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Biomedical subjects

D M Aram

Publications and source records attributed to D M Aram.

36 records · Page 2Linked to original sources
PubMed1987

Lexical retrieval in left and right brain lesioned children.

Performance on two measures of lexical retrieval for 19 left and 13 right brain lesioned children was compared to that of control subjects matched by age, sex, race, and social class. On the Word-Finding Test, left lesioned subjects were significantly slower in response time than left controls when given semantic and visual cues and made more errors when given rhyming cues. On the Rapid Automatized Naming Test, left lesioned subjects were significantly slower than left controls in naming all semantic categories, including colors, numbers, objects, and letters. In contrast, right lesioned subjects responded as quickly as or more quickly than did right controls in all access conditions and in naming semantic categories yet tended to produce more errors than their controls, suggesting a speed-accuracy tradeoff. Children sustaining left brain lesions before 1 year of age appeared to be as impaired as those whose lesions occurred after 1 year of age. Diverse lesion sites within the left hemisphere were associated with increased lexical retrieval latencies.

Adolescent↗
PubMed1987

Unilateral brain lesions in childhood: performance on the Revised Token Test.

Comprehension of connected language as assessed by the Revised Token Test (RTT) was studied in 17 children with left hemisphere lesions (LL) and 11 with right hemisphere lesions (RL). LL children's significantly lower performance on several subtests than left controls (LC) matched by age, sex, race, and social class appeared to be related to the memory demands of these subtests rather than the limited syntactic elements assessed by the RTT. LL subjects requested significantly more command repetitions than control or RL subjects and when a repetition was not requested LL subjects often responded with immediacy. Although RL children tended to perform lower than right matched controls (RC), these differences were not significant nor readily related to either the memory or specific linguistic structures assessed. RL subjects required fewer command repetitions than LL subjects and exhibited a significantly greater frequency of immediate responses than controls or LL subjects. While based on few children, a trend for LL children with retrorolandic lesions to perform more poorly than those with left prerolandic lesions was suggested. No systematic difference in performance was apparent for children with left cortical vs. left subcortical lesions or among discrete sites of lesions within the right hemisphere. Children with left lesions prior to 1 year of age performed no better and, in several instances, significantly poorer than LL patients sustaining lesions after 1 year of age. Among RL subjects, those sustaining lesions after 1 year of age had greater difficulty than those with lesion onset before 1 year of age, especially on linguistic elements which seemed to be dependent upon visual spatial properties. Further studies are needed to evaluate the comprehension of more complex linguistic structures among children with unilateral brain lesions as well as to study the role of more basic factors such as memory and attention in explaining the present findings.

Adolescent↗
PubMed1986

Spoken syntax in children with acquired unilateral hemisphere lesions.

The spoken syntax of eight left hemisphere lesioned and eight right hemisphere lesioned children were compared to matched controls. The children's lesions were acquired between 0.08 and 6.17 years of age (mean = 1.33 years), and at the time of testing they were between 1.67 and 8.15 years of age (mean = 4.19). Based on analyses of spontaneous language samples, left hemisphere lesioned subjects performed more poorly than did their controls on most measures of simple and complex sentence structure. In contrast right lesioned subjects performed similarly to their controls on these measures, except for a tendency to make more errors in simple sentence structures. These findings provide further evidence that the left and right hemispheres are not comparable in supporting syntactic abilities.

Brain↗
PubMed1986

Handedness and sex of children with developmental language disorders.

The handedness and sex of 4- and 5-year-old children with developmental language disorders were studied through a comparison of language disordered children and a normal control group and through a comparison of six linguistically homogeneous subgroups of language disordered children. Differences between the handedness of a generalized language disordered group and a normal control group were not found, possibly due to the multiple etiologies of developmental language disorders. Children with severe language disorders, however, were non-right-handed more often than children with mild language disorders. Furthermore, certain types of linguistic deficits were associated with non-right-handedness, whereas age and cognitive abilities were not. Males were more often language disordered than females; however, sex ratios did not significantly differ among the subgroups, possibly due to the small number of language disordered females in this study. Implications for cerebral laterality in developmental language disorders are discussed.

Child, Preschool↗
PubMed1986

Trophic changes following early unilateral injury to the brain.

Measurements of the lengths of the feet and hands are reported for 15 neurologically normal children and for 17 children with left and 12 with right cerebral lesions. For those with left lesions the length of the left hand and foot significantly exceeded the right, while for those with right lesions the right hand and foot significantly exceeded the left. No significant foot or hand differences were found among the neurologically normal children. These findings demonstrate the association of atrophic limb-changes with unilateral brain lesions, and suggest that asymmetrical foot and hand growth may be a biological marker of early cerebral lesions.

Age Factors↗
PubMed1986

Family history of children with developmental language disorders.

The present study shows the increased incidence of language-related disorders among family members of children with language disorders. The family histories of 74 children with developmental language disorders and 36 normal children were compared. The children with language disorders had significantly more family members who reported speech, stuttering, reading, and language disorders than the normal control group.

Articulation Disorders↗
PubMed1985

Muteness of cerebellar origin.

Acute bilateral damage to large areas of both cerebellar hemispheres including the dentate nuclei led to temporary loss of speech in six children. In each case muteness was unassociated with motor paralysis, loss of higher cognitive functions, or cranial nerve dysfunction. Muteness lasted one to three months. All patients were severely dysarthric during recovery. We conclude that transient muteness may result from acute bilateral cerebellar injury.

Cerebellar Diseases↗
PubMed1985

Neurologic sequelae of cardiac catheterization.

Neurologic complications are a known and at times tragic consequence of cardiac catheterization. During a four-year period, 1,362 procedures were performed at our institution on children less than 15 years of age. Eighteen children, without prior nervous system disease, developed neurologic sequelae within 24 hours of cardiac catheterization (1.3%). Three presented with seizures only, ten with neurologic deficits, and five with both focal seizures and stroke. Computerized tomography scans (16 patients) demonstrated areas of nonhemorrhagic infarction in all but one. The 18 patients were studied retrospectively for possible factors contributing to the neurologic complications. They were matched to controls by age, cardiac lesion, and catheterization technique. Data examined included catheterization duration and approach, contrast agent, precatheterization urine specific gravity, pre- and postcatheterization hematocrit, blood loss, and intracatheterization events. Catheter and catheter sheath clots were noted in both patient groups. The neurologic complication group had 7/18 intracatheterization neurologic events versus only one in the controls and the change in hematocrit was greater in the complication group (t = 2.89, p less than 0.01). Due to this study's results and to prevent possible thromboembolic events, a heparinization protocol was instituted and patients were prospectively observed for neurologic complications. No neurologic complications have occurred over three years since the institution of this protocol.

Cardiac Catheterization↗
PubMed1985

Intelligence and hypoxemia in children with congenital heart disease: fact or artifact?

Previous studies have reported lower intelligence for cyanotic than for acyanotic children with congenital heart disorders, a finding attributed to the degree of hypoxemia present. Several important variables have not been examined consistently, however, including coexisting neurologic or genetic disorders, definitive surgery, degree of sickness, age at testing sex and social class. The present study examined the relation of these variables to obtained intelligence measures for 82 consecutively admitted children, excluding children with abnormal neurologic examinations and those having received definitive surgery. Consistent with earlier reports, intelligence quotients for the acyanotic children (112.81 +/- 14.52 mean +/- SD) were significantly higher (t = 2.60; p = 0.006) than for the cyanotic group (103.50 +/- 15.81). Although sex, race and social class were not significantly different between the 28 cyanotic and the 54 acyanotic children, the cyanotic children were significantly sicker (x2 = 9.12; p = 0.005) and younger (t = 4.10; p = 0.001). However, when young and old children and the degree of sickness within cyanotic and acyanotic groups were compared, no significant differences were found. These findings demonstrate that intelligence differences between cyanotic and acyanotic children persist when the effect of neurologic abnormalities and definitive surgery is removed and remain despite the severity of sickness or child's age at testing.

Adolescent↗
PubMed1985

Verbal and cognitive sequelae following unilateral lesions acquired in early childhood.

Eight left-hemisphere lesioned children and eight right-hemisphere lesioned children between 18 months and 8 years of age were compared to control subjects on a battery of intelligence and language measures. Both left- and right-lesioned subjects had lower IQ scores than their controls, yet most functioned within the normal range or higher. Lexical comprehension and production were depressed in both subject groups and appeared to be depressed to a greater degree in right-lesioned subjects than in those with left lesions. In contrast, syntactic production in left-lesioned subjects was markedly deficient in comparison to controls as well as right-lesioned subjects. Although both subjects and controls included children with articulation errors, the number of misarticulating children and misarticulated sounds was greatest in the left-lesioned group. Finally, fluency disorders were observed in both right- and left-lesioned subjects but were not observed in controls. The study provides further evidence that the right and left hemispheres are not equipotential for language and that left-hemisphere lesions acquired early in childhood impair syntactic development to a greater degree than do right-hemisphere lesions.

Articulation Disorders↗
PubMed1984

Preschoolers with language disorders: 10 years later.

Language, intelligence, academic achievement, and behavioral adjustment were assessed in a group of 20 adolescents originally studied 10 years earlier as preschoolers with language disorders. At follow-up, 20% had WISC-R IQ scores in the mentally deficient range and were being educated in EMR classrooms. Of the remaining 16, 11 (69%) had required special tutoring, grade retention, or LD class placement. The majority of non-EMR subjects continued to evidence persistent deficits in language and academic achievement and were rated by their parents as being less socially competent and having more behavioral problems than their peers. Of the initial preschool measures available, the Leiter was found to be the best single predictor of intelligence, language, class placement, and reading achievement in adolescence, although the NSST: Expressive subtest also was a strong predictor of adolescent language.

Achievement↗
PubMed1983

Acquired capsular/striatal aphasia in childhood.

We studied a case of language loss caused by an acquired vascular lesion in the putamen, anterior limb of the internal capsule, and lateral aspect of the head of the caudate nucleus in a 7-year-old right-handed girl. Acute right-sided hemiplegia, mutism, oral apraxia, and disturbance in language comprehension but no dysarthria were present. During recovery, a nonfluent aphasia with anomia was evident. After six months, only mild hemiparesis and minor spelling difficulties persisted. We compared this patient with an 11-year-old right-handed girl with right-sided hemiparesis and dysarthria but no language loss following a lesion in the globus pallidus, a portion of the posterior limb of the internal capsule, and the body of the caudate. The presence of a language disturbance in the first but not the second patient was attributed to the difference in lesion location. The symptoms and lesions were similar to those in recent reports of adult patients. To our knowledge, this is the first report of these findings in a child with a left-hemisphere lesion.

Aphasia↗
PubMed1983

Syntactic findings in developmental verbal apraxia.

Spontaneous language samples of eight children diagnosed as presenting developmental verbal apraxia were analyzed in terms of their mean length of utterance, Developmental Sentence Scores, use of 14 grammatical markers, and yes-no and wh-question forms. Although MLUs were greater than the range associated with stage V syntactic development, all children demonstrated difficulties with stage V and beyond grammatical markers and many omitted stage II markers. Developmental Sentence Scores were generally well below chronologic age expectations and revealed notable difficulties with personal pronoun and main verb selection. Omissions or noninversions of auxiliary and/or copulas in yes-no and wh-questions were apparent. Omissions of regular and irregular third-person singular markers, inconsistent use of regular and irregular past tense, and difficulty with question transformations provide evidence that at least some of the errors presented by this group of apraxic children cannot be attributed to motor speech and/or phonologic limitations but rather they evidence concomitant syntactic disorders.

Apraxias↗
PubMed1983

Sequential and non-speech praxic abilities in developmental verbal apraxia.

Verbal and non-verbal sequential abilities were compared in a group of 10 children with developmental verbal apraxia. Manual gestures, constructional praxic abilities and non-speech volitional oral movements were also studied. Results indicated that these children were deficient in verbal sequential abilities, both with reference to their non-verbal sequential abilities and to normative data. As a group, the children did not present manual-gestural or constructional apraxias, nor oral apraxias for single non-speech volitional movements. However, most had difficulty with sequences of non-speech volitional oral movements.

Adolescent↗
PubMed1980

Preschool language disorders and subsequent language and academic difficulties.

Sixty-three language-disordered children first evaluated in their preschool years were followed four to five years after initial diagnosis. At follow-up approximately 40% of these children continued to present speech and language problems and approximately 40% presented other learning problems. Preschool levels of language comprehension, formulation, semantics, syntax, phonology, and speech production were found to be moderately correlated to subsequent class placement in the elementary grades. Duration of preschool therapy was not related to either the severity of preschool language disorder or to any subsequent speech, language, or academic abilities. Duration of school therapy was related to severity of phonologic deficit as rated during the preschool years and to all follow-up ratings for speech, language, and academic abilities.

Achievement↗
PubMedDate not supplied

Presentation, clinical course, and outcome of childhood stroke.

We reviewed the presentations, clinical courses, and outcomes of 42 children with unilateral hemispheric stroke. Infants with strokes identified within the first few days of life usually presented with seizures. These infants had few abnormal neurologic findings as neonates, but hemiparesis became evident as gross motor development proceeded. Infants with strokes identified later in the first year of life usually presented with pathologic early hand preference without a history of an ictus. During subsequent development, the motor deficits in these children became more evident, producing an apparent progression of the neurologic abnormalities. Strokes identified in older children typically presented as sudden hemiparesis, often associated with seizures. The hemiparesis in these children was most severe at the onset, followed by some improvement in strength in all patients. Functional outcome was variable. At last follow-up, all children were ambulatory, some with clinically apparent hemiparesis. Eight of the 42 children (19%) developed recurrent seizures with an onset ranging from 4 months to more than 10 years (median: 26 months) after the stroke.

Adolescent↗