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Untrained community help in the rehabilitation of stroke sufferers with language disorder.

The Newcastle Speech-After-Stroke Project is one of many schemes in Britain that have used untrained helpers to set up community clubs and home visiting for dysphasic stroke sufferers. To examine the contribution to rehabilitation made by such activities, patients' language abilities and social confidence were assessed when they entered the project and after about six months. Formal tests of language showed no significant improvement after six months, but social confidence increased. Such projects can make a valuable contribution in helping dysphasic people to regain a role in the community. Nevertheless, too much should not be expected of them in the way of direct help in the patients' recovery of language.

Cerebrovascular Disorders↗

Psychiatric risk in children with speech and language disorders.

Based on an initial community sample of 1,655 5-year-old children, this report utilized the risk statistic to estimate a child's risk for developing a psychiatric disturbance depending on his or her status as speech/language-impaired. Results showed that risk estimates varied as a function of gender and source of information (teacher, parent, psychiatric reports). Overall, speech- and language-impaired children had a higher risk for developing a psychiatric disturbance compared with normal language controls, with speech/language-impaired girls being at greater risk than boys.

Adaptation, Psychological↗

[Group training for parents of young children with specific developmental speech and language disorder (SDLD)].

OBJECTIVE: Children with SDLD have a high risk of psychiatric disorder. For early intervention training of the parents in structured small groups is recommended. The aim of this pilot project is the development of a program for parents of german speaking children and the assessment of the acceptability by the parents. METHOD: The selected topics for the parent training were grouped in six moduls. The joint analysis of short videosequences of interactions were used as a mean medium. The acceptability was assessed by questionaires. RESULTS: In three groups with 4 - 8 participants so far completed the feedback was positive. CONCLUSIONS: The structured training of parents is an acceptable form also for german parents.

Child↗

[Set of neuropsychological tests for the assessment of language disorders after damage to the right cerebral hemisphere: preliminary results].

A set of five experimental tests was prepared for the assessment of language disturbances in right hemisphere-damaged (RHD) patients. The Right Hemisphere Language Battery by Bryan (1995) was a basis for these tests. The set comprises the Metaphor Picture Test, the Written Metaphor Test, the Inferential Meaning Test, the Humour Test and the Lexical Semantic Test. Thirty-six RHD, 15 left hemisphere damaged (LHD) without aphasia and 30 control (C) subjects took part in the investigation. All test significantly differed between the RHD and C groups. No significant differences were noted between LHD and control groups, except for the Inferential Meaning Test. The quantitative performance of tests was different in all the groups. Results of the study indicated patients with right frontal damages to make more errors than those with right posterior lesions.

Aphasia↗

[A test for the detection of speech and language disorders in the acute phase after stroke. Development and clinical application].

No standardized assessment of aphasic symptoms for stroke patients in the acute phase has as yet been published in the German language. Current test batteries such as the AAT are too time-consuming and cannot be performed on severely impaired patients. A short test for the examination of aphasic and dysarthric symptoms has been developed which contains 7 subtests in three main areas: spontaneous speech, comprehension and planning of movements, speech and language abilities. Since abilities in acute cases may only be functionally impaired and often only detectable after stimulation, standardized stimulation is applied in most of the subtests. In this way it is possible to test acute stroke patients for aphasic and dysarthric symptoms. The course of recovery in a typical case is described.

Aged↗

The description and interpretation of aphasic language disorder.

The nature of aphasic impairment is reviewed from four viewpoints: (1) the construction of behavioural classifications that predict the locus of brain damage; (2) the initial assessment of a range of psycholinguistic functions sufficiently wide to detect the main outlines of deficit and preservation; (3) the elucidation of change in functional status, including both spontaneous and therapy-aided recovery; (4) the relationship between models of normal linguistic performance and the structure of pathological disorder. Arguments are provided against studies of aphasia based upon clinical (or other) taxonomies; arguments are given for the closer integration of analyses of normal and aphasic language.

Aphasia↗

[Structural correlation of schizophrenic thought and language disorders with delusional perception and variations of intentionality].

This study originated from a phenomenological and speech-act theoretical concept of schizophrenic concretism. An experimental study was performed showing a highly significant lack in the schizophrenic patients' ability to use metaphors correctly. Basing on the interpretation of proverbs, the hypothesis is rejected that false interpretations of schizophrenic patients are due to intermingling of personal conflicts. On the other hand, it could be shown that concretistic interpretations of proverbs represent an avoidance of conflicts. The concepts of "substitution" and "transfer" enabled us to measure pathological concreteness and "deconflictualisation". The differentiation between schizophrenic and nonpsychotic patients was found to be highly significant. In a complementary study it could be shown that the chronic schizophrenics' disability to transfer images of proverbs to an interpersonally relevant context does not differ significantly from that of patients with their first schizophrenic episode. Discussing our empirical findings, we try to show that the concretistic reduction of thought and speech is also a paradigma of delusion. The "incorrigibility" of schizophrenic delusion was seen to be based on reification of verbal signs and metaphors. After trying to show a connection between the concretistic "Lebensform" (Wittgenstein) and the disordered intentionality of schizophrenic patients, pointers towards psychotherapeutic implications are given.

Chronic Disease↗

[Schizophrenia and language disorders].

The speech of schizophrenics is idiosyncratic, possibly unrelated to thought disorders. Review of relevant literature indicates that schizophrenic speech disorders include: errors in the use of pronouns, articles, verbs and verb tenses, which are neither pointed out or corrected; absence of redundancy, skewering of the meaning of words, faulty establishment of common references with others. Sentences appear disjointed due to improvised vocabulary and the scant use of conjunctions and other linking words or phrases. Speech is slow, trite, and fails to convey information proportionate to speech production. Discourse is self-centered and the needs of others are ignored. In general, schizophrenic speech performance worsens the more ambiguous, intimate or complex the topic.

Communication↗