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The effect of a diagnostic label of language delay on adults' perceptions of preschool children.

The effects of the label of expressive language disorder (ELD) on adults' perceptions of preschoolers were investigated. Twenty adults interacted with 3 children of typical development and one child previously diagnosed with ELD. Adults were randomly assigned to a label group (in which the child with ELD was identified) or a nonlabel group (in which the child with ELD was not identified). After interacting with dyads of children, adults ranked them according to behavioral characteristics and competencies. Results indicated that the nonlabel group ranked the child with ELD as significantly less likable and less productive, and they predicted less academic competence from her. In contrast, the label group did not differentiate the children behaviorally, but they predicted less social competence from the child with ELD. Implications regarding the use of labels in the inclusion of children with disabilities are discussed.

Adult↗

"Tip-of-the-tongue" phenomenon in Parkinson disease.

Articulatory disturbances are frequently described in Parkinson disease, but language disorders are not. We have occasionally encountered parkinsonian patients with word-finding difficulty unrelated to memory loss, intellectual impairment, or dysarthria. To examine this, 22 medically stable parkinsonian patients were given the vocabulary subtest of the WAIS, the Boston Naming Test, measures of verbal fluency, and sentence repetition. Signs and symptoms of parkinsonism were rated. WAIS vocabulary subtest scores were above the mean for normal aged subjects, but confrontation naming was one standard deviation below norms for age and education. Naming was facilitated by cues in most patients. Only sentence repetition correlated with dysarthria. Category naming was impaired and correlated significantly with the severity of parkinsonism, especially bradykinesia. This suggests that a type of anomia may occur in Parkinson disease. it shares the clinical characteristics of the "tip-of-the-tongue" phenomenon and "word production anomia" seen in some aphasics.

Anomia↗

A new empirical angle on the variability debate: quantitative neurosyntactic analyses of a large data set from Broca's aphasia.

Behavioral variation in Broca's aphasia has been characterized as boundless, calling into question the validity of the syndrome-based schema and related diagnostic methods of acquired language disorders. More generally, this putative variability has cast serious doubts on the feasibility of localizing linguistic operations in cortex. We present a new approach to the quantitative analysis of deficient linguistic performance, and apply it to a large data set, constructed from the published literature: Comprehension data of 69 carefully selected Broca's aphasic patients, tested on nearly 6000 stimulus sentences, were partitioned in different ways, and subjected to a series of analyses. While a certain amount of variability is indeed evident in the data, our quantitative analyses reveal a highly robust selective impairment pattern for the group: the patients' ability to analyze syntactic movement is severely compromised, in line with the Trace-Deletion Hypothesis. Further analyses suggest that patients' performance on no-movement sentence types exhibits less variation than on sentences that contain movement. We discuss the clinical and theoretical implications of our results.

Aphasia, Broca↗

Contemporary accounts of the cognition/language relationship: implications for speech-language clinicians.

The role of cognition in children's language acquisition is a topic of current debate. This article provides a review of the normative literature and a discussion of questions regarding children who have difficulty acquiring language. Key terminology is described, along with basic issues. Major research questions are identified, along with the competing hypotheses that have been proposed and the evidence associated with each hypothesis. Implications for models of language disorders and remediation activities are discussed.

Child Language↗

Atypical dominance for language in developmental dysphasia.

The authors report an association between developmental language disorder and acquired aphasia in a 13-year-old right-handed boy. Acquired aphasia was caused by a right-frontal abscess (crossed aphasia). It was non-fluent, with a disorder of auditory comprehension, an unusual feature of prerolandic lesions. This case shows that developmental language impairment can be associated not only with an atypical cerebral dominance, but also with unusual patterns of intrahemispheric specialization. The rapid and complete recovery of this boy's aphasia suggests that the cerebral plasticity for acquired lesions can be normal in such cases.

Adolescent↗

[The Landau-Kleffner syndrome: a special form of acquired childhood aphasia].

The syndrome of "acuqired aphasia with convulsive disorder" occurs in children between 3 and 7 years of age and is characterized by a language disorder with heterogeneous epileptic manifestations. The pathogenesis is unknown. The course can show marked fluctuations. Our study of 6 children shows that the outcome can range from extremely unfavorable to complete recovery. The variables that possibly influence the course are discussed.

Aphasia↗

Aphasia after left hemispheric intracerebral hemorrhage.

The function of subcortical nuclear structures in language is uncertain, and language disorders after injury to these structures are described incompletely. We report 15 patients with left putaminal or thalamic hemorrhage, describe the range of language and behavioral disorders produced, and review the potential mechanisms of these disorders. Clinicoanatomic correlations revealed no definite differences between aphasia after hemorrhage in putamen or in thalamus.

Adult↗

Characterization of Foxp2 and Foxp1 mRNA and protein in the developing and mature brain.

Foxp2 and Foxp1 are recently identified members of the Fox family of winged-helix/forkhead transcription factor genes. A recent study has found that mutations in human FOXP2 produce a severe language disorder. Since Foxp2 appears to be important in language, we wanted to explore the expression of this gene and a homologous gene, Foxp1, in the developing brain. In the present study, we investigated the time course and localization of Foxp2 and Foxp1 mRNA and protein expression in the developing and adult mouse using in situ hybridization and immunohistochemistry. Foxp2 and Foxp1 are expressed as early as E12.5 and persist into adulthood. Foxp2 and Foxp1 were most highly expressed in the developing and mature basal ganglia. Expression of Foxp2 was also observed in the cerebral cortex (layer 6), cerebellum (Purkinje neurons), and thalamus. Foxp1 expression was observed in the cerebral cortex (layers 3-5), hippocampus (CA1), and thalamus. Very little ventricular zone expression was observed for Foxp2 and Foxp1 and the expression of both of these genes occurred following neuronal migration, suggesting a role for these genes in postmigratory neuronal differentiation. Furthermore, we demonstrated the expression of FOXP2 in human fetal brain by RT-PCR, in the perisylvian area of the left and right cerebral hemispheres, as well as in the frontal and occipital cortices. Overall, the widespread expression of Foxp2 in the developing brain makes it difficult to draw specific conclusions about which areas of Foxp2 expression are critical to human language function.

Animals↗

The small world of human language.

Words in human language interact in sentences in non-random ways, and allow humans to construct an astronomic variety of sentences from a limited number of discrete units. This construction process is extremely fast and robust. The co-occurrence of words in sentences reflects language organization in a subtle manner that can be described in terms of a graph of word interactions. Here, we show that such graphs display two important features recently found in a disparate number of complex systems. (i) The so called small-world effect. In particular, the average distance between two words, d (i.e. the average minimum number of links to be crossed from an arbitrary word to another), is shown to be d approximately equal to 2-3, even though the human brain can store many thousands. (ii) A scale-free distribution of degrees. The known pronounced effects of disconnecting the most connected vertices in such networks can be identified in some language disorders. These observations indicate some unexpected features of language organization that might reflect the evolutionary and social history of lexicons and the origins of their flexibility and combinatorial nature.

Biological Evolution↗

Language dysfunction in cerebrovascular disease.

Language disorder is often mistaken for confusion, psychosis, or memory loss, and thorough evaluation may require much time. A simple beside examination can often separate aphasic syndromes, and the anatomic location of the lesion can be inferred. Speech therapy, although not entirely satisfactory, is helpful in most patients.

Anomia↗

Adaptive behavior of young urban children with developmental disabilities.

Adaptive behavior was investigated for 497 urban preschool children with developmental disabilities (autism, pervasive developmental disorder, language impairment, mental retardation, attention-deficit hyperactivity disorder, cognitive deficit), ranging in age from 15 to 71 months, 38% of whom were in foster care. Disabilities were identified through comprehensive multidisciplinary evaluation. Adaptive behavior was assessed with the Vineland Adaptive Behavior Scales. Results indicate a strong positive relation between adaptive behavior and intelligence if measured globally. When Vineland domains were assessed separately, this relation varied across domains and disability groups. With intelligence controlled, adaptive behavior patterns differed for disability groups in communication and socialization.

Activities of Daily Living↗

[Anxiety disorders in the fourth edition of the classification of mental disorders prepared by the American Psychiatric Association: diagnostic and statistical manual of mental disorders (DMS-IV -- options book].

In 1991 the American Psychiatric Association proposed a draft version of the IV edition of Diagnostic and Statistical Manual of Mental Disorders--the DSM IV Options Book. Authors of this version wanted to increase clarity of the criteria sets and to provide compatibility with the Tenth Edition of the International Classification of Diseases (ICD-10). The purpose of this Options Book is to propose some changes in wording, diagnostic divisions and to discuss various options concerning the placement of sections and disorders within the classification. The "Disorders of Infancy, Childhood or Adolescence" section was renamed "Disorders Usually First Evident in Infancy, Childhood or Adolescence" and moved to the front of the classification and also was expended to 11 groups of disorders. Several suggestions have been made about including new diagnostic groupings such as: Rett's Disorder, Eating Disorders and Voice Disorder. The Options Book introduces a superior category for Attention Deficit Disorders (with and without hyperactivity) and for Conduct Disorder/Oppositional Defiant Disorder. Several options are proposed regarding The Anxiety Disorders of Childhood or Adolescence. Since there is no evidence for distinction in this category according to the age criterion, one option would be to move these disorders into the adult anxiety section (similarly to the Mood Disorders and Schizophrenia). In the new version the title "Specific Developmental Disorders" is omitted. The suggestion is to include Phonological Disorder (Articulation Disorders) and Elective Mutism in the Speech and Language Disorders section.

Anxiety Disorders↗

[Changes in regional cerebral blood flow in nondominant hemisphere during speech task in aphasics.: a PET activation study].

To investigate the patients with language disorder and to detect the activated areas in language processing, we measured the changes in the regional cerebral blood flow (CBF) during speech task (¿counting¿ task) using O-15 water PET activation technique in six normal subjects (age 58.3 +/- 8.1), mean +/- SD), ten fluent aphasics (age 60.3 +/- 12.5) and six nonfluent aphasics (age 50.5 +/- 8.3). In ¿counting¿ task, the subjects were instructed to count the number aloud from 1 to 10 and repeat the sequence over and over in the native language (Japanese) at the rate of one number per 2.5 sec. The data were analyzed with stereotactic intersubject averaging analysis for the normal subjects. Apart from it, the regions of interest (ROI) analysis (a circular ROI of 12 mm diameter) was performed in the language-related areas: posteroinferofrontal areas (PIF), posterosuperotemporal area (PST), and Rolandic areas (related to the mouth and lips) were significantly activated bilaterally in the ¿counting¿ task. PIF were activated with a dominance in the left side. In the resting state, rCBF in the left PIF and left PST were activated with a dominance in the left side. In the resting state, rCBF in the left PIF and left PST was reduced in both fluent and nonfluent aphasics. In nonfluent aphasics, the magnitude of activation in the right PIF by ¿counting¿ task was significantly greater than normal subjects and patients with fluent aphasia (ANOVA). It suggests the importance of the right PIF in the simple language processing in the nonfluent aphasia. In the sixteen aphasic patients, the increase in rCBF in the right PST during the ¿counting¿ task was negatively correlated with the score of comprehension (WAB) in the Spearman ranked correlation (p < 0.05). It suggests that, while the activity of the right PST is minimal for the ¿counting¿ in normal subjects, it plays an important and compensatory role in aphasic patients.

Adult↗