Thinking outside the (black) box.
Explore the source record for details and available documents.
Brain↗
Biomedical subjects
A L Holland
Publications and source records attributed to A L Holland.
Assessment of syntax after adolescent brain injury: effects of memory on test performance.
In this study, we investigated the influence of working memory load on performance of a task designed to measure receptive syntax ability. Subjects were 6 brain-injured adolescents and 6 hospitalized control subjects matched for age, sex, and general ability. Each subject was administered the Listening/Grammar subtest of the Test of Adolescent Language (TOAL-3) and a modified version of this subtest with identical syntax and fewer response choices (i.e., a reduced working memory processing and storage load). The syntactic structures tested on these tasks also were measured in spontaneous narratives. The brain-injured subjects' performance was significantly worse than that of controls on both versions of the syntax comprehension subtest. There was a significant group-by-task interaction, as brain-injured subjects' performance was significantly worse on the Listening/Grammar subtest than the modified subtest, whereas Control subjects'performance did not differ across the two tasks. In their spontaneous narratives, subjects in both groups produced the syntactic structures tested on the receptive syntax tasks, with no between-groups difference in syntax production. The results are discussed in terms of test validity and the impact of measurement methods on test performance in disordered groups.
Adolescent↗
Spoken language of individuals with mild fluent aphasia under focused and divided-attention conditions.
The spoken language of individuals with mild aphasia and age-matched control subjects was studied under conditions of isolation, focused attention, and divided attention. A picture-description task was completed alone and in competition with a tone-discrimination task. Regardless of condition, individuals with aphasia performed more poorly on most morphosyntactic, lexical, and pragmatic measures of spoken language than control subjects. Increasing condition complexity resulted in little quantitative or qualitative change in the spoken language of the control group. In contrast, the individuals with aphasia showed dual-task interference; as they shifted from isolation to divided-attention conditions, they produced fewer syntactically complete and complex utterances, fewer words, and poorer word-finding accuracy. In pragmatic terms, their communication was considered less successful and less efficient. These results suggest that decrements of attentional capacity or its allocation may negatively affect the quantity and quality of the spoken language of individuals with mild aphasia.
Adult↗
Aphasia or dementia: the cautionary tale of Dr. JJ.
This case study involves the differential diagnosis of aphasia versus dementia. However, the case of Dr. JJ is instructive from a number of aspects, presented here as "cautionary notes" which are intended to remind clinicians of sometimes-forgotten interpersonal issues in the diagnosis of disorders of speech and language. This case also is intended to illustrate that merely distinguishing between dementia and aphasia is sometimes inadequate, particularly when potentially transmittable (and in some cases, curable) dementias might be involved.
Aged↗
Functional outcome assessment of aphasia following left hemisphere stroke.
This article discusses issues regarding the assessment of functional outcomes in individuals who have aphasia following stroke. Some different approaches to functional outcome measurement are critically reviewed, ranging from general measures of stroke outcome to measures that have been designed specifically for aphasic individuals, to measurements focusing on aphasia's effects on quality of life. Examples of how to relate treatment of aphasia directly to functional outcomes assessment are also provided.
Aphasia↗
Auditory processing in individuals with mild aphasia: a study of resource allocation.
This study examined the effects of lesion location (frontal vs. posterior) and nature of distraction (nonverbal vs. verbal secondary, competing task) on mildly aphasic individuals' performances of listening tasks that required semantic judgments and lexical decisions under isolation, focused attention, and divided attention conditions. Despite comparable accuracy among all groups during isolation conditions, the aphasic groups responded less accurately and more slowly than the normal control group during focused and divided attention conditions. Generally, the two aphasic groups performed similarly, quantitatively and qualitatively. Demographic characteristics such as time post stroke did not correlate with performance decrements. Independent of group, all individuals showed greater disruption of auditory processing skills when the secondary task was verbal rather than nonverbal. Within a limited-capacity model of attention, the results suggest that aphasic individuals display impairments of attention and resource allocation and that these impairments negatively interact with their auditory processing abilities.
Adult↗
Treatment efficacy: aphasia.
This article presents a brief overview of aphasia, followed by a summary of research studies and program evaluation data addressed to answering the question of the efficacy of treatment for aphasia. Selected studies are reviewed in terms of the quality of evidence they present. In addition, a number of questions that remain unanswered are also presented. Several tables, designed to provide clarifying information concerning several aspects of research design (number and types of patients studied, examples of well-designed small-group or single-subject studies, clinical techniques for which efficacy data are available), are included. The conclusion of this review is that, generally, treatment for aphasia is efficacious.
Aphasia↗
The FACS of life ASHA facs--a functional outcome measure for adults.
Explore the source record for details and available documents.
American Speech-Language-Hearing Association↗
Language development after unilateral brain injury.
This longitudinal study describes the growth of syntactic abilities and vocabulary size in nine children with unilateral antepartum or perinatal brain injury. Five children with left hemisphere damage (LHD) and four with right hemisphere damage (RHD), ages 15 to 48 months, were evaluated on three or more occasions. Language samples generated from parent-child interaction were transcribed, coded, and analyzed using the Child Language Data Exchange System. Individual growth trajectories were constructed by graphing three dependent variables--MLU, scores on the Index of Productive Syntax (IPSYN), and number of different words--as a function of the child's age. One subject remained in a prelinguistic stage throughout the study. Simple linear functions best described the growth of MLU, IPSYN scores, and vocabulary in the other eight children. The slopes of the individual growth trajectories, the graphic representations of rates of progress, were comparable in the eight children. Seven children showed developmental delays in initial word use and five in the onset of multiword utterances. However, by age 24 months, four children with LHD and two children with RHD had syntactic capabilities comparable to those of children without brain injuries. The developmental patterns suggested that both cerebral hemispheres may play critical roles in the very earliest stages of language acquisition. Some unilateral lesions caused little discernible effect on language outcome in the toddler-preschool years after the initial developmental delays.
Brain Damage, Chronic↗
A longitudinal study of word-reading ability in Alzheimer's disease: evidence from the National Adult Reading Test.
The purpose of this longitudinal study was to examine word-reading ability of subjects with probable Alzheimer's disease (AD), using the National Adult Reading Test (NART). In addition to the NART, a battery of neuropsychological tests was administered to 18 AD and 20 elderly control subjects at yearly intervals over 3 years. Repeated measures analysis with grouping factors showed that the controls scored better than AD subjects on the NART at each test date and the AD subjects scored significantly worse over time. NART scores were significantly correlated with dementia severity in AD subjects at final testing only, suggesting that the NART is sensitive to dementia severity only at the later stages of the disease. Associations between the NART and other cognitive measures yielded few significant results. Finally, error responses to NART words were summarized by type and percentage for each group at each test session.
Aged↗
Predictors of decline in Alzheimer's disease.
Age of onset and aphasia are frequently proposed as predictors of decline in Alzheimer's disease (AD). We compared longitudinally the neuropsychological test performance of AD patients classified as Fast Decliners (FD, N = 18) based on the rate of change of their scores on the Mini-Mental State Examination (MMS) and a group classified as Slow Decliners (SD, N = 15). There was no statistical difference in the age of onset of AD or in severity of dementia at first visit. Performance on verbal tests was the best predictor of rapid cognitive decline, even after the influence of the overall degree of dementia had been accounted for. Among the language tasks, performance on a naming test was the best predictor. The results of this study do not support age of onset as a predictor of the course of AD. On the other hand, poor performance on language tests does predict a more rapid rate of decline in AD.
Aged↗
Predicting cognitive recovery from closed head-injury in children and adolescents.
Longitudinal data from 84 head-injured children and adolescents, who were tested at three points in the first year postinjury, were analyzed to determine the best combination of demographic, injury-related, and behavioral factors predicting cognitive performance. Dependent variables were language, memory, visuomotor, and speeded performance factor scores obtained through confirmatory factor analyses of an extensive test battery. Multiple regression analyses indicated that injury severity and the existence of previous psychological, physical, or cognitive disorders were primary for predicting acute (1 month post-hospital discharge) performance for older subjects. For younger subjects, however, parental marital status was the most important correlate of acute cognitive performance. Those residing in homes with both parents fared better than children in one-parent families. At 6 months and 1 year postinjury, the older subjects who performed most poorly initially remained the most impaired. For younger children, acute cognitive standing was also an important predictor of later performance, but parental marital status remained a crucial influence on their longer-term recovery of cognitive skills.
Adolescent↗
Aphasia: the challenge of recovery.
Explore the source record for details and available documents.
Adaptation, Psychological↗
Lexical learning and language abilities in preschoolers with perinatal brain damage.
Studies of children with early-acquired brain damage have noted limitations on language development following such damage and have raised questions regarding the process by which these children acquire language skills. The purpose of this study was to examine the effects of perinatally acquired brain damage on early language abilities and on lexical development through the use of standard assessments, language samples, and a miniature linguistic system approach to teach a novel lexicon. Four children, ages 26-41 months, with localized, perinatal brain lesions documented on ultrasound or CT scan were selected for this study and were compared to 4 matched controls. The results show no differences in the pattern of scores and learning in children with right and left brain damage. With the exception of phonological development, subjects scored below controls on all formal language measures; however, the subjects often scored at or above test norms. Brain-injured subjects were similar to controls with respect to the number of novel words that they initially learned on comprehension and production tasks and the number that they consistently comprehended. Brain-injured subjects generally acquired fewer words when the criterion was consistent accurate production. Interestingly, subjects required more exposures to novel lexical items than did controls before reaching a given level of proficiency. Production seemed to be more difficult for all children, but more so for the brain-injured subjects. It appears that the effects of early damage have an impact on many aspects of language development and that these apparent deficits may reflect the child's need for greater exposure to language skills and structures before acquiring them.
Brain Damage, Chronic↗
Home treatment for aphasic patients by trained nonprofessionals.
Thirty-seven aphasic men received 8-10 hr of individual treatment each week for 12 weeks from a home therapist (wife, friend, relative) who was trained and directed by a speech pathologist. Treatment was followed by 12 weeks of no treatment. Patients were evaluated at entry and at 6, 12, 18, and 24 weeks after entry with a battery of speech and language measures. The group made substantial progress on all measures during the 12 weeks of treatment and ceased to progress when treatment was discontinued. Progress for the home treatment patients did not differ significantly from that of patients who received 12 weeks of individual treatment from speech pathologists or from that of patients for whom treatment was deferred for 12 weeks. Patient selection, training of the home therapists, and other methodological aspects are described to assist speech pathologists in making decisions about the use of trained volunteers in aphasia treatment.
Aged↗
Predictors of language restitution following stroke: a multivariate analysis.
A consecutive sample of 50 language-impaired patients was evaluated prospectively during the first 3 to 4 months following unilateral left- or right-hemisphere stroke. A multiple logistic linear regression model was used to assess the relative importance of eight predictor variables on the likelihood of language recovery. Those found to be significantly associated with language recovery included age (favoring younger patients) and length of hospital stay (favoring shorter stays). Gender (favoring males), type of stroke (favoring hemorrhages), and side of lesion (favoring right) were only moderate correlates of recovery. Neither race nor history of previous stroke was a significant predictor of language recovery. Multivariate statistical analysis was useful in illuminating the joint relationship between clinical and demographic predictor variables and language recovery.
Age Factors↗
Characteristics of recovery of drawing ability in left and right brain-damaged patients.
Drawings of a "person" were obtained from 21 patients with left brain damage (LBD) and 13 patients with right brain damage (RBD) at hospital discharge and 1 month postdischarge, corresponding to 2-4 and 6-8 weeks postonset, respectively. Early LBD drawings were simplistic and often incoherent. Most were placed in the upper left quadrant of the page. RBD drawings were scattered, fragmented, and elaborately detailed. Many showed evidence of left-sided neglect. The resolution of drawing disability also differed between the two groups: LBD subjects recovered drawing abilities more rapidly and more completely than RBD subjects. These differences in drawing characteristics and in the resolution of drawing disability were discernable for experienced neuropsychologists.
Adult↗
Evolution of aphasia in the first year post-onset.
Evolution of aphasia was studied in the first year of recovery in 43 patients sustaining left hemisphere strokes with language impairment. Observations were made daily during acute hospitalization and subsequently at approximately one, two, three, four-to-six and seven-to-twelve month intervals post-stroke. Aphasias were classified according to standard criteria. A significantly larger percentage of the sample (59%) exhibited evolution of aphasia than in previous studies. This was attributed to earlier and more intensive patient observations in this investigation. Most changes occurred within the first two weeks of recovery. Two patterns of evolution were clearly present in the sample, one being early rapid change and the other a more gradual evolution. An expansion and integration of Gloning and Quatember's (1964) model of evolution is proposed on the basis of combined results from several studies. Also, the influence of aging, evolution of aphasia and the emergence of dementia post-stroke are discussed.
Adult↗