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PubMed2005

Second language interferes with word production in fluent bilinguals: brain potential and functional imaging evidence.

Bilingual individuals need effective mechanisms to prevent interference between their languages. Using event-related brain potentials (ERPs) and functional magnetic resonance imaging (fMRI), we present evidence for interference of phonological information from the nontarget language in German-Spanish bilinguals. A tacit picture-naming task was used in which bilinguals and monolinguals had to make speeded responses based on the first letter of the picture's name in the target language. In one condition, subjects were required to respond when the name began with a vowel and to withhold a response if it started with a consonant. Stimuli had been selected such that in half of the trials, the names in both languages necessitated the same response, whereas in the other half, responses were different for the two languages. For the bilinguals, the language in which the stimuli had to be named was changed after each block. Bilinguals showed phonological interference compared with monolingual performance, which was evident in their performance, ERPs, and fMRI patterns. Nonlanguagespecific brain areas such as the left middle prefrontal cortex were found to be crucial for the control of interference.

Adult↗
PubMed1999

Sign-language interpretation in psychotherapy with deaf patients.

Sporadic encounters with deaf patients seeking psychotherapy present a challenge to general clinicians outside of specialized services for the deaf. Skills for working with people who do not share one's own language mode and culture are not routinely taught in most training programs, so clinicians may be unprepared when they first encounter a deaf patient. While it would be ideal to be able to match deaf patients with therapists fluent in their preferred language mode, this is often not feasible in smaller centers. Working with a trained professional sign-language interpreter can be a productive alternative, as long as patient, therapist, and interpreter understand and are comfortable with the process. Peer-reviewed literature on sign language interpretation in psychotherapy is sparse, but some practical guidelines can be gleaned from it and supplemented by information provided by the deaf community through the Internet. This paper arose from one psychiatric resident's first experience of psychotherapy working with a sign-language interpreter, and summarizes the literature search that resulted from a quest for understanding of deaf culture and experience, of the unique characteristics of sign language, and of the effects on the therapeutic relationship of the presence of the interpreter.

Adult↗
PubMed1980

Some prelinguistic aspects of language development.

Most studies of language acquisition since Chomsky's break-through in linguistics have all utilized as a theoretical base various theories of cognitive development out of which words, phrases, and meanings are created. This study attempts to outline the underpinnings of language ontogenetically and to show the role of affective engagements with caretakers. Some of the prelinguistic aspects of language development are examined in relation to the volution of language function. The newborn infant engages and terminates visual, kinesthetic, oral, and sound reciprocity with the mother, as shown in the cough-smile game, thus providing the infant a significant measure of control over these reciprocal exchanges. The social smile, modulations thereof, and the face itself become organizers of meaningful vocalization, a focal point around which phonemes emerge from the mutuality of the mother-infant relationship. The evolution and meaning of the pointing gesture as it relates to language functioning and to the stages of separation-individuation is discussed. It is suggested that the child's capacity to evaluate the context of utterances in relation to dynamically integrated facial-vocal configurations with familiar caretakers provides the basis for the development of semantics and syntax in later language functioning.

Child↗
PubMedDate not supplied

Effectiveness of Spanish intervention for first-grade English language learners at risk for reading difficulties.

The effectiveness of an explicit, systematic reading intervention for first-grade students whose home language was Spanish and who were at risk for reading difficulties was examined. Participants were 69 students in 20 classrooms in 7 schools from 3 districts who initially did not pass the screening in Spanish and were randomly assigned within schools to a treatment or comparison group; after 7 months, 64 students remained in the study. The intervention matched the language of instruction of their core reading program (Spanish). Treatment groups of 3 to 5 students met daily for 50 min and were provided systematic and explicit instruction in oral language and reading by trained bilingual intervention teachers. Comparison students received the school's standard intervention for struggling readers. Observations during core reading instruction provided information about the reading instruction and language use of the teachers. There were no differences between the treatment and comparison groups in either Spanish or English on any measures at pretest, but there were significant posttest differences in favor of the treatment group for the following outcomes in Spanish: Letter-Sound Identification (d = 0.72), Phonological Awareness composite (d = 0.73), Woodcock Language Proficiency Battery-Revised Oral Language composite (d = 0.35), Word Attack (d = 0.85), Passage Comprehension (d = 0.55), and two measures of reading fluency (d = 0.58-0.75).

Child↗
PubMed1998

Current trends in laryngectomy rehabilitation: a survey of speech-language pathologists.

This study determined the perceptions of experienced speech-language pathologists regarding current practices in the speech rehabilitation of laryngectomy patients since the introduction of the tracheoesophageal puncture-voice prosthesis technique in 1980. The sample population consisted of 151 experienced speech-language pathologists, or 43% of those who were sent questionnaires. The speech-language pathologists ranked tracheoesophageal puncture-voice prosthesis as their most preferred speech rehabilitation method and the electrolarynx as their least preferred, even though the electrolarynx continues to be the most frequently used method. Variable use of the tracheoesophageal puncture procedure by otolaryngologists was reported, with only a small portion perceived as using it routinely. About 65% of the speech-language pathologists reported that more than half of the laryngectomy patients were being given choices among speech rehabilitation methods. Nearly 50% of the speech-language pathologists reported that fewer than six speech therapy sessions were necessary with tracheoesophageal puncture patients, whereas more than 20% reported the need for 10 sessions or more. Use of manual closure of the tracheostoma by tracheoesophageal puncture patients far outweighed their use of automatic speaking valves. Most speech-language pathologists reported that they were involved in teams with otolaryngologists to determine patient suitability for tracheoesophageal puncture and to troubleshoot problems. Eighteen different categories of medical and speech production problems were reported.

Equipment Failure↗
PubMed2000

Growth patterns among infants with language deficits: a case-control study.

We compared growth parameters in infants with language delay to those in children with global delay and to typical controls. Thirty infants with expressive language delay and 36 with combined expressive and receptive language delay were compared with 27 infants with general development delay and with 124 controls. Data on weight, height, head circumference, and feeding behavior were obtained from birth up to age 78 weeks, and converted to percentiles. Medical and sociodemographic data were also evaluated. The weight curves in the combined expressive and receptive language delay group were significantly lower than in the comparison groups, but no cases of failure to thrive were noted. Height and head circumference curves in the combined expressive and receptive language delay group were also lower than in the typical controls. Infants with combined expressive and receptive language delay were lighter and shorter than controls. However, none of the parameters were more than two standard deviations below the mean. It is possible that this finding is of constitutional origin.

Body Height↗
PubMed2005

Correlation of Functional Independence Measure for Children (WeeFIM) with developmental language tests in children with developmental delay.

The Functional Independence Measure for Children (WeeFIM) is a simple tool for assessing the functional independence of three domains: mobility, self-care, and cognition. Children are usually apprehensive about performing standardized structured language or developmental tests, and only licensed professionals can administer standardized tests. We attempted to apply the Functional Independence Measure for Children for assessing children with developmental delay and to assess for any correlation of these scores with standardized language tests. We recruited 49 children with developmental delay, and the Functional Independence Measure for Children was administered. Two standardized language tests (Symbolic Play Test and Reynell Language Developmental Scale) were administered to assess language age. There was a significant correlation between Functional Independence Measure for Children scores with both verbal comprehension age and verbal expression age. There was no correlation of Functional Independence Measure for Children scores with gender, age, or having domestic helpers. Having trained staff administer the Functional Independence Measure for Children can reliably correlate the current language ability of a child with developmental delay; thus, the test can be used as a quick screening tool for targeted training.

Activities of Daily Living↗
PubMed1992

Language acculturation and screening practices of elderly Hispanic women. The role of exposure to health-related information from the media.

The present study examined the hypothesis that language acculturation of Hispanics in the United States increases their exposure to media-based health information which, in turn, increases medical screening practices and knowledge of cancer symptoms. We interviewed 598 elderly Hispanic women (55-92 years of age) residing in Los Angeles. Language acculturation was measured with items on understanding of English and language preference for interpersonal communication, reading materials, television, and radio. Recency of screening (physician breast exam, Pap smear, routine physical exam, mammogram) and exposure to media-based health information were assessed with Likert-type scales; knowledge of symptoms of breast, cervical, colorectal, and oral cancers was assessed through open-ended questions. The results of multiple regression analyses provide support for the hypothesis. First, language acculturation predicted media exposure after controlling for demographic variables. Second, media exposure predicted screening and symptom knowledge after controlling for language acculturation and the demographic factors. The findings suggest that cancer prevention programs should use Spanish-language media to reach a wider Hispanic audience, especially those who are monolingual.

Acculturation↗
PubMed2004

Intensive language training enhances brain plasticity in chronic aphasia.

BACKGROUND: Focal clusters of slow wave activity in the delta frequency range (1-4 Hz), as measured by magnetencephalography (MEG), are usually located in the vicinity of structural damage in the brain. Such oscillations are usually considered pathological and indicative of areas incapable of normal functioning owing to deafferentation from relevant input sources. In the present study we investigated the change in Delta Dipole Density in 28 patients with chronic aphasia (>12 months post onset) following cerebrovascular stroke of the left hemisphere before and after intensive speech and language therapy (3 hours/day over 2 weeks). RESULTS: Neuropsychologically assessed language functions improved significantly after training. Perilesional delta activity decreased after therapy in 16 of the 28 patients, while an increase was evident in 12 patients. The magnitude of change of delta activity in these areas correlated with the amount of change in language functions as measured by standardized language tests. CONCLUSIONS: These results emphasize the significance of perilesional areas in the rehabilitation of aphasia even years after the stroke, and might reflect reorganisation of the language network that provides the basis for improved language functions after intensive training.

Adult↗
PubMed2000

Bone lead levels and language processing performance.

The relation between bone lead absorption and language processing abilities in 156 randomly selected 11- to 14-year-old boys who were asymptomatic for lead toxicity is examined. Tibial lead concentrations were measured by X-ray fluorescence spectroscopy. The language processing outcome variables consisted of the least and most difficult subtests from the Nonword Repetition Task, Competing Language Processing Task, and the Revised Token Test. Participants were classified by quartiles according to bone lead concentrations, and analysis of variance and analysis of covariance measured the impact on language processing scores. Results showed that children in the highest bone lead quartile displayed decreased language processing performance on the most difficult language processing tasks but not on the easier tasks.

Adolescent↗
PubMed2002

Face encoding and psychometric testing in healthy dextrals with right hemisphere language.

OBJECTIVE: To document how right hemisphere language dominance in neurologically normal right-handed individuals affects lateralization of face encoding and level of performance in neuropsychological tests. METHODS: Three healthy right-handed adults with predominantly right hemisphere language activation during single-word or sentence-level processing were identified from 210 consecutive right-handed subjects studied using blood oxygenation level-dependent contrast fMRI. These three study subjects (S1 to S3) underwent a second scanning session where they performed word and face encoding. Their functional scans were contrasted with those obtained from six healthy control subjects (C1 to C6) with left hemisphere language dominance. Psychometric tests were performed on the study subjects. RESULTS: Right hemisphere-dominant language activation was reproduced in the second scanning session in the three study subjects. The extent to which the lateralization of face encoding was reversed varied. Right hemisphere language was associated with lower (but within normal) verbal IQ compared with performance IQ in two of three volunteers. Verbal and nonverbal memory scores were normal and did not differ appreciably. CONCLUSION: Right hemisphere-dominant language in healthy dextrals exists but is rare. The extent to which face encoding is reversed in these individuals is variable. Cognitive function does not appear to be significantly compromised even though some psychometric test scores are asymmetric in favor of nonverbal performance when the reversal of lateralization of face and word memory is not complete.

Adult↗
PubMed2000

Activation of language cortex with automatic speech tasks.

OBJECTIVE: To identify automatic speech tasks that reliably demonstrate increased regional cerebral blood flow (rCBF) in Broca's and Wernicke's areas of the cortex using PET. BACKGROUND: Localizing language with direct cortical stimulation mapping requires that patients have a stable baseline on tests that engage eloquent cortex. For dysphasic patients or younger children, automatic speech tasks such as counting are often used in lieu of more complex language tests. Evidence from both lesion and neuroimaging studies suggests that these tasks may not adequately engage language cortices. In this study, we examined rCBF during automatic oromotor and speech tasks of varying complexity to identify those eliciting increased CBF in Broca's and Wernicke's areas. METHODS: Eight normal volunteers underwent PET during rest, tongue movements, and three automatic speech tasks: repeating a phoneme sequence, repeating the months of the year, and reciting a memorized prose passage. Images were averaged across subjects and compared across tasks for regional localization and laterality. RESULTS: Whereas all activation tasks produced increased relative CBF in brain regions that correlated with articulation and auditory processing, only the two tasks that used real words (versus phonemes) showed left-lateralized rCBF increases in posterior superior temporal lobe (Wernicke's area), and only the prose repetition task produced left lateralized activity in Broca's area. CONCLUSIONS: Whereas automatic speech typically does not engage language cortex, repeating a memorized prose passage showed unambiguous activation in both Broca's and Wernicke's areas. These results caution against the use of common automatic speech tasks for mapping eloquent cortex and suggest an alternative task for those with poor language abilities or acquired dysphasia who cannot perform standardized language tests reliably.

Adult↗
PubMed2002

Language dominance in partial epilepsy patients identified with an fMRI reading task.

BACKGROUND: fMRI language tasks readily identify frontal language areas; temporal activation has been less consistent. No studies have compared clinical visual judgment to quantitative region of interest (ROI) analysis. OBJECTIVE: To identify temporal language areas in patients with partial epilepsy using a reading paradigm with clinical and ROI interpretation. METHODS: Thirty patients with temporal lobe epilepsy, aged 8 to 56 years, had 1.5-T fMRI. Patients silently named an object described by a sentence compared to a visual control. Data were analyzed with ROI analysis from t-maps. Regional asymmetry indices (AI) were calculated ([L-R]/[L+R]) and language dominance defined as >0.20. t-Maps were visually rated by three readers at three t thresholds. Twenty-one patients had intracarotid amobarbital test (IAT). RESULTS: The fMRI reading task provided evidence of language lateralization in 27 of 30 patients with ROI analysis. Twenty-five were left dominant, two right, one bilateral, and two were nondiagnostic; IAT and fMRI agreed in most patients, three had partial agreement, none overtly disagreed. Interrater agreement ranged between 0.77 to 0.82 (Cramer V; p < 0.0001); agreement between visual and ROI reading with IAT was 0.71 to 0.77 (Cramer V; p < 0.0001). Viewing data at lower thresholds added interpretation to 12 patients on visual analysis and 8 with ROI analysis. CONCLUSIONS: An fMRI reading paradigm can identify language dominance in frontal and temporal areas. Clinical visual interpretation is comparable to quantitative ROI analysis.

Adolescent↗
PubMed2003

Visual, cognitive, and language assessments at 39 months: a follow-up study of children fed formulas containing long-chain polyunsaturated fatty acids to 1 year of age.

OBJECTIVE: Docosahexaenoic acid (DHA) and arachidonic acid (ARA) are long-chain polyunsaturated fatty acids found in breast milk and recently added to infant formulas. Their importance in infant nutrition was recognized by the rapid accretion of these fatty acids in the brain during the first postnatal year, reports of enhanced intellectual development in breastfed children, and recognition of the physiologic importance of DHA in visual and neural systems from studies in animal models. These considerations led to clinical trials to evaluate whether infant formulas that are supplemented with DHA or both DHA and ARA would enhance visual and cognitive development or whether conversion of linoleic acid and alpha-linolenic acid, the essential fatty acid precursors of ARA and DHA, respectively, at the levels found in infant formulas is sufficient to support adequately visual and cognitive development. Visual and cognitive development were not different with supplementation in some studies, whereas other studies reported benefits of adding DHA or both DHA and ARA to formula. One of the first trials with term infants that were fed formula supplemented with DHA or both DHA and ARA evaluated growth, visual acuity (Visual Evoked Potential; Acuity Card Procedure), mental and motor development (Bayley Scales of Infant Development), and early language development (MacArthur Communicative Developmental Inventories). Growth, visual acuity, and mental and motor development were not different among the 3 formula groups or between the breastfed and formula-fed infants in the first year of life. At 14 months of age, infants who were fed the formula with DHA but no ARA had lower vocabulary production and comprehension scores than infants who were fed the unsupplemented control formula or who were breastfed, respectively. The present follow-up study evaluated IQ, receptive and expressive vocabulary, visual-motor function, and visual acuity of children from the original trial when they reached 39 months of age. METHODS: Infants were randomized within 1 week after birth and fed a control formula (n = 65), one containing DHA (n = 65), or one containing both ARA and DHA (n = 66) to 1 year of age. A comparison group (n = 80) was exclusively breastfed for at least 3 months after which the infants continued to be exclusively breastfed or were supplemented with and/or weaned to infant formula. At 39 months, standard tests of IQ (Stanford Binet IQ), receptive vocabulary (Peabody Picture Vocabulary Test-Revised), expressive vocabulary (mean length of utterance), visual-motor function (Beery Visual-Motor Index), and visual acuity (Acuity Card Procedure) were administered. Growth, red blood cell fatty acid levels, and morbidity also were evaluated. RESULTS: Results were analyzed using analysis of variance or linear regression models. The regression model for IQ, receptive and expressive language, and the visual-motor index controlled for site, birth weight, sex, maternal education, maternal age, and the child's age at testing. The regression model for visual acuity controlled for site only. A variable selection model also identified which of 22 potentially prognostic variables among different categories (feeding groups, the child and family demographics, indicators of illness since birth, and environment) were most influential for IQ and expressive vocabulary. A total of 157 (80%) of the 197 infants studied at 12 months participated in this follow-up study. Characteristics of the families were representative of US families with children up to 5 years of age, and there were no differences in the demographic or family characteristics among the randomized formula groups. As expected, the formula and breastfed groups differed in ethnicity, marital status, parental education, and the prevalence of smoking. Sex, ethnicity, gestational age at birth, and birth weight for those who participated at 39 months did not differ from those who did not. The 12-month Bayley mental and motor scores and 14-month vocabulary scores of the children who participated also were were not different from those who did not. At 39 months, IQ, receptive and expressive language, visual-motor function, and visual acuity were not different among the 3 randomized formula groups or between the breastfed and formula groups. The adjusted means for the control, ARA+DHA, DHA, and breastfed groups were as follows: IQ scores, 104, 101, 100, 106; Peabody Picture Vocabulary Test, 99.2, 97.2, 95.1, 97.4; mean length of utterance, 3.64, 3.75, 3.93, 4.08; the visual-motor index, 2.26, 2.24, 2.05, 2.40; and visual acuity (cycles/degree), 30.4, 27.9, 27.5, 28.6, respectively. IQ was positively associated with female sex and maternal education and negatively associated with the number of siblings and exposure to cigarette smoking in utero and/or postnatally. Expressive language also was positively associated with maternal education and negatively associated with the average hours in child care per week and hospitalizations since birth but only when the breastfed group was included in the analysis. The associations between maternal education and child IQ scores are consistent with previous reports as are the associations between prenatal exposure to cigarette smoke and IQ and early language development. Approximately one third of the variance for IQ was explained by sex, maternal education, the number of siblings, and exposure to cigarette smoke. Growth achievement, red blood cell fatty acid levels, and morbidity did not differ among groups. CONCLUSIONS: We reported previously that infants who were fed an unsupplemented formula or one with DHA or with both DHA and ARA through 12 months or were breastfed showed no differences in mental and motor development, but those who were fed DHA without ARA had lower vocabulary scores on a standardized, parent-report instrument at 14 months of age when compared with infants who were fed the unsupplemented formula or who were breastfed. When the infants were reassessed at 39 months using age-appropriate tests of receptive and expressive language as well as IQ, visual-motor function and visual acuity, no differences among the formula groups or between the formula and breastfed groups were found. The 14-month observation thus may have been a transient effect of DHA (without ARA) supplementation on early vocabulary development or may have occurred by chance. The absence of differences in growth achievement adds to the evidence that DHA with or without ARA supports normal growth in full-term infants. In conclusion, adding both DHA and ARA when supplementing infant formulas with long-chain polyunsaturated fatty acids supports visual and cognitive development through 39 months.

Arachidonic Acid↗
PubMed2005

Are language barriers associated with serious medical events in hospitalized pediatric patients?

OBJECTIVE: Language barriers may lead to medical errors by impeding patient-provider communication. The objective of this study was to determine whether hospitalized pediatric patients whose families have language barriers are more likely to incur serious medical errors than patients whose families do not have language barriers. METHODS: A case-control study was conducted in a large, academic, regional children's hospital in the Pacific Northwest. Case patients (n = 97) included all hospitalizations of patients who were younger than 21 years and had a reported serious medical event from January 1, 1998, to December 31, 2003. Control patients (n = 475) were chosen from hospitalizations without a reported serious medical event and were matched with case patients on age, admitting service, admission to intensive care, and date of admission. The main exposure was a language barrier defined by self- or provider-reported need for an interpreter. Serious medical events were defined as events that led to unintended or potentially adverse outcomes identified by the hospital's quality improvement staff. RESULTS: Fourteen (14.4%) of the case patients and 53 (11.2%) of the control patients were assigned an interpreter during their hospitalization. Overall, we found no increased risk for serious medical events in patients and families who requested an interpreter compared with patients and families who did not request an interpreter (odds ratio: 1.36; 95% confidence interval: 0.73-2.55). Spanish-speaking patients who requested an interpreter comprised 11 (11.3%) of the case patients and 26 (5.5%) of the control patients. This subgroup had a twofold increased risk for serious medical events compared with patients who did not request an interpreter (odds ratio: 2.26; 95% confidence interval: 1.06-4.81). CONCLUSIONS: Spanish-speaking patients whose families have a language barrier seem to have a significantly increased risk for serious medical events during pediatric hospitalization compared with patients whose families do not have a language barrier.

Adolescent↗
PubMed1988

Mothers' estimates of hearing family members' competence in sign language and the deaf child's loneliness.

This study examined the associations between mothers' estimates of both hearing family members' competence in sign language and their deaf child's loneliness. 32 mothers of children who functioned as deaf were asked to assess their hearing family members' competence in sign language and to complete the UCLA Loneliness Scale for an estimate of their deaf child's loneliness. Significant positive correlations were found among hearing family members' estimated competence in sign language; however, no significant correlations were found between hearing family members' estimated competence in sign language and their deaf child's estimated loneliness. These findings suggest that hearing members may contribute to each other's competence in sign language and may communicate with their deaf child through alternative methods rather than formal sign language.

Adolescent↗
PubMed2002

Unidimensionality of the Chinese version of the Foreign Language Reading Anxiety Scale.

Previous research showed the Foreign Language Reading Anxiety Scale is reliable and valid for assessing reading anxiety in groups of American college students beginning study of French, Japanese, or Russian. Because Saito, Horwitz, and Garza (1999) reported that reading anxiety tends to vary with the target language, the present investigation examined the factorial validity of the Chinese version of the scale in college students of English as a foreign language in Taiwan, Confirmatory factor analysis with maximum likelihood method supports the unidimensionality of the scale, which is reliable and valid for eliciting reading anxiety of Chinese college foreign language learners and for predicting their global language performance. This study suggests exploring how language proficiency, culture, and topic familiarity may be related to such anxiety.

Adult↗
PubMed2001

Language, cognition, and short-term memory in individuals with Down syndrome.

The developmentally emerging phenotype of language and cognition in individuals with Down syndrome is summarized on the basis of the project's prior work. Identified are a) the emerging divergence of expressive and receptive language, b) the emerging divergence of lexical and syntactic knowledge in each process, and c) the emerging divergence within cognitive skills of auditory short-term memory and visuospatial short-term memory from other visuospatial skills. Expressive syntax and auditory short-term memory are identified as areas of particular difficulty. Evidence for the continued acquisition of language skills in adolescence is presented. The role of the two components of working memory, auditory and visual, in language development is investigated in studies of narrative and longitudinal change in language skills. Predictors of individual differences during six years of language development are evaluated through hierarchical linear modelling. Chronological age, visuospatial short-term memory, and auditory-short term memory are identified as key predictors of performance at study entry, but not individual change over time, for expressive syntax. The same predictors account for variation in comprehension skill at study outset; and change over the six years can be predicted by chronological age and the change in visuospatial short-term memory skills.

Cognition Disorders↗