Conferees meet April 22nd to negotiate HIV testing compromise language: provision unfairly penalizes high incidence states.
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AIDS Serodiagnosis↗
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Comparison of conversation, freeplay, and story generation as methods of language sample elicitation.
The spontaneous language sample forms an important part of the language evaluation protocol (M. Dunn, J. Flax, M. Sliwinski, and D. Aram, 1996; J. L. Evans and H. K. Craig, 1992; L. E. Evans and J. Miller, 1999) because of the limitations of standardized language tests and their unavailability in certain languages, such as Afrikaans. This study examined 3 methods of language elicitation, namely conversation (CV), freeplay (FP), and story generation (SG), on the following 5 measures to determine which method is best for clinical practice: number of utterances, variety of syntactic structures, mean length of the utterance (MLU), number of syntactic errors, and proportion of complex syntactic utterances as elicited from ten 5-year-old, Afrikaans-speaking boys. FP elicited significantly more utterances than did SG but elicited a smaller proportion of complex syntactic structures than did CV and SG. Furthermore, SG elicited longer utterances than did CV or FP. It is recommended that SG be used in clinical practice with 5-year-olds if the clinician wishes to observe maximum behavior. Where typical behavior is to be evaluated, the clinician can select a language elicitation method that best suits the client's personality and communication style, bearing in mind that FP does elicit a larger language sample.
Child, Preschool↗
Reliability of hearing-impaired children's responses to oral and total presentations of the Test of Auditory Comprehension of Language.
The Test of Auditory Comprehension of Language (TACL) (Carrow, 1973) was administered on two occasions to two groups of hearing-impaired children. The test was administered in the usual manner (face-to-face, spoken) to children who were being educated by oral methods. The test was also simultaneously spoken and signed to children who were being educated by total-communication methods. Reliability of responses was high for both groups (r = 0.96 for oral-aural and 0.90 for total-communication children) and error patterns were similar. The TACL appears to be an appropriate and reliable instrument for use with hearing-impaired children.
Auditory Perception↗
Psychometric review of language and articulation tests for preschool children.
Thirty language and articulation tests developed for use with preschool children were reviewed using ten psychometric criteria appropriate to norm-referenced tests. Half of the reviewed tests met no more than two criteria, and only three tests met over four criteria. Most frequently unmet criteria were those requiring empirical evidence of validity and reliability. Implications are drawn regarding the current status of norm-referenced language and articulation tests for preschool children.
Articulation Disorders↗
Spontaneous speech of patients with dementia of the Alzheimer type and mild cognitive impairment.
This article discusses the potential of three assessments of language function in the diagnosis of Alzheimer-type dementia (DAT). A total of 115 patients (mean age 65.9 years) attending a memory clinic were assessed using three language tests: a picture description task (Boston Cookie-Theft picture), the Boston Naming Test, and a semantic and phonemic word fluency measure. Results of these assessments were compared with those of clinical diagnosis including the Global Deterioration Scale (GDS). The patients were classified by ICD-10 diagnosis and GDS stage as without cognitive impairment (n = 40), mild cognitive impairment (n = 34), mild DAT (n = 21), and moderate to severe DAT (n = 20). Hypotheses were (a) that the complex task of a picture description could more readily identify language disturbances than specific language tests and that (b) examination of spontaneous speech could help to identify patients with even mild forms of DAT. In the picture description task, all diagnostic groups produced an equal number of words. However, patients with mild or moderate to severe DAT described significantly fewer objects and persons, actions, features, and localizations than patients without or with mild cognitive impairment. Persons with mild cognitive impairment had results similar to those without cognitive impairment. The Boston Naming Test and both fluency measures were superior to the picture description task in differentiating the diagnostic groups. In sum, both hypotheses had to be rejected. Our results confirm that DAT patients have distinct semantic speech disturbances whereas they are not impaired in the amount of produced speech.
Aged↗
Interrater reliability of the scoring of the screening test of adolescent language.
Group administrations of the Screening Test of Adolescent Language have been successful in identifying students with English-language problems among groups of university students who include many recent immigrants from southeastern Asia. However, scoring several items requires subjective judgement. Accordingly, interrater reliability was investigated by having two independent examiners score the written responses of 299 first-year medical students at two Australian universities. The examiners produced very similar distributions of total scores with means of 20.36 and 19.36 and achieved a high agreement in the categorisation of students with English problems. The Spearman rank-order correlation of 0.83 was high and statistically significant from zero.
Adolescent↗
Neurodevelopment of adopted children exposed in utero to cocaine.
OBJECTIVE: To assess the neurodevelopment of adopted children who had been exposed in utero to cocaine. DESIGN: A case-control observational study. PARTICIPANTS: Twenty-three children aged 14 months to 6.5 years exposed in utero to cocaine and their adoptive mothers, and 23 age-matched control children not exposed to cocaine and their mothers, matched with the adoptive mothers for IQ and socioeconomic status. SETTING: The Motherisk Programme at The Hospital for Sick Children, Toronto, a consultation service for chemical exposure during pregnancy. MAIN OUTCOME MEASURES: Height, weight and head circumference at birth and at follow-up, and achievement on standard tests of cognitive and language development. RESULTS: Compared with the control group, children exposed in utero to cocaine had an 8-fold increased risk for microcephaly (95% confidence interval 1.5 to 42.3); they also had a lower mean birth weight (p = 0.005) and a lower gestational age (p = 0.002). In follow-up the cocaine-exposed children caught up with the control subjects in weight and stature but not in head circumference (mean 31st percentile v. 63rd percentile) (p = 0.001). Although there were no significant differences between the two groups in global IQ, the cocaine-exposed children had significantly lower scores than the control subjects on the Reynell language test for both verbal comprehension (p = 0.003) and expressive language (p = 0.001). CONCLUSIONS: This is the first study to document that intrauterine exposure to cocaine is associated with measurable and clinically significant toxic neurologic effects, independent of postnatal home and environmental confounders. Because women who use cocaine during pregnancy almost invariably smoke cigarettes and often use alcohol, it is impossible to attribute the measured toxic effects to cocaine alone.
Adoption↗
Crossed aphasia. Functional brain imaging with PET or SPECT.
OBJECTIVES: To study patients with crossed aphasia (aphasia secondary to lesions in the right hemisphere in right-handed patients) with functional brain imaging using positron emission tomography (PET) or single photon emission computed tomography (SPECT); to see whether left hemisphere structures were metabolically depressed during the acute phase and, in 1 patient, during recovery; and to review the modern literature on crossed aphasia, with special reference to left hemisphere involvement. DESIGN: Case studies of 3 patients with crossed aphasia, including language testing, computed tomographic scanning, and functional imaging with PET or SPECT. SETTING: Hospital case studies. PATIENTS: Three right-handed patients with crossed aphasia secondary to acute infarctions in the right hemisphere and left hemiparesis. METHODS: All 3 patients were studied by means of bedside language testing, computed tomographic scanning, and functional brain imaging with PET or SPECT. Patient 1 also underwent serial testing with the Boston Diagnostic Aphasia Examination and follow-up PET scanning after 2 months of recovery. OUTCOME MEASURES: Clinical examination in all 3 patients and follow-up Boston Diagnostic Aphasia Examination and PET scanning in patient 1. RESULTS: Two patients had severe global aphasia and 1 had Broca aphasia. In all cases, computed tomographic scans failed to reveal any left hemispheric lesions. Functional imaging with PET or SPECT showed extensive hypometabolism or hypoperfusion in the right hemisphere, with initial reductions in the left hemisphere as well. In patient I, a follow-up PET image showed only persistent hypometabolism in the right hemisphere. CONCLUSIONS: These findings suggest that abnormal dominance for at least some language functions in the right hemisphere underlies the syndrome of crossed aphasia. Diaschisis, or functional depression of the anatomically normal left hemisphere, was seen in all 3 patients during the acute phase, but not in patient 1 after recovery had begun.
Aged↗
Matching words to concepts in two languages: a test of the concept mediation model of bilingual representation.
A categorization paradigm was used to investigate the relations between lexical and conceptual connections in bilingual memory. Fifty-one more fluent and less fluent English-French bilinguals viewed category names (e.g., vegetable) and then decided whether a target word (e.g., peas) was a member of that category. The category names and target words appeared in both English and French across experimental conditions. Because category matching requires access to conceptual memory, only relatively fluent bilinguals, who are able to directly access meaning for their second language, were expected to be able to use category information across languages. The performance of less-fluent bilinguals was expected to reflect reliance on lexical-level connections between languages, requiring translation of second-language words. The results provided evidence for concept mediation by more-fluent bilinguals, because categorization latencies were independent of the language of the category name. However, the performance of less-fluent bilinguals indicated that they did not follow a simple lexical translation strategy. Instead, these subjects were faster at categorizing words in both languages when the language of the category name matched the language of the target word, suggesting that they were able to access limited conceptual information from the second language. A model of the development of concept mediation during second language acquisition is described.
Adult↗
Benign partial epilepsy in childhood: selective cognitive deficits are related to the location of focal spikes determined by combined EEG/MEG.
PURPOSE: Benign partial epilepsy (BPE) in childhood is characterized by the occurrence of interictal stereotyped focal spikes with variable localization in the EEG. Children with BPE often exhibit neuropsychological deficits. It is unclear whether a correlation exists between these deficits and the localization of spikes, several EEG studies giving inconsistent results. Magnetoencephalography (MEG) improves the accuracy of spike localization. Therefore by using combined MEG/EEG, we investigated the topographic relation between focal spikes and neuropsychological findings in children with BPE. METHODS: Twenty-seven children diagnosed consecutively with BPE were enrolled in the study. All were examined by combined MEG/EEG and magnetic resonance imaging (MRI). Location of spikes was determined by dipole source estimation. A standardized neuropsychological assessment was conducted, including Kaufman ABC battery, language tests, and motor performance series. All children with sufficient MEG data were included in the correlation analysis (N = 20). RESULTS: Focal spikes were located in the perisylvian region in 13 children, in the occipital region in seven, and in the frontal region in one. Five children had bilateral or multiple foci. Children with left perisylvian spikes did not differ from the others in global IQ, but performed significantly lower in language tests (p = 0.01). Children with occipital spikes performed significantly lower in simultaneous information processing (p = 0.01), especially in visual transformation tasks. CONCLUSIONS: Combined MEG/EEG investigation is a useful tool to examine interictal focal spikes. Our results show a correlation between the location of spikes and selective cognitive deficits in children with BPE. These findings indicate that focal interictal spikes may interfere with complex cognitive functions.
Brain Mapping↗
Parents' report of vocabulary and grammatical development of African American preschoolers: child and environmental associations.
This study examined how child and family factors affect individual differences in the language development of African American children between 18 and 30 months of age. Participants were 87 African American children, primarily from low-income families. Children's vocabulary and grammatical skills were assessed at 18, 24, and 30 months of age using the short form of the MacArthur Communicative Development Inventory (CDI), a standardized parent report tool. Standardized language tests were administered repeatedly between 1 and 3 years of age. Results showed that children's vocabulary and utterance length grew linearly over time between 18 and 30 months of age. Children from more stimulating and responsive homes were reported to have larger vocabularies, to use more irregular nouns and verbs, and to use longer utterances, in addition to having more rapid rates of acquisition of irregular forms and longer utterances over time. Girls used longer utterances than boys and more irregular forms. Girls also had larger vocabularies in a secondary analysis that eliminated children whose parent report of their vocabulary was substantially lower than children's scores on a standardized language test. There are indications that some parents may be under-reporting their children's early vocabulary and grammatical development, with a high proportion of the parents reporting their child's 30 month vocabulary and grammatical development as being at or below the 10th percentile according to the CDI norms.
Black or African American↗
The bilingual brain: bilingual aphasia.
Since most people in the world know more than one language, bilingual aphasia is an important line of research in clinical and theoretical neurolinguistics. From a clinical and ethical viewpoint, it is no longer acceptable that bilingual aphasics be assessed in only one of the languages they know. Bilingual aphasic patients should receive comparable language tests in all their languages. In the present work, language recovery of 20 bilingual Friulian-Italian aphasics was investigated. Thirteen patients (65%) showed a similar impairment in both languages (parallel recovery), four patients (20%) showed a greater impairment of L2, while three patients (15%) showed a greater impairment of L1. Despite the many hypotheses advanced to account for nonparallel recovery, none of them seems to provide satisfactory explanations. The study of bilingual aphasics with parallel impairment of both languages allows us to verify the hypothesis whereby grammatical disorders in aphasia depend on the specific structure of each language. As far as rehabilitation programs for multilingual aphasics are concerned, several questions have been raised, many of which still need a satisfactory answer.
Adolescent↗
Evaluation of four Spanish word-recognition-ability lists.
Tests of word recognition ability (formerly Speech Discrimination) should be suitable for the linguistic background of the person being tested. Few efforts have been made to develop a standardized test in the Spanish language. Current literature reports on six studies that have several drawbacks. The purpose of the present study was to evaluate a commercially available Spanish language test. The material consists of four lists of 50 bisyllabic tetraphonemic Spanish words. The words were recorded at a professional laboratory (Auditec of St. Louis) by a native Spanish speaker. In the present study, the lists were evaluated in terms of interlist equivalence, word difficulty, intelligibility of the talker, and slope of the performance/intensity (PI) function. Taped lists were presented to 16 normal-hearing native Spanish speaking adults at four presentation levels. Mean intelligibility scores were poorest for list three. Statistical analysis indicated that the intelligibility of list three is significantly different than the other lists at the 0.05 level. On the average, at low presentation levels, the nine subjects of Mexican origin obtained better scores than the seven subjects of other nationalities. The slope of the PI-PB function (4.3%) was comparable to that obtained by other investigators of English lists. The words most frequently missed contain the /s/ sound and are words that retain their meaning even after deletion of the final /s/. The talker's speech intelligibility was judged to be very clear.
Adult↗
Intracarotid amobarbital test of language and memory before temporal lobectomy for seizure control.
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Adolescent↗
Assessment for temporary registration. Tests in language proficiency.
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Communication↗
[Remarks on the Freiburg language understanding test].
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Adolescent↗
Speech-language outcomes of hemispherectomy in children and young adults.
Children and young adults who had undergone right or left hemispherectomy for intractable seizures after a period of normal language acquisition were compared with respect to scores on speech and language tests. The majority of the subjects had full scale IQs in the borderline to mentally retarded range. Language scores were computed in relation to estimated mental age, not chronological age. On this basis, the left hemispherectomized children were more likely to show syntactic comprehension and rapid-rate auditory processing deficits than the right hemispherectomized. The two groups were similar to one another and to normal children in speech production. The findings are discussed in relation to developmental language disorders.
Adolescent↗
Development of speech-audiometric materials for native Spanish-speaking adults.
The lack of valid and reliable Spanish speech audiometry materials constitutes an important clinical problem. Such tests necessitate the construction of appropriate materials. Analysis of English and Spanish literature on speech audiometry led to the identification of guidelines for new test materials in the Spanish language. Test lists were devised, recorded and used to evaluate 10 normal-hearing native Spanish-speaking subjects. The results obtained led to a final set of recorded lists. Boston College Auditory Test lists may be used successfully with Spanish-speaking patients. The current study should provide the impetus and sufficient guidelines upon which speech stimuli in other languages may be constructed.
Adult↗