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PubMed1996

Clinical characteristics of children referred to a child development center for evaluation of speech, language, and communication disorders.

Speech, language, and communication disorders are prominent reasons for referrals to a child development center. From 1984 to 1988, 1,090 preschool children were referred to our child development center, which serves the Tel Aviv metropolitan area. Of all referrals, 432 (41%) were primarily due to speech, language, and communication problems. After exclusion of those with IQ < 50 and those with non-language-related disabilities, 323 children remained. The children were classified into different subtypes of developmental language disorders and autistic spectrum disorders. The main developmental language disorder subtypes were combined expressive-receptive (49%) and expressive (44%). Central processing deficits were less common, occurring in 20 (7%) of the children. Parents of children with developmental language disorders had educational levels similar to those of parents of children referred to the child development center for other causes. However, parents of children with infantile autism had higher educational levels than parents of children with developmental language disorder or parents of children referred for other causes (P < .001). Our results reflect the distribution of language and related problems in an unselected population of preschool children referred to a child development center.

Autistic Disorder↗

PubMed2000

The effects of psychoactive drugs and neuroleptics on language in normal subjects and schizophrenic patients: a review.

The aim of this survey is to present an overview of research into psychopharmacology as regards the effects of different psychoactive drugs and neuroleptics (NL) on language in normal subjects and schizophrenic patients. Eighteen studies that have investigated the effects of different drugs (alcohol, amphetamines, secobarbital, L-dopa, psilocybin, ketamine, fenfluramine) and neuroleptics (conventional and atypical) on language are reviewed. There are no studies concerning the effects of neuroleptics on language in healthy subjects. The results of the effects of other molecules indicate that language production can be increased (alcohol, amphetamine, secobarbital), rendered more complex (d-amphetamine), more focused (L-dopa) or more unfocused (psilocybin) and clearly impaired (ketamine). For schizophrenic patients, most studies show that conventional neuroleptic treatments, at a therapeutic dosage and in acute or chronic mode, reduce language disorders at all levels (clinic, linguistic, psycholinguistic). In conjunction with other molecules, the classical NL, when administered at a moderate dosage and in chronic mode, modify language in schizophrenia, either by improving the verbal flow and reducing pauses and positive thought disorder (NL + amphetamine) or by inducing an impairment in the language measurements (NL + fenfluramine). Clinical, methodological and theoretical considerations of results are debated in the framework of schizophrenic language disorders.

Adult↗

PubMed2003

Interactions of the hippocampal system and the prefrontal cortex in learning language-like rules.

One of the most influential views on the hippocampal function suggests that this brain region is critically involved in relational memory processing, that is, binding converging inputs to mediate the representation of relationships among the constituents of episodes. It has been proposed that this binding is automatic and obligatory during learning and remembering In addition, neuroimaging studies have highlighted the importance of the prefrontal cortex, in learning, memory, and language processing. However, the posited importance of hippocampal-prefrontal interaction remains to be empirically tested. In the present study we used functional magnetic resonance imaging to examine in detail this interaction by assessing learning-related changes in hemodynamic activity during artificial language acquisition. It has been shown previously that artificial grammar systems might be learned by evaluating pattern-based relations in word sequences and generalizing beyond specific word order, that is, rule abstraction. During scanning, participants learned an artificial language whose miniature grammar meets the universal principles of a natural language. Increased proficiency level of the artificial language is associated with decreased left hippocampal activity. In contrast, we observed an increased recruitment of the left inferior frontal gyrus (Broca's area), a region that contributes to syntax processing in natural language. The present results, therefore, indicate a learning-related change in brain circuitry underlying relational processes of language learning, with a transition from a similarity-based learning system in the medial temporal lobes to a language-related processing system in the left prefrontal cortex.

Adult↗

PubMed2004

Determination of cortical language dominance using functional transcranial Doppler sonography in left-handers.

OBJECTIVE: Verbal analytical functions are primarily related to the left hemisphere in right-handers, but there is yet no agreement about cortical language dominance in left-handers. Also, there are some contradictory reports about sex differences in cortical language lateralization. The aim of this study is to investigate cortical language dominance in left-handers and to explore gender influence on cortical language representation. METHODS: We performed functional transcranial Doppler sonography (previous validated for determination of cerebral language lateralization) during a word generation task, measuring changes in mean cerebral blood flow velocity (BFVmean) in both middle cerebral arteries (MCA) in 150 healthy subjects (75 left-handers and 75 right-handers). In left-handers we observed significant increase BFVmean in right MCA in 58 (77.3%) subjects. Bilateral increase was observed in 11 (14.7%) subjects and increase in left MCA in 6 (8%) subjects. In right-handed group 93.3% subjects showed left cortical dominance, while 6.7% showed bilateral language representation. RESULTS: Current results showed significant (P<0.0001) right hemispheric language dominance in healthy left-handed subjects. CONCLUSIONS: Our results showed significant difference in hemispheric dominance for verbal function between righthanders and lefthanders. Also there is statistically insignificant female gender tendency for bilateral hemispheric language representation in both handedness.

Adult↗

PubMed2002

The cognitive functions of language.

This paper explores a variety of different versions of the thesis that natural language is involved in human thinking. It distinguishes amongst strong and weak forms of this thesis, dismissing some as implausibly strong and others as uninterestingly weak. Strong forms dismissed include the view that language is conceptually necessary for thought (endorsed by many philosophers) and the view that language is de facto the medium of all human conceptual thinking (endorsed by many philosophers and social scientists). Weak forms include the view that language is necessary for the acquisition of many human concepts and the view that language can serve to scaffold human thought processes. The paper also discusses the thesis that language may be the medium of conscious propositional thinking, but argues that this cannot be its most fundamental cognitive role. The idea is then proposed that natural language is the medium for nondomain-specific thinking, serving to integrate the outputs of a variety of domain-specific conceptual faculties (or central-cognitive "quasimodules"). Recent experimental evidence in support of this idea is reviewed and the implications of the idea are discussed, especially for our conception of the architecture of human cognition. Finally, some further kinds of evidence which might serve to corroborate or refute the hypothesis are mentioned. The overall goal of the paper is to review a wide variety of accounts of the cognitive function of natural language, integrating a number of different kinds of evidence and theoretical consideration in order to propose and elaborate the most plausible candidate.

Cognition↗

PubMed1996

Functional MRI localization of language in a 9-year-old child.

BACKGROUND: Localizing critical brain functions such as language in children is difficult and generally requires invasive techniques. Recently sensory, motor and language functions in adults have been mapped to specific brain locations using functional imaging techniques. Of these techniques, functional MRI (fMRI) is the least invasive and has the highest spatial and temporal resolution. Its use in adults is well documented but application to children has not been as well described. In the present study lateralization and localization of language was evaluated with fMRI prior to epilepsy surgery in a nine-year-old male with complex partial seizures, attentional difficulty and decreased verbal proficiency. METHODS: Two language paradigms well studied in adults (read, verb generation) and two additional language paradigms (antonym generation, latter fluency) were studied using whole brain fMRI after stimulus items and timing were adjusted to achieve the desired performance level during imaging. The patient was also conditioned to the magnet environment prior to imaging. RESULTS: Word reading and letter fluency tasks produced lateralized and localized activation similar to that seen in adults. The patient had no language deficits following an anterior 2/3 dominant temporal lobe resection. CONCLUSIONS: With modifications of protocols such as those detailed in this report, this non-invasive method for localizing language function is feasible for the presurgical evaluation of children as well being applicable for a variety of developmental language issues.

Brain↗

PubMed2004

Matching preschool children with autism spectrum disorders and comparison children for language ability: methodological challenges.

Earlier identification of children with autism spectrum disorders (ASDs) is welcome, but presents a number of challenges to the clinical and the research enterprises (see Charman & Baird [2002] for a review). In the research enterprise, one critical methodological challenge is the use of appropriate measures on which to match groups of preschoolers with ASDs to comparison groups with other neurodevelopmental conditions. Language and communication impairments are central to the diagnosis of ASD and, therefore, critical variables to consider in group-matched research designs. In the domain of language function the challenges include the very poor language competence of many preschoolers with ASDs, the fact that some early language competencies form part of the formal diagnostic criteria of ASD and diagnostic algorithms on research diagnostic instruments, the uneven profile of language competency in children with ASDs, and the difference between performance on measures of formal language competency in the testing situation and everyday language use. The current paper will review these challenges and suggest some possible approaches to overcome them, including using more than one measure of language ability and adopting a pragmatic approach to group composition and statistical analysis.

Autistic Disorder↗

PubMed2003

Code-switching across brainstorming sessions: implications for the revised hierarchical model of bilingual language processing.

The revised hierarchical model (RHM) of bilingual language processing posits independent word form representations for the dominant language (L1) and the nondominant language (L2), facilitated translation from L2 words to L1 words, access to common concepts for L1 and L2, and stronger activation of concepts for L1 than for L2. Spanish-English and English-Spanish bilinguals brainstormed for two sessions; half switched languages (L1-L2 or L2-L1) and half stayed in the same language (L1-L1 or L2-L2) across sessions. In both sessions, L1 brainstorming resulted in more efficient idea productivity than L2 brainstorming, supporting stronger concept activation for L1, consistent with the RHM. Switching languages from L2 to L1 resulted in the most efficient idea productivity in Session 2, suggesting that switching to L1 not only permits strong concept activation, but also the activation of concepts that are relatively different than those activated by L2, inconsistent with the RHM. Switching languages increased the proportion of Session 1 ideas repeated during Session 2, despite instructions not to repeat. This finding suggests that there is activation of concepts as well as word forms in same language brainstorming and that this dual activation aids in following instructions not to repeat, consistent with the RHM. It is suggested that the RHM be re-specified to accommodate the notion that L1 and L2 access relatively different concepts.

Cognition↗

PubMed2003

Usefulness of language and memory testing during intracarotid amobarbital testing: observations from an fMRI study.

BACKGROUND: Several procedures for testing language lateralization and memory function exist during the intracarotid amobarbital test (IAT). The use of functional magnetic resonance imaging (fMRI) gives the opportunity to assess the validity of some of these procedures, or at least to inspect the neuronal correlates. A comprehensive fMRI protocol was tested, aimed at addressing aspects of lateralization of language, as well as testing memory in relation to activation of mesiotemporal regions. Here we report observations with possible consequences for the current IAT procedures. MATERIALS AND METHODS: The protocol consisted of three language tasks (overt naming, semantic decision and silent word generation) and two memory tasks (encoding and retrieving visual scenes). The paradigms used a block-related procedure in nine right-handed normal volunteers. During the procedure dynamic weighted full brain images were acquired which are sensitive to the blood oxygenation activation effect. RESULTS: Encoding showed symmetrical bilateral activation in the mesiotemporal regions, specifically the hippocampus, parahippocampal gyrus and fusiform gyrus. With a retrieval task activation of the mesiotemporal areas was restricted to the posterior hippocampal area. Overt object naming showed results, similar to encoding tasks with bilateral activation of hippocampal areas. Silent word generation showed much stronger ability to lateralize than the other two language-related tasks and especially object naming. CONCLUSION: Activation revealed by fMRI activation shows that IAT procedures, using active semantic language processing or comprehensive procedures with multiple language tasks have the highest guarantee for individual activation lateralization. Simple object naming does not guarantee a lateralized language fMRI activation pattern. Of the different memory procedures during IAT, the procedures (Interview and the Montreal) demanding encoding processing will be related to larger areas of bilateral hippocampal activation than procedures (Seattle) exclusively requiring retrieval. Moreover, tasks using recognition of previously presented language items (naming objects) are equally effective for assessing hippocampal activation compared with presenting separate memory items.

Adult↗

PubMed1999

Cross-language tests of hemispheric strategies in reading nonwords.

Four experiments explored the effects of specific language characteristics on hemispheric functioning in reading nonwords using a lateralized trigram identification task. Previous research using nonsense consonant-vowel-consonant (CVC) trigrams has shown that total error scores reveal a right visual field (RVF) advantage in Hebrew, Japanese, and English. Qualitative error patterns have shown that the right hemisphere uses a sequential strategy, whereas the left hemisphere uses a more parallel strategy in English but shows the opposite pattern in Hebrew. Experiment 1 tested whether this is due to the test language or to the native language of the participants. Results showed that native language had a stronger effect on hemispheric strategies than test language. Experiment 2 showed that latency to target letters in the CVCs revealed the same asymmetry as qualitative errors for Hebrew speakers but not for English speakers and that exposure duration of the stimuli affected misses differentially according to letter position. Experiment 3 used number trigrams to equate reading conventions in the 2 languages. Qualitative error scores still revealed opposing asymmetry patterns. Experiments 1-3 used vertical presentations. Experiment 4 used horizontal presentation, which eliminated sequential processing in both hemispheres in Hebrew speakers, whereas English speakers still showed sequential processing in both hemispheres. Comparison of the 2 presentations suggests that stimulus arrangement affected qualitative errors in the left visual field but not the RVF for English speakers and in both visual fields for Hebrew speakers. It is suggested that these differences result from orthographic and morphological differences between the languages: Reading Hebrew requires attention to be deployed to all the constituents of the stimulus in parallel, whereas reading English allows sequential processing of the letters in both hemispheres. Implications of cross-language studies for models of hemispheric function are discussed.

Adult↗

PubMed1989

Familial concentration of developmental language impairment.

A questionnaire concerning the history of treatment of developmental language disorder was used to evaluate the prevalence of these problems within the immediate family members of second-grade children with and without language impairment. The data obtained from these families revealed strong evidence that such language problems are not randomly distributed across families but rather tend to concentrate within families. Although all family members of the language-impaired second graders demonstrated substantially increased odds for language impairment over those who came from families with normal second graders, a considerable range of increased odds for language impairment existed among the family members. Specifically, brothers and to a lesser degree sisters had a higher familial association with language impairment than did the parents. These results suggest that the factors that contribute to developmental language disorders are at least in part associated with the family unit.

Adult↗

PubMed1984

Anticipatory imagery ability in normal and language-disabled children.

The literature on cognitive functioning of language-disabled children suggests that they exhibit specific disabilities in nonlinguistic as well as linguistic domains. These disabilities have been hypothesized to be related to deficits in cognitive representational ability. Anticipatory imagery and spatial representation have been reported as two nonlinguistic representational areas in which language-disordered children are deficient. The present study compared normal and language-disabled children on spatial representation tasks involving anticipatory imagery. Five spatial tasks were administered to two groups of 7 1/2-9 1/2-year-old children matched on sex, age, native language, and racial background. One group included 18 language-disabled children and the other group 18 children with normal language development. The language-disabled were less accurate than the normal children on all tasks which involved anticipation or prediction of mental rotations, movements, or other transformations. The results of this study suggest difficulty with dynamic cognitive representation in the linguistic and nonlinguistic deficits demonstrated by language-disabled children.

Child↗

PubMed1986

Analytic study of the Tadoma method: language abilities of three deaf-blind subjects.

This study reports on the linguistic abilities of 3 adult deaf-blind subjects. The subjects perceive spoken language through touch, placing a hand on the face of the speaker and monitoring the speaker's articulatory motions, a method of speechreading known as Tadoma. Two of the subjects, deaf-blind since infancy, acquired language and learned to speak through this tactile system; the third subject has used Tadoma since becoming deaf-blind at age 7. Linguistic knowledge and productive language are analyzed, using standardized tests and several tests constructed for this study. The subjects' language abilities prove to be extensive, comparing favorably in many areas with hearing individuals. The results illustrate a relatively minor effect of limited language exposure on eventual language achievement. The results also demonstrate the adequacy of the tactile sense, in these highly trained Tadoma users, for transmitting information about spoken language sufficient to support the development of language and learning to produce speech.

Blindness↗

PubMed1997

Language production abilities of children whose stuttering persisted or recovered.

This study evaluated the language production capabilities of 32 young children whose stuttering followed divergent paths: one group whose stuttering persisted, one group who stuttered relatively briefly and recovered, and one group who stuttered for a longer period prior to recovery. Three indices of language production (mean length of utterance, number of different words, and number of total words) were obtained from spontaneous language samples. Measures of language production were calculated from samples collected at an initial visit near stuttering onset and at a one-year follow-up visit. Results revealed that the majority of the children who stuttered performed within the average range on these measures of language production. One child, a child whose stuttering persisted, consistently performed below the average range on all measures. Comparison of the three groups revealed greater variability, as well as atypical patterns of development, in the language production skills of children whose stuttering persisted. These findings suggest that although language production deficits do not appear to be widespread in children who stutter, examination of individual patterns of performance is central to clarifying the developmental relationship between language proficiency and the production of fluent speech.

Age of Onset↗

PubMed1998

Language-impaired preschoolers: a follow-up into adolescence.

This paper reports a longitudinal follow-up of 71 adolescents with a preschool history of speech-language impairment, originally studied by Bishop and Edmundson (1987). These children had been subdivided at 4 years into those with nonverbal IQ 2 SD below the mean (General Delay group), and those with normal nonverbal intelligence (SLI group). At age 5;6 the SLI group was subdivided into those whose language problems had resolved, and those with persistent SLI. The General Delay group was also followed up. At age 15-16 years, these children were compared with age-matched normal-language controls on a battery of tests of spoken language and literacy skills. Children whose language problems had resolved did not differ from controls on tests of vocabulary and language comprehension skills. However, they performed significantly less well on tests of phonological processing and literacy skill. Children who still had significant language difficulties at 5;6 had significant impairments in all aspects of spoken and written language functioning, as did children classified as having a general delay. These children fell further and further behind their peer group in vocabulary growth over time.

Achievement↗

PubMed1998

Identifiers of predominantly Spanish-speaking children with language impairment.

The purpose of this study was to identify a set of measures that would discriminate 31 predominantly Spanish-speaking children with normal language (NL children) from 31 children with language impairment (LI children). The LI children were identified as such by experienced, bilingual (Spanish/English), ASHA-certified, speech-language pathologists who were currently seeing the children in their caseloads. Children ranged in age from 5 to 7 years and were matched for age, gender, and school. Additionally, nonverbal cognitive measures assured that they did not differ significantly intellectually. Measures of vocabulary, novel bound-morpheme learning skills, and language form were randomly administered to all children. Further, parents responded to questions about their perceptions of their children's speech and language skills and family history of speech and language problems. A stepwise discriminant analysis indicated that 4 measures discriminated the groups of children with a sensitivity of 91.3% and a specificity of 100% (p < .0001): parental report of the child's speech and language skills, number of errors per T-unit, mean length per T-unit, and family history of speech and language problems. A second discriminant analysis indicated that the sensitivity and specificity could be maintained when only the first 2 measures were included. Confirmatory discriminant analyses of the 2- and 4-measure models indicated that the discriminant accuracy was stable on an independent sample.

Child↗

PubMed2003

Technical refinements for validating functional MRI-based neuronavigation data by electrical stimulation during cortical language mapping.

Preoperative functional neuroimaging techniques represent an appealing method to localize language areas in tumor surgery, but their reliability still needs to be confirmed by accurate comparison with more invasive but validated mapping techniques like intraoperative electrical cortical stimulation. Two patients harboring a glioma involving speech areas underwent mapping of language function by preoperative functional magnetic resonance imaging (fMRI), whose results were integrated into the neuronavigation device, and by intraoperative electrical stimulation mapping (ESM). The utilization of neuronavigation allowed us to estimate the degree of spatial correspondence between language areas detected by the two techniques. Language areas identified by functional magnetic resonance imaging on the cerebral cortex exposed during surgery corresponded to those identified by invasive mapping in both patients. It was possible to achieve a gross total tumor removal while respecting language areas in both cases, with no permanent postoperative phasic aggravation. The concordance of results between pre- and intraoperative mapping techniques in our patients indicates that preoperative fMRI language mapping may prove useful when planning the resection of intracerebral lesions in language areas. However, accurate neurofunctional imaging protocols and image analysis are crucial to obtain a preoperative language mapping that is in agreement with ESM findings.

Brain Mapping↗

PubMed2006

Language ability after early detection of permanent childhood hearing impairment.

BACKGROUND: Children with bilateral permanent hearing impairment often have impaired language and speech abilities. However, the effects of universal newborn screening for permanent bilateral childhood hearing impairment and the effects of confirmation of hearing impairment by nine months of age on subsequent verbal abilities are uncertain. METHODS: We studied 120 children with bilateral permanent hearing impairment identified from a large birth cohort in southern England, at a mean of 7.9 years of age. Of the 120 children, 61 were born during periods with universal newborn screening and 57 had hearing impairment that was confirmed by nine months of age. The primary outcomes were language as compared with nonverbal ability and speech expressed as z scores (the number of standard deviations by which the score differed from the mean score among 63 age-matched children with normal hearing), adjusted for the severity of the hearing impairment and for maternal education. RESULTS: Confirmation of hearing impairment by nine months of age was associated with higher adjusted mean z scores for language as compared with nonverbal ability (adjusted mean difference for receptive language, 0.82; 95 percent confidence interval, 0.31 to 1.33; and adjusted mean difference for expressive language, 0.70; 95 percent confidence interval, 0.13 to 1.26). Birth during periods with universal newborn screening was also associated with higher adjusted z scores for receptive language as compared with nonverbal ability (adjusted mean difference, 0.60; 95 percent confidence interval, 0.07 to 1.13), although the z scores for expressive language as compared with nonverbal ability were not significantly higher. Speech scores did not differ significantly between those who were exposed to newborn screening or early confirmation and those who were not. CONCLUSIONS: Early detection of childhood hearing impairment was associated with higher scores for language but not for speech in midchildhood.

Child↗