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PubMedDate not supplied

Common pattern of language impairment in vascular dementia and in Alzheimer disease.

The authors studied language performance patterns in early stages of vascular dementia and Alzheimer disease. The objective was to clarify to what extent dissolution of language in vascular dementia is similar to that in Alzheimer disease. Both structured language tests (comprehension, repetition, reading, and naming tasks) and nonstructured language tests (object and picture description) were employed. The structured tasks evidenced impairment on complex auditory comprehension and on picture naming for both dementia groups, whereas oral reading and single word repetition did not differentiate the patients from matched control subjects. On the unstructured narrative tasks, both patient groups showed normal fluency, but content analysis revealed that the patients with dementia produced fewer semantic units (themes) than the control subjects. In summary, both patient groups showed impairment, specifically on semantically mediated language tasks. According to the present results, language impairment in vascular dementia resembles that observed in Alzheimer disease. Semantically mediated functions are among the most sensitive language measures in differentiating early stages of both vascular dementia and Alzheimer disease from normal aging.

Aged↗

PubMed2000

Language disorders: a 10-year research update review.

OBJECTIVE: To review the past 10 years of research in child language or communication disorders, which are highly prevalent in the general population and comorbid with childhood psychiatric disorders. METHOD: A literature search of 3 major databases was conducted. The child language literature, describing the domains of language development--phonology, grammar, semantics, and pragmatics--is reviewed. RESULTS: Disorders of grammar, semantics, and pragmatics, but not phonology, overlap significantly with childhood psychiatric disorders. Receptive language disorders have emerged as high-risk indicators, often undiagnosed. Language disorders and delays are psychiatric risk factors and have implications for evaluation, therapy, and research. However, they are often undiagnosed in child mental health and community settings. The research has focused mostly on monolingual English-speaking children. CONCLUSION: Awareness of basic child language development, delay, and deviance is crucial for the practicing child and adolescent psychiatrist, who must diagnose and refer relevant cases for treatment and remediation. Future research needs to address the growing language diversity of our clinical populations.

Adolescent↗

PubMed1990

Early language ability as a function of ventricular dilatation associated with intraventricular hemorrhage.

This study examined the impact of right and left lateral ventricle dilatation on early language function associated with intraventricular hemorrhage (IVH). Because language is controlled primarily by the left cerebral hemisphere, it was hypothesized that language ability would be related to extent of left side dilatation more than to right. The relations of the number of other common complications of prematurity and socioeconomic status to language also were explored, and their independent contributions to the variance in the outcome were determined. The receptive and expressive language abilities of 45 low birth weight preterms, 18 of whom suffered IVH, were evaluated at a mean age of 16 months. Correlational analyses indicated that left, but not right, ventricle dilatation was inversely related to the expressive language measure. Partial correlations, holding the effects of medical complications and socioeconomic status constant, indicated that the impact of left ventricle dilatation was independent of these variables. Number of medical complications also had an independent relation to expressive language outcome that was equivalent to that of the left ventricle dilatation. Implications of these findings are discussed.

Cerebral Hemorrhage↗

PubMed2005

Influence of the prospective payment system on speech-language pathology services.

OBJECTIVE: The present study was performed to determine the clinical effects of the Inpatient Rehabilitation Facility Prospective Payment System (IRF PPS) on speech and language intervention services and to examine the feasibility of using the federally mandated FIM instrument to establish resource allocation to patients with cognitive, communication, and swallowing disorders. DESIGN: A pre-IRF PPS and post-IRF PPS comparative study was conducted over a 1-yr time interval using data from the American Speech-Language-Hearing Association's National Outcomes Measurement System. Toward this end, the National Outcomes Measurement System's Functional Communication Measures were used to obtain data from 2,631 patients residing in 96 freestanding rehabilitation hospitals or hospitals with rehabilitation units implementing the prospective payment system on or after January 1, 2002. To ensure reliable retrospective and prospective data comparisons, all sites were active participants within the National Outcomes Measurement System program before the introduction of IRF PPS within their facilities. RESULTS: Findings revealed changes in both the utilization of speech-language pathologists and patient outcomes. Under the IRF PPS, there was a clear decline in speech- and language-related lengths of stay. However, clinicians attempted to compensate for these decrements in lengths of stay by increasing the intensity and frequency of their speech and language services. Despite these compensatory efforts, further analyses of the data revealed that under the IRF PPS, fewer patients achieved multiple levels of functional progress in speech and language abilities than before this payment system was implemented. This trend was most noteworthy in the treatment areas of swallowing, motor speech, and memory. In addition, this study revealed that, compared with the National Outcomes Measurement System's Functional Communication Measures, the FIM instrument significantly under-represented and undervalued the extent of a patient's overall progress in recovering from their cognitive, communication, or swallowing disabilities. CONCLUSION: These findings support the notion that the introduction of the IRF PPS has, perhaps unintentionally, caused more patients with cognitive, communication, and swallowing disorders to be discharged from inpatient rehabilitative care with less than adequate functional skill levels. The discouraging results in speech-language pathology utilization and patient outcomes will be useful for clinicians in the future when facing the ongoing challenges of maintaining quality care while streamlining services under the prospective payment system.

Aged↗

PubMed2004

Chaos and language.

Human language is a complex communication system with unlimited expressibility. Children spontaneously develop a native language by exposure to linguistic data from their speech community. Over historical time, languages change dramatically and unpredictably by accumulation of small changes and by interaction with other languages. We have previously developed a mathematical model for the acquisition and evolution of language in heterogeneous populations of speakers. This model is based on game dynamical equations with learning. Here, we show that simple examples of such equations can display complex limit cycles and chaos. Hence, language dynamical equations mimic complicated and unpredictable changes of languages over time. In terms of evolutionary game theory, we note that imperfect learning can induce chaotic switching among strict Nash equilibria.

Biological Evolution↗

PubMed1994

Language and communication in autistic disorders.

Communication problems form one of the key diagnostic criteria for autism, but there is a wide variety of manifestations. The theory that autistic individuals are unable to represent mental states can shed light on both the nature and range of communication impairments. This theory predicts that the specific communication deficit lies in the use of language to affect other minds. Language is not special in this respect, and is important only in so far as it may be used to give evidence of a speaker's thoughts and intentions. Thus, in autism, language level would be expected to relate strongly to performance on standard tests of theory of mind. Normal language acquisition appears to build upon the ability to recognize and orient towards ostensive behaviour. For this reason, it may not be necessary to postulate additional language impairments in order to explain the almost universal prevalence of language delay in children with autism. Autism, then, provides a model for studying the important distinction between language and communication, and demonstrates the vital part which mind-reading plays in normal human verbal and non-verbal interaction.

Autistic Disorder↗

PubMedDate not supplied

Maternal responsiveness and children's achievement of language milestones.

This prospective longitudinal study examined the contribution of dimensions of maternal responsiveness (descriptions, play, imitations) to the timing of five milestones in children's (N = 40) early expressive language: first imitations, first words, 50 words in expressive language, combinatorial speech, and the use of language to talk about the past. Events-History Analysis, a statistical technique that estimates the extent to which predictors influence the timing of events, was used. At 9 and 13 months, maternal responsiveness and children's activities (e.g., vocalizations, play) were coded from videotaped interactions of mother-child free play; information about children's language acquisition was obtained through biweekly interviews with mothers from 9 through 21 months. Maternal responsiveness at both ages predicted the timing of children's achieving language milestones over and above children's observed behaviors. Responsiveness at 13 months was a stronger predictor of the timing of language milestones than was responsiveness at 9 months, and certain dimensions of responsiveness were more predictive than others. The multidimensional nature of maternal responsiveness and specificity in mother-child language relations are discussed.

Achievement↗

PubMed1999

The development and predictive relations of play and language across the second year.

The play and language development of 171 toddlers was examined at 14 and 18 months by observing their activities on the Symbolic Play Test and by assessing their language skills using the MacArthur Communicative Development Inventories (MCDI) and the Reynell Developmental Language Scales. Additionally, data from the Bayley Scales of Infant Development and the MCDI were obtained at 24 months, in order to investigate how play and language measures taken at 14 and 18 months predict children's development at the age of 2 years. The results showed that the vocabulary production and symbolic play of the 14-month-old toddlers made a unique contribution to their language and cognitive skills at the age of 2 years, while at 18 months only language variables made a similar contribution. Other-directed pretense discriminated between the children's subsequent language and cognitive skills best, whereas nonsymbolic play had no independent predictive contribution. Significant gender differences were found in the use of nonsymbolic and symbolic play acts already at 14 months. Gender did not, however, contribute to the prediction of the children's subsequent skills, whereas maternal education significantly added to the prediction of the 2-year-olds' maximum sentence length and that of their cognitive development.

Analysis of Variance↗

PubMedDate not supplied

The language teaching device.

An overview is presented which seeks to describe the typical behaviours and features which characterize communicative acts between caregivers and young infants from birth through to the early stages of language acquisition. These behaviours are held to be significantly different from those which may be observed in adult-to-adult discourse. They are automatically adjusted to the received level of language development in the child and are dependent upon the parent-child relationship. It is hypothesized that these special properties of maternal communicative behaviour are crucial in enabling children to substantiate their language learning capacities. To this extent these properties may be perceived as language teaching strategies even though they are not employed with conscious didactic intent. Because these strategies apparently occur universally and with natural spontaneity in the communicative behaviour adopted by adults towards children, the term 'language teaching device' is proposed to encapsulate them. A short consideration is given to the educational implications of the language teaching device for professionals working with children and concerned with promoting language development. Particular reference is made to the very young, the impaired and the developmentally delayed.

Communication↗

PubMed2004

Relationship between theory of mind and language ability in children and adolescents with intellectual disability.

BACKGROUND: The present study was designed to evaluate the validity of the false belief task as a measure of theory of mind development in individuals with intellectual disability (ID). In most if it variants, the false belief task is linguistically demanding. This raises the possibility that the finding that individuals with ID do poorly on it might reflect language difficulties rather than theory of mind difficulties. Complicating matters further, however, is the fact that there are theoretical reasons to suppose that there might be a relationship between some dimensions of language ability and theory of mind development in individuals with ID (as well as in other populations). METHOD: In the present study, children and adolescents with ID and typically developing (non-verbal) mental age matches completed a standard false belief task and several tasks designed to measure language ability. RESULTS: We reasoned that a pattern in which false belief performance was correlated with all measures of language ability would reflect an artefactual relationship, whereas a more highly circumscribed, theoretically sensible pattern of correlations that was similar across both groups would support the validity of the false belief task. CONCLUSIONS: The results indicated that for individuals with ID who have limited narrative language skills, those limitations contribute substantially to their failure on the false belief task. For individuals with ID who have more highly developed narrative language skills (about 40% of the sample tested), however, the false belief task may provide a valid measure of their progress towards acquiring an adequate theory of mind. This latter conclusion was suggested by the fact screening out individuals who failed to meet linguistic and cognitive prerequisites for dealing with the performance demands of the false belief task yielded non-significant correlations between false belief performance and the language measures for both the group with ID and the typically developing comparison group.

Adolescent↗

PubMed1986

Language development of term and preterm children during the first five years of life.

Language development during the first five years is reported for 114 high-risk preterm children (20 with varying degrees of cerebral palsy) and 97 healthy term children. Most stages of language development occurred at slightly later ages among the neurologically unimpaired preterm children than among those born at term. Preterm children with cerebral palsy were more delayed and had more articulation defects compared with neurologically unimpaired preterm children. Girls were more advanced in early language development and showed less articulation defects than boys. The perinatal optimality score was significantly correlated with the ages at which the stages of language development were reached, and with language performance at five years in preterm children, but much less in term children. Birthweight and gestational age were negatively correlated with language development at all ages. Socio-economic status and birth order had an age-related influences on language development, but no correlation was found with the number of minor congenital malformations.

Articulation Disorders↗

PubMed2006

Language lateralization in temporal lobe epilepsy: a comparison between fMRI and the Wada Test.

PURPOSE: Recent studies have claimed that language functional magnetic resonance imaging (fMRI) can identify language lateralization in patients with temporal lobe epilepsy (TLE) and that fMRI-based findings are highly concordant with the conventional assessment procedure of speech dominance, the intracarotid amobarbital test (IAT). METHODS: To establish the power of language fMRI to detect language lateralization during presurgical assessment, we compared the findings of a semantic decision paradigm with the results of a standard IAT in 68 patients with chronic intractable right and left temporal lobe epilepsy (rTLE, n=28; lTLE, n=40) who consecutively underwent a presurgical evaluation program. The patient group also included 14 (20.6%) subjects with atypical (bilateral or right hemisphere) speech. Four raters used a visual analysis procedure to determine the laterality of speech-related activation individually for each patient. RESULTS: Overall congruence between fMRI-based laterality and the laterality quotient of the IAT was 89.3% in rTLE and 72.5% in lTLE patients. Concordance was best in rTLE patients with left speech. In lTLE patients, language fMRI identified atypical, right hemisphere speech dominance in every case, but missed left hemisphere speech dominance in 17.2%. Frontal activations had higher concordance with the IAT than did activations in temporoparietal or combined regions of interest (ROIs). Because of methodologic problems, recognition of bilateral speech was difficult. CONCLUSIONS: These data provide evidence that language fMRI as used in the present study has limited correlation with the IAT, especially in patients with lTLE and with mixed speech dominance. Further refinements regarding the paradigms and analysis procedures will be needed to improve the contribution of language fMRI for presurgical assessment.

Adolescent↗

PubMed1999

Language plus for international graduate students in nursing.

PURPOSE: To provide information about an English-language support program that focuses on the needs of international graduate nursing students. The growing presence of these students coincides with the increasing numbers of universities committed to world health. Crucial social and language competence affect the success and progress of international students in graduate nursing programs. DESIGN: Reviewed literature was 1980 to 1998, in nursing and applied linguistic research including second-language acquisition, phonology, discourse analysis, and language pragmatics to identify social and language phenomena. FINDINGS: Investigators suggest essential elements such as conventions of academic writing, reading comprehension, vocabulary, and pronunciation skills be included in the supportive Language Plus program. CONCLUSIONS: Ongoing development of the Language Plus program can promote collaboration between nurses and linguists and increase the success of international graduate nursing students.

Communication Barriers↗

PubMed1994

Language function following subdural grid-directed temporal lobectomy.

The purpose of the study was to determine the extent to which a temporal resection may be undertaken without producing risk to temporal language areas. Patients undergoing craniotomy and placement of a subdural electrode array (SEA) for evaluation of intractable epilepsy were studied to determine the variability of distance of temporal language cortex from the temporal pole. Hemisphere dominance was determined by intracarotid sodium amytal injection. Temporal lobe speech arrest (SA) was mapped with a 64 contact point SEA. Thirty-one patients had left dominant hemisphere SEAs. Thirty had SA 5 cm to 9 cm from the temporal pole (median 7 cm). One had SA at 3 cm. Twenty-one patients subsequently had temporal lobectomy (TL). Mean extent of resection was 5.7 cm (range 3 to 9 cm). In 18 TL patients who had neuropsychometric evaluation of language function pre- and post-surgery, there was no significant deterioration. Thirty-nine patients had right non-dominant SEAs placed. Eighteen had TL. Thirteen of these had pre- and post-surgery language evaluation and there was no significant change. Comparison of preoperative scores showed significant superiority of the right non-dominant group over the left dominant group for naming. TL up to 5 cm without stimulation mapping of language areas would be safe in the majority of cases, but one subject (3%) had SA mapped anterior to this and a small number of cases may therefore be at risk to language function following a 5 cm TL. Extensive lateral resections up to 9 cm are possible with preservation of language function with stimulation cortical mapping.

Adolescent↗

PubMed2005

Comorbidity in severe developmental language disorders: neuropediatric and psychological considerations.

AIM: To explore possible patterns of comorbidity in children with severe developmental language disorders (DLD). METHODS: A retrospective investigation of the clinical records of 28 children relating to oral motor and language problems, psychological profiles, medical history and EEG findings. RESULTS: 36% of all the children had pure expressive language problems, 64% had combined expressive-receptive language problems and 57% had additional oral motor problems. Girls predominated in expressive-receptive problems, while boys predominated in oral motor problems. Children with expressive-receptive disorders were over-represented at the lower end of normal full-scale IQ (p = 0.015). Lower verbal than non-verbal IQ levels were almost as common as equal levels, but a lower non-verbal IQ than verbal IQ was also found. Pre/perinatal problems were found in 21%, and heredity for developmental language problems or dyslexia in 39%. There was a higher proportion of attention and motor problems, EEG abnormalities, and epileptic syndromes than in the general population (p < 0.001). CONCLUSION: In severe DLD, both pure expressive and mixed expressive-receptive problems are found, and oral motor problems are common. Gender differences regarding symptoms are present. Receptive language ability is associated with the full-scale IQ level. A high proportion of EEG abnormalities and epilepsy is found. There is a complex pattern of comorbidity between speech-language symptoms, psychological characteristics, heredity and EEG findings.

Adolescent↗

PubMed2001

Auditory backward recognition masking in children with a specific language impairment and children with a specific reading disability.

The auditory backward recognition masking (ABRM) and intensity discrimination (ID) thresholds of children with a specific language impairment and poor reading (SLI-poor readers), children with an SLI and average reading (SLI-average readers), children with a specific reading disability and average spoken language skills (SRD-average language), and children with normal spoken and written language (controls) were estimated with "child-friendly" psychophysical tasks. The pattern of ABRM and ID scores suggests that a subset of children with concomitant oral language and reading impairments has poor ABRM thresholds, and that a subgroup of children with an SLI or SRD has poorer ID thresholds than controls. The latter result warns against using rapid auditory processing tasks that do not actively control for auditory discrimination ability. Further, some unusually poor ABRM scores and ID scores question the validity of extreme scores produced by children on psychophysical tasks. Finally, the poor oral language scores of many of the children who had impaired reading highlight the need to test the oral language skills of SRD samples to ascertain how homogeneous and specifically disabled they really are.

Adolescent↗

PubMed1991

Statistical analysis of bilingual speaker's speech for cross-language voice conversion.

The goal of cross-language voice conversion is to preserve the speech characteristics of one speaker when that speaker's speech is translated and used to synthesize speech in another language. In this paper, two preliminary studies, i.e., a statistical analysis of spectrum differences in different languages and the first attempt at a cross-language voice conversion, are reported. Speech uttered by a bilingual speaker is analyzed to examine spectrum difference between English and Japanese. Experimental results are (1) the codebook size for mixed speech from English and Japanese should be almost twice the codebook size of either English or Japanese; (2) although many code vectors occurred in both English and Japanese, some have a tendency to predominate in one language or the other; (3) code vectors that predominantly occurred in English are contained in the phonemes /r/, /ae/, /f/, /s/, and code vectors that predominantly occurred in Japanese are contained in /i/, /u/, /N/; and (4) judged from listening tests, listeners cannot reliably indicate the distinction between English speech decoded by a Japanese codebook and English speech decoded by an English codebook. A voice conversion algorithm based on codebook mapping was applied to cross-language voice conversion, and its performance was somewhat less effective than for voice conversion in the same language.

Algorithms↗

PubMed2002

Arteriovenous brain malformations: is functional MR imaging reliable for studying language reorganization in patients? Initial observations.

PURPOSE: To determine whether the blood flow abnormalities frequently associated with arteriovenous malformations (AVMs) can alter functional magnetic resonance (MR) imaging evaluation of language lateralization and whether reorganization of language function occurs in patients with brain AVMs. MATERIALS AND METHODS: Eleven patients with left-hemisphere brain AVMs and 10 age-matched control subjects were examined with 1.5-T blood oxygen level-dependent (BOLD) functional MR imaging. Verbal fluency, sentence repetition, and story listening tasks were performed. The functional MR imaging laterality index in the frontal and temporal lobes was defined as the (L - R)/(L + R) ratio, where L and R are the numbers of activated pixels in the left and right hemispheres, respectively. Statistical analyses were performed with Wilcoxon signed rank, Fisher exact, and Kruskal-Wallis tests. RESULTS: Control subjects had left-sided language dominance, although symmetric pixel counts were observed in the frontal lobes in two subjects and in the temporal lobes in one subject. Six patients had left-sided language dominance similar to that observed in control subjects. Five of these patients had AVMs outside frontal or temporal language areas, without flow abnormalities. Five patients had abnormally right-sided asymmetric indexes (below mean control subject value - 2 SDs), which suggested language reorganization (P <.05). Results of Wada examination and/or postembolization functional MR imaging performed in two of these patients showed that the abnormal laterality indexes were at least partly due to severe flow abnormalities that impaired detection of BOLD MR imaging signal intensity. CONCLUSION: These data suggest that flow abnormalities may interfere with language lateralization assessment with functional MR imaging.

Adult↗