. Premotor areas involved in action observation (Brodmann area [BA] 6) were found to be specifically modulated by action information "mismatching" to a language context. Importantly, an increase in integration load of both verbal and gestural information into prior speech context activated Broca's area and adjacent cortex (BA 45/47). A classical language area, Broca's area, is not only recruited for language-internal processing but also when action observation is integrated with speech. These findings provide direct evidence that action and language processing share a high-level neural integration system.

Adult↗
PubMed2006

The psychotherapist and the sign language interpreter.

Specialized psychotherapy for deaf people in the Dutch and Western European mental health systems is still a rather young specialism. A key policy principle in Dutch mental health care for the deaf is that they should receive treatment in the language most accessible to them, which is usually Dutch Sign Language (Nederlandse Gebarentaal or NGT). Although psychotherapists for the deaf are trained to use sign language, situations will always arise in which a sign language interpreter is needed. Most psychotherapists have the opinion that working with a sign language interpreter in therapy sessions can be a valuable alternative option but also see it as a second-best solution because of its impact on the therapeutic process. This paper describes our years of collaborationship as a therapist and a sign language interpreter. If this collaborationship is optimal, it can generate a certain "therapeutic power" in the therapy sessions. Achieving this depends largely on the interplay between the therapist and the interpreter, which in our case is the result of literature research and our experiences during the last 17 years. We analyze this special collaborative relationship, which has several dimensions and recurrent themes like, the role conception of the interpreter, situational interpreting, organizing the interpretation setting, or managing therapeutic phenomena during therapy sessions.

Adolescent↗
PubMed1996

Language in dreaming and regional EEG alpha power.

In an intensive single-subject design, electroencephalographic (EEG) alpha power and receptive and expressive language in dreaming were studied in 12 dreams during rapid eye movement (REM) sleep on 12 separate nights. Bilateral EEG was recorded continuously from 21 sites and digitized. We used the Fast Fourier transformation (FFT) for power spectral analysis to measure EEG power in the alpha frequency range (8-12 Hz) at each of the EEG sites. The subject was awakened after about 14 minutes into the second REM period, and dream reports were collected. We scored the dream reports for expressive and receptive language. The lower the alpha power on the left sides of those homologous pairs that roughly correspond to Broca's (C3) or Wernicke's area (P3), the more expressive or receptive language in dream reports. The largest difference between the correlation of the left and that of the right homologous pair of regions was found in the central (C3, C4) area for expressive language and in the parietal (P3, P4) area for receptive language. Our finding suggests lateralized and localized cortical activation in relation to language in dreaming.

Adult↗
PubMed2005

Magnetoencephalography identifies rapid temporal processing deficit in autism and language impairment.

Deficient rapid temporal processing may contribute to impaired language development by interfering with the processing of brief acoustic transitions crucial for speech perception. Using magnetoencephalography, evoked neural activity (M50, M100) to two 40 ms tones passively presented in rapid succession was recorded in 10 neurologically normal adults and 40 8-17-year-olds with autism, specific language impairment, Asperger syndrome or typical development. While 80% of study participants with intact language (Asperger syndrome, typical development, adults) showed identifiable responses to the second tone, which presented rapid temporal processing demands, 65% of study participants with impaired language (autism, specific language impairment) did not, despite having shown identifiable responses to the first tone. Rapid temporal processing impairments may be fundamentally associated with impairments in language rather than autism spectrum disorder.

Acoustic Stimulation↗
PubMedDate not supplied

Language disorders and learning disabilities in school-refusing adolescents.

OBJECTIVE: We undertook this study to test the hypothesis that school-refusing adolescents hospitalized on an inpatient psychiatric unit have more language and learning disabilities than diagnosis-, age-, and sex-matched psychiatric controls. METHOD: The Woodcock-Johnson Tests of Achievement-Revised (WJTA-R), the WISC-R, the Adolescent Language Screening Test, the Clinical Evaluation of Language Fundamentals-Revised, and the Test of Language Competence (TLC) were given to a group of well-characterized, primarily depressed school refusers and matched psychiatric controls. RESULTS: We found that school-refusing adolescents had significantly lower WISC-R verbal intelligence scores, lower Math and Written Language subscale scores on the WJTA-R, and lower scores on the TLC than nonrefusers. School refusers were found to have a significantly higher incidence of both language impairments and learning disabilities than controls. CONCLUSIONS: We infer that academic and communicative frustration and the adolescent's resulting inability to meet the academic and social demands in the school environment may play a role in the etiology of school refusal.

Adolescent↗
PubMed1988

Language concordance as a determinant of patient compliance and emergency room use in patients with asthma.

To test the hypothesis that the ability of physicians to speak the same language as asthmatic patients promotes patient compliance and the use of scheduled office appointments in preference to emergency services, the charts of 96 Spanish-speaking patients with asthma were reviewed. Of these patients, 65 were cared for by seven Spanish-speaking bilingual physicians and 31 were cared for by 23 non-Spanish speaking physicians. Compared with patients with language concordant physicians, patients with language discordant physicians were only slightly more likely to omit medication, to miss office appointments, and to make at least one emergency room visit. Subgroup analysis showed that, with extended follow-up, patients cared for by a language discordant physician were more likely to omit medication (rate ratio: 3.24; p = 0.08), more likely to miss office appointments (rate ratio: 3.06; P = 0.01), and were slightly more likely to make an emergency room visit (rate ratio: 2.07; P = 0.12) than patients with language concordant physicians. Cox regression analyses taking account of differences in follow-up time, age, gender, pay-status, and severity of disease confirmed these findings. These data suggest that patient compliance and more cost-effective use of ambulatory care services may be associated with the ability of physicians to speak the same language as their patients.

Adult↗
PubMed2006

Language and length of stay in the pediatric emergency department.

BACKGROUND: Quality and accessibility of care for patients presenting to the emergency department (ED) can be limited if they cannot communicate in the same language as their health care provider. STUDY OBJECTIVES: We aimed to determine if children whose parents speak a primary language other than English have a longer length of stay (LOS) in the ED compared with English-speaking families. METHODS: We reviewed computerized ED records of age-matched English and 4 most common non-English languages in a tertiary pediatric hospital in Toronto, Canada. We randomly chose English-speaking families in a 3:1 ratio with non-English. We performed bivariate analyses and a multivariable linear regression to test the relationship between language, triage score, age, gender, day of the week, and diagnostic grouping. RESULTS: Out of 48,497 visits for 1 year, we included 6051 English-, 628 Spanish-, 486 Cantonese-, 486 Mandarin-, and 417 Tamil-speaking families. The average LOS was 3.86 and 3.95 hours for English and non-English-speaking patients, respectively (P > 0.05). Non-English speakers had lower acuity more frequently (P = 0.004) and arrived more over weekdays (P = 0.02). In the multivariate regression model, language, triage score, age, and gender were all significantly associated with LOS. Only 6% of the variance in LOS was explained by the regression model. CONCLUSIONS: Language, triage score, patient age, and gender are significantly associated with LOS in the ED. Among other interventions, securing ways to accommodate non-English-speaking health providers in the ED can possibly shorten the LOS and reduce nonacute visits to the ED.

Child, Preschool↗
PubMed2005

Functional magnetic resonance imaging for assessment of language and memory in clinical practice.

PURPOSE OF REVIEW: There has been considerable interest in the role that functional magnetic resonance imaging (fMRI) may play in the assessment of patients with epilepsy. This review considers recent progress in this field and the current role of fMRI in the preoperative assessment of language and memory function. RECENT FINDINGS: Many studies have compared fMRI with the intracarotid amytal test for establishing language dominance, with most showing over 90% concordance between the two tests. Atypical dominance is greater in patients with left temporal lobe epilepsy and has been shown to be associated with increased epileptic activity. Preoperative fMRI has been used to predict language deficits following left anterior temporal lobe resection. A variety of paradigms have been used to assess memory function, and novel paradigms have demonstrated robust medial temporal lobe activation. Different patterns of encoding activity have been observed between patients with unilateral temporal lobe epilepsy and control individuals. SUMMARY: The application of fMRI paradigms used in cognitive neuroscience to patients with epilepsy is complicated by several factors. Although fMRI is increasingly being used clinically to establish language dominance, further work is required to localize accurately those specific language functions that are most at risk following surgery. Memory paradigms are not yet validated for use in surgical planning, although methodological and technical advances should make this possible in the near future. Further studies looking at the reorganization of language and memory function after surgery are also required.

Epilepsy↗
PubMed2002

Bantu language trees reflect the spread of farming across sub-Saharan Africa: a maximum-parsimony analysis.

Linguistic divergence occurs after speech communities divide, in a process similar to speciation among isolated biological populations. The resulting languages are hierarchically related, like genes or species. Phylogenetic methods developed in evolutionary biology can thus be used to infer language trees, with the caveat that 'borrowing' of linguistic elements between languages also occurs, to some degree. Maximum-parsimony trees for 75 Bantu and Bantoid African languages were constructed using 92 items of basic vocabulary. The level of character fit on the trees was high (consistency index was 0.65), indicating that a tree model fits Bantu language evolution well, at least for the basic vocabulary. The Bantu language tree reflects the spread of farming across this part of sub-Saharan Africa between ca. 3000 BC and AD 500. Modern Bantu subgroups, defined by clades on parsimony trees, mirror the earliest farming traditions both geographically and temporally. This suggests that the major subgroups of modern Bantu stem from the Neolithic and Early Iron Age, with little subsequent movement by speech communities.

Africa South of the Sahara↗
PubMed2004

Biomechanical and perceptual constraints on the bandwidth requirements of sign language.

Access to telecommunication systems by deaf users of sign language can be greatly enhanced with the incorporation of video conferencing in addition to text-based adaptations. However, the communication channel bandwidth is often challenged by the spatial requirements to represent the image in each frame and temporal demands to preserve the movement trajectory with a sufficiently high frame rate. Effective systems must balance the portion of a limited channel bandwidth devoted to the quality of the individual frames and the frame rate in order to meet their intended needs. Conventional video conferencing technology generally addresses the limitations of channel capacity by drastically reducing the frame rate, while preserving image quality. This produces a jerky image that disturbs the trajectories of the hands and arms, which are essential in sign language. In contrast, a sign language communication system must provide a frame rate that is capable of representing the kinematic bandwidth of human movement. Prototype sign language communication systems often attempt to maintain a high frame rate by reducing the quality of the image with lossy spatial compression. Unfortunately, this still requires a combined spatial and temporal data rate, which exceeds the limited channel of residential and wireless telephony. While spatial compression techniques have been effective in reducing the data, there has been no comparable compression of sign language in the temporal domain. Even modest reductions in the frame rate introduce perceptually disturbing flicker that decreases intelligibility. This paper introduces a method through which temporal compression on the order of 5:1 can be achieved. This is accomplished by decoupling the biomechanical or kinematic bandwidth necessary to represent continuous movements in sign language from the perceptually determined critical flicker frequency.

Adult↗
PubMed2002

Auditory memory for backward masking signals in children with language impairment.

This study was designed to investigate early auditory memory and its possible contribution to an auditory processing deficit shown by some children with language impairment. Ten children with language impairment and 10 age-matched controls participated in a series of simultaneous and backward masking tasks. The same backward masking stimulus was then used to elicit a mismatch negativity response. In the behavioral conditions, children in the language impairment group had significantly higher (poorer) signal thresholds than their nonimpaired controls in backward masking, but their thresholds in simultaneous masking were not significantly different. In the mismatch-negativity conditions, latency was prolonged and the amplitude was diminished in the children with language impairment. Taken together, these psychoacoustic and electrophysiological data suggest that in a group of children with language impairment, underlying the nonsensory language disorder, there is a neurophysiological impairment in auditory memory for complex, nonlinguistic sounds.

Attention↗
PubMed2003

Race/ethnicity, language, and patients' assessments of care in Medicaid managed care.

OBJECTIVE: Consumer assessments of health care provide important information about how well health plans and clinicians meet the needs of the people they serve. The purpose of this study was to examine whether consumer reports and ratings of care in Medicaid managed care vary by race/ethnicity and language. DATA SOURCES: Data were derived from the National CAHPS Benchmarking Database (NCBD) 3.0 and consisted of 49,327 adults enrolled in Medicaid managed care plans in 14 states in 2000. DATA COLLECTION: The CAHPS data were collected by telephone and mail. Surveys were administered in Spanish and English. The response rate across plans was 38 percent. STUDY DESIGN: Data were analyzed using linear regression models. The dependent variables were CAHPS 2.0 global rating items (personal doctor, specialist, health care, health plan) and multi-item reports of care (getting needed care, timeliness of care, provider communication, staff helpfulness, plan service). The independent variables were race/ethnicity, language spoken at home (English, Spanish, Other), and survey language (English or Spanish). Survey respondents were assigned to one of nine racial/ethnic categories based on Hispanic ethnicity and race: White, Hispanic/Latino, Black/African American, Asian/Pacific Islanders, American Indian/Alaskan native, American Indian/White, Black/White, Other Multiracial, Other Race/Ethnicity. Whites, Asians, and Hispanics were further classified into language subgroups based on the survey language and based on the language primarily spoken at home. Covariates included gender, age, education, and self-rated health. PRINCIPAL FINDINGS: Racial/ethnic and linguistic minorities tended to report worse care than did whites. Linguistic minorities reported worse care than did racial and ethnic minorities. CONCLUSIONS: This study suggests that racial and ethnic minorities and persons with limited English proficiency face barriers to care, despite Medicaid-enabled financial access. Health care organizations should address the observed disparities in access to care for racial/ethnic and linguistic minorities as part of their quality improvement efforts.

Adult↗
PubMed2006

Infants show a facilitation effect for native language phonetic perception between 6 and 12 months.

Patterns of developmental change in phonetic perception are critical to theory development. Many previous studies document a decline in nonnative phonetic perception between 6 and 12 months of age. However, much less experimental attention has been paid to developmental change in native-language phonetic perception over the same time period. We hypothesized that language experience in the first year facilitates native-language phonetic performance between 6 and 12 months of age. We tested 6-8- and 10-12-month-old infants in the United States and Japan to examine native and nonnative patterns of developmental change using the American English /r-l/ contrast. The goals of the experiment were to: (a) determine whether facilitation characterizes native-language phonetic change between 6 and 12 months of age, (b) examine the decline previously observed for nonnative contrasts and (c) test directional asymmetries for consonants. The results show a significant increase in performance for the native-language contrast in the first year, a decline in nonnative perception over the same time period, and indicate directional asymmetries that are constant across age and culture. We argue that neural commitment to native-language phonetic properties explains the pattern of developmental change in the first year.

Age Factors↗
PubMedDate not supplied

Mother and infant talk about mental states relates to desire language and emotion understanding.

This study assessed the relation between mother mental state language and child desire language and emotion understanding in 15-24-month-olds. At both time points, mothers described pictures to their infants and mother talk was coded for mental and nonmental state language. Children were administered 2 emotion understanding tasks and their mental and nonmental state vocabulary levels were obtained via parental report. The results demonstrated that mother use of desire language with 15-month-old children uniquely predicted a child's later mental state language and emotion task performance, even after accounting for potentially confounding variables. In addition, mothers' tendency to refer to the child's over others' desires was the more consistent correlate of mental state language and emotion understanding.

Affect↗
PubMed2005

Reorganization of language-related neuronal networks in patients with left temporal lobe epilepsy - an fMRI study.

To investigate the inter- and intrahemispheric reorganization of the language cortex in left temporal lobe epilepsy (TLE) with left-sided hippocampal sclerosis. A functional magnetic resonance imaging was performed on 13 right-handed patients suffering from medically intractable left TLE, and in 13 sex- and age-matched healthy controls. The activation paradigm used was a silent word generation task. A language laterality index (LI) was calculated from the number of activated voxels in the right and left anterior two-thirds of the hemispheres. Significant differences between the patients and the controls were observed in the activation of the left-sided inferior frontal gyrus. Less consistent findings in this region, as well as the relative protection of Broca's area from the activation, were revealed in the patients. In addition, different patterns of activation were proven in the cerebellum and other cortical as well as subcortical brain structures within both hemispheres. Significant differences were also found in the values of the language LIs between the investigated groups: these values suggested a more bihemispheric language representation in the patients. As anticipated, lateralization of the language functions in the epileptics significantly decreased in connection with an earlier age of initial insult. Our results support the hypothesis of a significant intra- and interhemispheric functional reorganization of language-related neuronal networks in left TLE.

Adult↗
PubMed1988

Language development of low-birthweight infants at two years.

Fifty low-birthweight (LBW) and 18 fullterm normal infants were prospectively evaluated at eight months and two years of age for language development and neurodevelopmental status. The LBW cohort was divided into those who were appropriate for gestational age (AGA) (N = 35) and small for gestational age (SGA) (N = 15) to assess the effect of intra-uterine growth retardation on language development within a premature population. LBW SGA infants lagged significantly behind term infants in both receptive and expressive language, but to a lesser degree than LBW AGA infants. Multiple regression analyses of gestational age, Hollingshead socio-economic status score, and eight-month neurological score as independent variables, and the receptive and expressive language scores as dependent variables, indicated that these three predictor variables had a significant cumulative effect on language development. Language was delayed in 28 per cent of the LBW children at two years.

Brain Diseases↗
PubMed1989

Language and neurodevelopmental outcome of low-birthweight infants at three years.

Forty low-birthweight (LBW) infants (28 AGA, 12 SGA) and 16 fullterm infants have been followed for three years with neurological, developmental, language, behavior and audiometric assessments. Only two (5 per cent) of the LBW infants were neurologically abnormal at three years. The AGA infants continued to lag cognitively and in receptive language in comparison with the fullterm infants. Socio-economic factors had a significant effect on the language development of all three groups. Short gestation and neurological status at eight months continued to have a significant effect on language performance. A variety of behavioral characteristics correlated with cognitive and language scores, and impaired middle-ear status was associated with lower cognitive function. These data support the concept that language development of LBW infants is influenced by perinatal, neurological and socio-economic factors, and by behavioral characteristics and middle-ear status.

Child Behavior↗