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PubMed1985

Production and comprehension of narrative discourse in normal and language disordered children.

Children's use of cohesion in spoken narratives was compared across three groups: normal, language disordered with good story comprehension, and language disordered with poor story comprehension (CA: 7:6-10:6). Comprehension was defined by the children's responses to questions structured to assess both factual information and knowledge of episodic relationships. Results indicated that the good comprehending language disordered children and the normal children used similar linguistic cohesive structures, but both groups differed from the poor comprehending language disordered children. Both groups of language disordered children used less adequate cohesion than the normal children. Discussion and conclusions are presented on the various levels of language ability that contribute to narrative discourse.

Child↗

PubMed1983

Word production and comprehension in Alzheimer's disease: the breakdown of semantic knowledge.

Relatively mildly impaired patients with suspected Alzheimer's disease (N = 14; Verbal IQ = 96) and normal controls of similar age and education (N = 11) were administered tests requiring production (naming and fluency) and comprehension of single words. Word comprehension was assessed on a superordinate level (rating words for degree of "pleasantness") and on a more specific level (matching abstract pictorial representations with printed words denoting objects, action, emotions, and modifiers). Performance on standardized measures of semantic knowledge (Vocabulary and Similarities subtests of the WAIS) was also evaluated. The naming and fluency abilities of the Alzheimer's patients were found to be highly correlated (r = .80) and impaired. Naming errors often consisted of semantic field errors which were either hierarchically or linearly related to the target name. In comparison with normals, verbal fluency was characterized by a tendency to generate proportionally more category names concurrent with reduced production of items within a category. Single-word comprehension was also impaired, except when judgments of affective meaning were required. It was argued that these results suggest that Alzheimer's disease may lead to a specific disruption in semantic knowledge characterized by a difficulty in differentiating between items within the same semantic category concurrent with the relative preservation of broader categorical information.

Aged↗

PubMed1984

Recovery of single word comprehension: CT-scan correlates.

9tory comprehension for single words, as measured by the BDAE Word Discrimination subtest, was studied longitudinally in a group of 37 aphasic patients. The majority of the patients had impaired performance at 1 month postonset, but recovery by Month 6 postonset was quite striking. Damage to Wernicke's area did not preclude recovery of single word comprehension to within the normal range. Only patients with very extensive left hemisphere lesions had incomplete recovery of single word comprehension.

Adult↗

PubMed1984

Repetition and comprehension of spoken sentences by reading-disabled children.

The language problems of reading-disabled elementary school children are not confined to written language alone. These children often exhibit problems of ordered recall of verbal materials that are equally severe whether the materials are presented in printed or in spoken form. Sentences that pose problems of pronoun reference might be expected to place a special burden on short-term memory because close grammatical relationships obtain between words that are distant from one another. With this logic in mind, third-grade children with specific reading disability and classmates matched for age and IQ were tested on five sentence types, each of which poses a problem in assigning pronoun reference. On one occasion the children were tested for comprehension of the sentences by a forced-choice picture verification task. On a later occasion they received the same sentences as a repetition test. Good and poor readers differed significantly in immediate recall of the reflexive sentences, but not in comprehension of them as assessed by picture choice. It was suggested that the pictures provided cues which lightened the memory load, a possibility that could explain why the poor readers were not demonstrably inferior in comprehension of the sentences even though they made significantly more errors than the good readers in recalling them.

Child↗

PubMed1987

Word recognition and comprehension skills in hyperlexic children.

Five hyperlexic boys (4-5 to 10-1 years), who had been diagnosed with infantile autism or pervasive developmental delay in early childhood, were evaluated. Measures of intelligence, single-word recognition and comprehension, and picture naming were administered to determine the precocity or deficiency of reading recognition and comprehension, the underlying mechanisms of oral reading, and possible parallels with the acquired dyslexia subtypes. The results indicated that hyperlexia may be operationalized as unexpected reading precocity as compared to IQ; however, reading comprehension was not unexpectedly deficient. The phonological route to reading appeared to be preferred to the lexical route, and the overall pattern of performance most closely paralleled that of the surface dyslexic subtype.

Autistic Disorder↗

PubMed1987

Comprehension of familiar phrases by left- but not by right-hemisphere damaged patients.

Single words, familiar phrases (idioms and speech formulas), and novel sentences (matched to the familiar phrases in length, frequency, and structure) were selected for a picture-matching auditory comprehension task and administered to left- and right-brain damaged (LBD, RBD) subjects. The groups did not differ in single word comprehension. A 2 x 2 ANOVA revealed opposite patterns on the two other tasks, with LBD subjects performing worse on novel than familiar phrases, and RBD subject impaired on familiar phrase but not on novel sentence comprehension. The role of grammatical/referential vs. holistic/inferential meaning in left and right hemisphere function is discussed.

Aged↗

PubMed1989

Agrammatic comprehension of relative clauses.

Four hypotheses that attempt to account for the comprehension deficit in agrammatism are put to an empirical test. The interest in them is in that they all view the deficit as highly selective. The first, proposed by D. Caplan and C. Futter (1986, Brain and Language, 27, 117-134), argues that agrammatic patients cannot carry out normal syntactic analysis beyond the category label of each incoming lexical item and are reduced to the use of a cognitive strategy that commends assignment of thematic roles to noun phrases merely by their linear position in the string. A second, less radical hypothesis (Y. Grodzinsky, 1986a, Brain and Language, 27, 135-159), accounts for the deficit differently, by deleting a particular kind of syntactic object (trace) from the otherwise normal representation, and augmenting the resulting, underspecified representation by a strategy, whose use is quite restricted. A third account that is tested contends that agrammatic aphasics fail to comprehend perceptually complex constructions, where the metric for complexity is determined by results obtained from comprehension tests of normal listeners. The fourth account (M. F. Schwartz, M. C. Linebarger, E. M. Saffran, and D. S. Pate, 1987, Language and Cognitive Processes, 2, 85-113) argues that the thematic transparency of a construction (whether or not thematic roles are assigned directly to positions) is the best predictor of the manner by which agrammatics can handle it. An empirical test is thus constructed, both to extend the evidential basis concerning the comprehension skills of these patients and to distinguish between the accounts. Four types of relative clauses are presented to the patients, where embedding type (center vs. right) is one variable, and location of gap (subject vs. object position) is the other. The patients are tested in a sentence-picture matching paradigm. The finding, that is rather robust, is that gap location is the best predictor of agrammatic performance: the patients perform well above chance on both types of subject gap relatives, and at chance levels on object gaps. It is then shown that the Trace-Deletion Hypothesis (Grodzinsky, 1986a) is the only one among the accounts considered that is compatible with these data.

Aphasia↗

PubMed1989

Sentence comprehension following agenesis of the corpus callosum.

The sentence comprehension skills of a 6-year-old girl with callosal agenesis were compared to skills of three other children matched for age and verbal IQ. Sentence-picture matching and acting out tasks were used with reversible active, passive, and center-embedded relative clause sentences. The acallosal subject showed a deficit in syntactic comprehension. The difficulty was due to a failure to assign correct semantic roles to some sentence forms, not to a lack of ability to discriminate among the sentence forms. The data are consistent with a previous report by M. Dennis (1977, In Topics in child neurology, pp. 189-212) that in acallosal subjects syntactic comprehension can be adversely affected. Because this acallosal subject is only 6 years old, follow-up studies will be needed to determine whether she eventually acquires normal syntactic skills.

Agenesis of Corpus Callosum↗

PubMed1990

The consequences of reduced memory span for the comprehension of semantic versus syntactic information.

Aphasic patients with restricted memory spans were assessed on their comprehension of syntactically simple sentences varying in numbers of content words and on their comprehension of sentences matched in content words but varying in syntactic complexity. Three different presentation modes were used: unlimited visual presentation, limited visual presentation, and auditory presentation. The difference between performance in the unlimited and limited modes was used as a measure of the extent to which memory decrements caused comprehension failure. These difference scores were related to memory span in order to assess whether the memory involved in sentence processing overlaps that assessed by a memory span task. For the sentences varying in number of content words, performance was worse for the limited presentation modes than the unlimited mode, and the difference between unlimited and limited presentation modes was highly related to memory span. For the sentences varying in syntactic complexity, there was no clear reduction in performance for limited presentation modes, and the difference scores did not relate to memory span. The results support the view that the processing of sentences with many content words draws on the short-term memory capacity assessed by memory span, while the processing of syntactic complexity does not.

Aged↗

PubMed1990

Verb processing during sentence comprehension in aphasia.

This study examines verb processing during on-line sentence comprehension in aphasia. We describe two experiments that explore whether a group of Broca's aphasics, who were agrammatic in comprehension as well as speech, a group of fluent aphasics, and a group of normal controls are sensitive to the argument structure arrangements of verbs. Subjects had to perform a complex secondary task both in the immediate vicinity of the verb and also at a point well past the verb while listening to sentences for meaning. Reaction times to this secondary task show that both normal controls and agrammatic Broca's aphasic subjects activate multiple argument structure possibilities for a verb in the vicinity of the verb, yet at a point downstream from the verb such effects disappear. These data suggest that the problems agrammatic subjects show with verbs in sentence comprehension, and the general lexical access deficit also recently claimed to be part of the agrammatics' problem, may not extend to the real-time processing of verbs and their arguments. Fluent aphasic subjects, on the other hand, do not show sensitivity to the argument structure properties of verbs, suggesting that these patients may have a semantic-like sentence processing deficit.

Aged↗

PubMed1991

On deriving the properties of agrammatic comprehension.

Several recent studies characterize agrammatic comprehension as a computational rather than a conceptual deficit. A restriction in the computational capacity of the processor may affect sentence comprehension performance unevenly due to the varying demands imposed by different sentence structures and different tasks. It is argued that structures involving longer inferential chains suffer greater degradation than structures involving shorter inferential chains. Many of the observed properties of agrammatic comprehension may be seen to follow from this principle alone.

Aphasia, Broca↗

PubMed1992

Speech production, syntax comprehension, and cognitive deficits in Parkinson's disease.

Speech samples were obtained that were analyzed for voice onset time (VOT) for 40 nondemented English speaking subjects, 20 with mild and 20 with moderate Parkinson's disease. Syntax comprehension and cognitive tests were administered to these subjects in the same test sessions. VOT disruptions for stop consonants in syllable initial position, similar to those noted for Broca's aphasia, occurred for nine subjects. Longer response times and errors in the comprehension of syntax as measured by the Rhode Island Test of Sentence Comprehension (RITLS) also occurred for these subjects. Anovas indicate that the VOT overlap subjects had significantly higher syntax error rates and longer response times on the RITLS than the VOT nonoverlap subjects--F(1, 70) = 12.38, p less than 0.0008; F(1, 70) = 7.70, p less than 0.007, respectively. The correlation between the number of VOT timing errors and the number of syntax errors was significant. (r = 0.6473, p less than 0.01). VOT overlap subjects also had significantly higher error rates in cognitive tasks involving abstraction and the ability to maintain a mental set. Prefrontal cortex, acting through subcortical basal ganglia pathways, is a component of the neural substrate that regulates human speech production, syntactic ability, and certain aspects of cognition. The deterioration of these subcortical pathways may explain similar phenomena in Broca's aphasia. Results are discussed in relation to "modular" theories.

Adult↗

PubMed1982

Stimulus-response profile analysis: a comprehensive, quantitative approach to the study of sensory coding and information processing.

In order to understand the coding and information processing capabilities of mechanosensory neurons, it is necessary to examine stimulus--response relationships under a wide variety of stimulus conditions, using a comprehensive set of quantitative analytic procedures. We employ the methodology of stimulus--response profile analysis, which is based on 4 principles: (1) the use of a broad-based battery of quantitatively controlled mechanical stimuli; (2) maintenance of comprehensive records of experiments; (3) detailed, quantitative analysis of single-unit responses; and (4) the application of these principles uniformly and consistently to all units studied. In addition to conventional graphical portrayals of single-unit activity, we employ a set of quantitative response indices, each of which represents a particular aspect of a unit's overall responsiveness. The distribution of a response index for the entire sample of neurons examined in a particular population offers insight into the manner in which a specific stimulus feature is presented within that population. The distributions of response indices obtained from different neural populations can be compared statistically in order to evaluate interpopulation differences in stimulus-response relationships. This comprehensive, quantitative approach is capable of demonstrating significant, although subtle, interpopulation differences which are not revealed by more cursory, qualitative methods.

Animals↗

PubMed1982

Pattern of recovery of oral and written expression and comprehension in aphasic patients.

Three hundred and eighty-eight aphasic patients (250 rehabilitated and 138 non-rehabilitated) were subjected to a study whose aim was to analyze the relationship between recovery in 4 specific language skills: oral and written expression and comprehension. By means of Cohen's K coefficient of agreement we sought to ascertain whether recovery of one out of these language skills significantly affected recovery of the remaining 3 language modalities. In rehabilitated patients recovery of oral ad written comprehension and expression always turned out to be linked; in non-rehabilitated patients oral comprehension recovery was not associated with recovery of oral expression, reading and writing. Regarding the evolution of aphasia type, none of the experimental subjects changed from a fluent to a non-fluent form of aphasia.

Agraphia↗

PubMed1996

Mathematical cognitive style and arithmetic sign comprehension: a study of EEG alpha and theta activity.

The localization of arithmetic sign comprehension was investigated using EEG spectral parameters as indicators of cortical engagement. Right-handed male subjects were selected on the basis of scores on the Mathematics Cognitive Style Survey and assigned to 2 groups, a 'left hemisphere oriented (LHO)' (N = 9) and 'right hemisphere oriented (RHO)' (N = 9) group. Subjects were presented with 4 conditions, a motoric baseline condition, two arithmetic fact retrieval tasks employing either a sign operator or verbal operator and a sign comprehension task which required subjects to fill in a missing sign (e.g. 6 ? 4 = 24). Both across subject correlational analysis of EEG alpha 1 asymmetry and performance as well as within subject analysis of condition means indicated a somewhat unique contribution of the right hemisphere to sign comprehension. LHO subjects exhibited greater relative left mid-temporal lobe activation than RHO subjects but less relative left frontal activation (theta band) than RHO subjects during the verbal operator task. It was tentatively concluded that this frontal lobe asymmetry difference was due to a mismatch in strategy preference and coding requirements among RHO subjects.

Adult↗

PubMed2005

A randomized clinical trial of hospital-based, comprehensive cardiac rehabilitation versus usual care for patients with congestive heart failure, ischemic heart disease, or high risk of ischemic heart disease (the DANREHAB trial)--design, intervention, and population.

BACKGROUND: Current guidelines broadly recommend comprehensive cardiac rehabilitation (CR), although evidence for this is still limited. It is not known whether evidence from before 1995 is still valid. STUDY DESIGN: The DANish Cardiac ReHABilitation (DANREHAB) trial was designed as a centrally randomized clinical trial to clarify whether hospital-based comprehensive CR is superior to usual care for patients with congestive heart failure, ischemic heart disease, or high risk for ischemic heart disease. A combined primary outcome measure included total mortality, myocardial infarction, or readmissions due to heart disease based on linkage to public registries. The CR was an individually tailored, multidisciplinary program (6 weeks of intensive CR and 12 months of follow-up) including patient education, exercise training, dietary counseling, smoking cessation, psychosocial support, risk factor management, and clinical assessment. STUDY POPULATION: Of 5060 discharged patients, 1614 (32%) were eligible for the trial and 770 patients were randomized (47% of those eligible). Participants were younger (P < .001) and had less comorbidity than nonparticipants (P < .03). CONCLUSION: Our trial shows that a large-scale, centrally randomized clinical trial on comprehensive CR can be conducted among a broadly defined patient group, but reaching the stipulated number of 1800 patients was difficult. Although the study included relatively many women and older people, elderly patients and patients with high comorbidity were underrepresented, which may influence the external validity.

Adult↗

PubMed2005

Outcome of a comprehensive neurorehabilitation program for patients with traumatic brain injury.

OBJECTIVE: To evaluate the outcome of a comprehensive neurorehabilitation program compared with that of conventional clinical care and rehabilitation for patients with traumatic brain injury (TBI). DESIGN: Nonrandomized, controlled trial with a 2-year follow-up. SETTING: Nationwide rehabilitation center and level I trauma center, both in Finland. PARTICIPANTS: We studied 19 consecutive adults with a significant TBI who underwent a comprehensive neurorehabilitation program and 20 control patients who received conventional rehabilitation referred by physicians in the general health care system. The outcome of the control patients was not known before the selection. The groups were similar in age, sex, education, injury severity (assessed on the Glasgow Coma Scale, radiologic and neuropsychologic findings, neurosurgical interventions), time from the injury, and preinjury employment status. INTERVENTIONS: A postacute, intensive, interdisciplinary, 6-week rehabilitation program for TBI patients who are considered to have adequate potential to achieve productivity by this means; focus on neuropsychologic rehabilitation and psychotherapy with vocational interventions and follow-up support. MAIN OUTCOME MEASURE: Status of productivity, judged as productive (defined as working, studying, or participating in volunteer activities) or nonproductive, evaluated on questionnaires filled in by patients and their significant others at the time of follow-up evaluation. RESULTS: At follow-up, 89% of the treated patients were productive compared with 55% of the controls. The rehabilitation program was significantly predictive of the productive status at follow-up (odds ratio=6.96; 95% confidence interval, 1.26-38.44; P=.017). Other factors did not explain the better productivity of the treatment group. Two neuropsychologist-evaluators, who were blind to the rehabilitation history of patients and to each other's evaluations, were perfectly consistent in their classification of patients' productivity statuses. CONCLUSIONS: The findings support the proposition that comprehensive neuropsychologically oriented rehabilitation programs can improve psychosocial functioning in terms of productivity in postacute patients with moderate to severe TBI. Additional larger controlled studies are needed to establish the efficacy of TBI rehabilitation interventions.

Adolescent↗

PubMed2005

The preservation of verb subcategory knowledge in a spoken language comprehension deficit.

Patient WBN has a lexical-semantic deficit resulting in impaired performance on language comprehension tasks that require access to verb meanings in both single-word and sentence contexts. However, WBN shows no such comprehension impairment with respect to lexical syntax. Specifically, he performs without error on comprehension tasks that rely on knowledge of lexical-specific verb subcategory requirements. This performance pattern supports theories of lexical representation and processing in which lexical syntactic information may be encoded and retrieved independently from lexical semantic information.

Aged, 80 and over↗