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PubMed1993

Music and language in degenerative disease of the brain.

Music and language functions were studied in two musicians with degenerative disease. Both patients were tested on a standardized language battery and a series of music tasks. In the first case with left cortical atrophy and primary progressive aphasia, expressive music functions were spared with impaired reception of rhythm. The second case with posterior cortical atrophy, greater on the right, was nonaphasic, had spatial agraphia, a visuopractic deficit, and severe expressive music deficits, but intact rhythm repetition. The aphasic patient showed dissociations between music and language in fluency and content; continuous, organized, although reiterative music production was contrasted with nonfluent language. The nonaphasic patient showed the opposite pattern of deficits; unmusical production with impaired melody and rhythm organization that was contrasted with fluent, intelligible language. The double dissociation between language and music functions supports the existence of independent cognitive systems, one consistent with conventional left lateralization models of language, temporal sequence, and analytic music processing and another with a right lateralization model of implicit music cognition.

Agraphia↗

PubMed2002

Visual attention to words in different languages in bilinguals: a magnetoencephalographic study.

We recorded evoked magnetic fields from bilingual subjects while they were visually presented with words. The task was to count words in a target language when most of the words were in another language and there were also nontarget deviants in a third language. Our results indicate that in a multilingual visual environment there is a different need for attention to a nontarget language depending on whether the subject is attending to words in the subject's first (L1) or second (L2) language. When words in L2 are attended to, more effort appears to be devoted to words in the nontarget language than when words in L1 are attended to. In addition, attention to the nontarget language while counting words in L2 does not seem to depend on the age of acquisition of L2.

Adolescent↗

PubMed2005

Decreased EEG coherence between prefrontal electrodes: a correlate of high language proficiency?

To investigate the influence of proficiency level on the cortical organization of foreign language processing, two groups of German speaking students, differing only in their proficiency in English as a second language, were subjected to EEG coherence analysis during foreign and native language processing (news reports, alpha1 frequency band). In the group with minor experience with English, coherence increase was observed with all electrode combinations, with left hemisphere (LH) predominance. In the high proficiency group, coherence increase was limited to temporal electrodes over LH. In the latter group only, coherence between prefrontal electrodes was significantly lower during the language tasks than during the baseline task (silence, noisy screen). Both results were obtained with foreign as well as native language processing. We suggest that reduced EEG coherence in highly proficient foreign language speakers reflects a more efficient operating strategy not only for their second, but also for their native language.

Adult↗

PubMed2006

Pushing up daisies: implicit and explicit language in oncologist-patient communication about death.

GOALS OF WORK: Although there are guidelines regarding how conversations with patients about prognosis in life-limiting illness should occur, there are little data about what doctors actually say. This study was designed to qualitatively analyze the language that oncologists and cancer patients use when talking about death. SUBJECTS AND METHODS: We recruited 29 adults who had incurable forms of cancer, were scheduled for a first-time visit with one of six oncologists affiliated with a teaching hospital in Australia, and consented to having their visit audiotaped and transcribed. Using content analytic techniques, we coded various features of language usage. MAIN RESULTS: Of the 29 visits, 23 (79.3%) included prognostic utterances about treatment-related and disease-related outcomes. In 12 (52.2%) of these 23 visits, explicit language about death ("terminal," variations of "death") was used. It was most commonly used by the oncologist after the physical examination, but it was sometimes used by patients or their kin, usually before the examination and involving emotional questioning about the patient's future. In all 23 (100%) visits, implicit language (euphemistic or indirect talk) was used in discussing death and focused on an anticipated life span (mentioned in 87.0% of visits), estimated time frame (69.6%), or projected survival (47.8%). CONCLUSIONS: Instead of using the word "death," most participants used some alternative phrase, including implicit language. Although oncologists are more likely than patients and their kin to use explicit language in discussing death, the oncologists tend to couple it with implicit language, possibly to mitigate the message effects.

Adult↗

PubMed2005

"SLANG"--Sensitive Language and the New Genetics--an exploratory study.

SLANG-Sensitive Language and the New Genetics--is a concept that arose out of informal discussions between a number of interested parties, both consumers and professionals, who were becoming increasingly uneasy with some of the language commonly used in medical genetics. Some language choices were felt by the authors to be inappropriate for a variety of reasons. Poor language choice may impede an individual's understanding of a genetic condition or important medical information and the chosen words themselves may simply be perceived as discriminatory and even offensive. SLANG is an important concept to explore partly because literature in this area confirms that language choices in medical settings can be of great significance to both patients and families. Studies have shown how language choices impact on professional practice by, as one example, changing the intended meaning of medical information and affecting individual perception of risk and choice which, in turn, may affect individual or familial well-being. In addition language choice has the power to affect how individuals perceive themselves and are viewed by others. This paper presents the results from our pilot study and discusses the implications for health professionals with particular reference to medical genetics settings.

Choice Behavior↗

PubMed1990

Pattern of language impairment is different in Alzheimer's disease and multi-infarct dementia.

Language impairment was assessed in 33 patients with Alzheimer's disease (AD), in 52 patients with multi-infarct dementia (MID), and in 86 elderly community residents. The investigation included the D-Test Battery based on the Luria's Neuropsychological Investigation for all subjects. An extended battery of Luria's language items was used for 30 demented patients (11 AD and 19 MID patients) and 86 controls. The changes in language functions in normal subjects could be clearly differentiated from those seen in patients with mild dementia. The patients with different degrees of dementia differed also significantly from each other in regard to language impairment. Moreover, patients with AD and MID appeared to have different patterns of language impairment although the severity of dementia and the levels of orientation, mnestic, and conceptual functions were equal. AD was associated especially with a defect in understanding of grammatical structures and MID with disorders in recognition of words, naming, and repetition. The differential diagnostic capacity of 23 selected language items proved to be 97% between AD, MID, and control subjects. The results indicate that the examination of language functions is valuable in the differential diagnosis of dementia.

Aged↗

PubMed1989

Communication in the hospital setting: a survey of medical and everyday language use amongst patients, nurses and doctors.

Forty physicians, 40 student nurses, and 40 hospital patients were surveyed regarding their usage and evaluations of medical and everyday language use in the hospital setting. Medical language (ML) and everyday language (EL) were operationalized as distinct speech registers that doctors, nurses and patients can use in their encounters with each other. A complex interaction of speaker characteristics (bilingualism in ML and EL) motivational factors (accommodation theory), situational language norms in favor of communicative effectiveness, as well as status and power differentials that exist between health professionals and patients were hypothesized to influence language switching strategies in the health setting. While doctors reported using mostly ML with health professionals, they did report converging to the EL of their patients. However, patients and student nurses did not perceive doctors converging to the EL of their patient. Student nurses reported using an equal mixture of ML/EL with each other, while converging to the ML of the doctor and converging to the EL of their patients. The 'communication broker' role of the nurse was corroborated by perceptions of nurses' language use from all groups. Patients reported using mostly EL with each other while attempting to converge to the ML of the health professional. Nurses perceived these attempts to converge by the patients, but doctors did not report a change in the patients' register as a function of conversants. Regarding the evaluation of language use strategies, all groups felt that it was more appropriate for health professionals to converge to the EL of patients than to maintain ML. In conversations with health professionals, patient use of EL was seen as more appropriate than ML.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1996

Working memory capacity predicts language comprehension in schizophrenic patients.

The association between language comprehension and working memory capacity was evaluated in 25 male DSM-III-R schizophrenic patients (14 inpatients; 11 outpatients), and in 11 male normal controls (no lifetime DSM-III-R disorder). Patients and controls did not differ significantly on age and education. Language comprehension was examined as a function of two types of processing demand: grammatical complexity (complex versus simple sentences) and presentation rate (accelerated versus conversational). Schizophrenic patients showed significantly reduced language comprehension and decreased working memory capacity for language, compared with controls. Patients showed general difficulty in comprehending accurately, rather than exhibiting problems with specific grammatical structures. Subject groups were highly accurate and did not differ in their ability to perceive the individual words in sentences presented at the accelerated rate (intelligibility). Presentation rate and grammatical complexity affected comprehension accuracy in all groups, however, with increases in rate and complexity producing decreases in understanding. Of most importance, theoretically, is the finding that working memory capacity predicted language comprehension accuracy in both schizophrenic patients and normal controls. Results suggest that language comprehension deficits in schizophrenic patients may involve a general dysfunction that is associated with working memory capacity for language.

Adult↗

PubMed2004

Spatiotemporal patterns of language-specific brain activity in patients with chronic aphasia after stroke using magnetoencephalography.

Six participants with chronic aphasia secondary to first-ever ischemic stroke within the middle cerebral artery (MCA) distribution of the left hemisphere and six neurologically intact controls of similar age were given a running recognition memory task for words while the magnetic flux normal to the scalp surface was measured with a whole-head neuromagnetometer. This task had been previously shown to be valid for the localization and lateralization of brain activity specific to receptive language function. As expected, patients exhibited relatively decreased activation in areas known to be involved in receptive language function, including superior temporal gyrus (STG) in the left hemisphere, as well as increased activation of areas outside of the left STG that might potentially support language function. Decreased activation within left STG was associated with a reduction in receptive language in patients, as was increased activation outside of left STG. Results support hypotheses suggesting that peri-lesional areas outside premorbid language areas may assume receptive language function after aphasia secondary to stroke, but that better recovery occurs when putative premorbid language areas are able to normalize.

Aged↗

PubMed1992

Adequacy of language function and verbal memory performance in unilateral temporal lobe epilepsy.

We examined adequacy of language functions, their influence on verbal learning and memory performance, and the relative effects of language function and laterality of seizure focus on the memory performance of 99 left-hemisphere dominant patients with invasively verified epilepsy of left (N = 47) or right (N = 52) temporal lobe origin. Patients with left temporal lobe epilepsy (TLE) scored significantly lower than the right TLE group on several aphasia battery subtests (Visual Naming, Sentence Repetition, Token Test, Reading Comprehension, Aural Comprehension). Adequacy of language function (nominal speech) was significantly related to verbal learning and memory performance for both left and right TLE groups. Finally, comparison of the predictive significance of laterality of TLE and adequacy of language function indicated that language functions (Visual Naming and Aural Comprehension), but not laterality of TLE, were significant predictors for verbal learning and memory performance. It is concluded that: 1) adequacy of basic language functions is particularly compromised in left TLE, 2) there is a significant relationship between adequacy of language function and several aspects of verbal learning and memory ability in both left and right temporal lobe groups, and 3) clinical assessment and theoretical models of memory need to consider these relationships.

Adolescent↗

PubMed2000

Event-related potentials during auditory language processing in congenitally blind and sighted people.

While behavioral studies have documented delayed language acquisition in blind children, other studies have revealed better speech discrimination abilities for blind than sighted adults. Several brain imaging studies have provided evidence for cortical reorganization due to visual deprivation but the cerebral organization of language in blind humans is not known yet. We hypothesized that the increasing specialization of language systems normally observed during development may not take place to the same degree in blind individuals since posterior visual areas do not receive their adequate input. On the other hand, we hypothesized that blind people, due to their greater reliance upon the auditory language signal, may process speech faster than sighted people. To test these assumptions, event-related potentials were recorded while 11 congenitally blind and 11 sighted adults matched in age, gender, handedness and education were engaged in a language task. Participants listened to sentences in order to decide after each sentence if it was meaningful or not. Incongruous sentence-final words elicited an N400 effect in both groups. The N400 effect had a left-lateralized fronto-central scalp distribution in the sighted but a symmetric and broad topography in the blind. Furthermore, the N400 effect started earlier in the blind than in the sighted. Closed class compared to open class sentence middle words elicited a more pronounced late negativity in the blind than in the sighted. These results suggest that blind people process auditory language stimuli faster than sighted people and that some language functions may be reorganized in the blind.

Adult↗

PubMed2001

Language and space: some interactions.

Is language linked to mental representations of space? There are several reasons to think that language and space might be separated in our cognitive systems, but they nevertheless interact in important ways. These interactions are evident in language viewed as a means of communication and in language considered a form of representation. In communication, spatial factors may be explicit in language itself, such as the spatial-gestural system of American Sign Language. Even the act of conversing with others is a spatial behavior because we orient to the locations of other participants. Language and spatial representations probably converge at an abstract level of concepts and simple spatial schemas.

Journal Article↗

PubMed1990

Structure in language. Creating form in talk.

In psycholinguistics, the systematic study of language production has begun to take a place beside the study of language comprehension as a means to the end of understanding human language use. Because a major and very visible component of speaking a language is knowing how to create forms to carry messages, efforts to explain language production must confront long-standing questions about the relationship between structure and function in psychological explanation. One traditionally appealing view of that relationship in the realm of language is that sentence structures are associated with or reducible to the general forces of cognition that drive interpretation and communication. This article surveys some of the challenges to this view that emerge from the study of speech errors, and sketches the progress that has been made in developing an alternative view, renewing the argument that syntactic structures are necessary elements in an explanation of language use.

Adult↗

PubMed1997

The language of management: an enduring challenge.

The language used in health care organizations has a profound effect on the way people conduct their work. The aim of this paper is to highlight and examine the significance of language in health care organizations, and raise awareness of its relevance to nurse managers. This is achieved by exploring three main themes. The contrasting views of health care, reflected in the language of management and nursing; the management of rhetoric; and researching language. It is argued that the material effects of language need to be recognized by nurse managers, if they are to fulfil their role effectively, and that language can also be used as a resource in the pursuit of this goal. Recommendations are made concerning the need for nurse managers to become sensitive to the varied dimensions of language and a means of initiating this process is suggested.

Communication Barriers↗

PubMed1997

Is language a barrier to the use of preventive services?

OBJECTIVE: To isolate the effect of spoken language from financial barriers to care, we examined the relation of language to use of preventive services in a system with universal access. DESIGN: Cross-sectional survey. SETTING: Household population of women living in Ontario, Canada, in 1990. PARTICIPANTS: Subjects were 22,448 women completing the 1990 Ontario Health Survey, a population-based random sample of households. MEASUREMENTS AND MAIN RESULTS: We defined language as the language spoken in the home and assessed self-reported receipt of breast examination, mammogram and Pap testing. We used logistic regression to calculate odds ratios for each service adjusting for potential sources of confounding: socio-economic characteristics, contact with the health care system, and measures reflecting culture. Ten percent of the women spoke a non-English language at home (4% French, 6% other). After adjustment, compared with English speakers, French-speaking women were significantly less likely to receive breast exams or mammography, and other language speakers were less likely to receive Pap testing. CONCLUSIONS: Women whose main spoken language was not English were less likely to receive important preventive services. Improving communication with patients with limited English may enhance participation in screening programs.

Adolescent↗

PubMed1998

Towards culturally competent health care: language use of bilingual staff.

The presence of diverse language skills within health staff provides opportunities to better meet the needs of a multicultural population. A cross-sectional survey of all staff within the South Western Sydney Area Health Service was undertaken to compare language skills with population needs and examine the context of language use. Thirty-one per cent of staff (n = 964) were bilingual or multilingual, with the predominant languages spoken being Tagalog (Filipino), Cantonese, Hindi, Spanish, Vietnamese and Italian. Thirty-seven per cent of bilingual staff used their language skills at least weekly, predominantly in situations of simple conversation and giving directions. Bilingual staff are a valuable resource for the organisation and the presence of a similar overall proportion of bilingual and bicultural staff may engender tolerance and adaptability in providing care to a diverse population. However, supply does not directly match community demand. This mismatch will continue unless recruitment is focused towards identified language groups. The high proportion of staff who rarely used their language skills (37%) may be due to lack of opportunity or limited need, and suggests that further research needs to examine service models that locate bilingual workers close to client need. This study takes a crucial first step towards realising equitable and culturally appropriate care utilising the principles of productive diversity.

Adult↗

PubMed2001

Language facility and theory of mind development in deaf children.

Deaf children with signing parents, nonnative signing deaf children, children from a hearing impaired unit (HIU), and oral deaf children were tested on three first-order theory of mind (ToM) tasks--a subset was also given a second-order task (Perner & Wimmer, 1985). A British Sign Language (BSL) receptive language task (Herman, Holmes, & Woll, 1999) and four nonverbal executive function tasks were also administered. The new BSL task allowed, for the first time, the receptive language abilities of deaf children to be measured alongside ToM abilities. Hearing children acted as controls. These children were given the same tasks, except the British Picture Vocabulary Scale was substituted for the BSL task. Language ability correlated positively and significantly with ToM ability, and age was correlated with language ability for both the deaf and hearing children. Age, however, underpinned the relationship between ToM and language for deaf children with signing parents and hearing children but not for nonnative signing, HIU, or oral deaf children. Executive function performance in deaf children was not related to ToM ability. A subset of hearing children, matched on age and language standard scores with signing deaf children, passed significantly more ToM tasks than the deaf children did. The findings are discussed with respect to the hypotheses proposed by Peterson and Siegal (1995, 2000) and Courtin (2000).

Journal Article↗

PubMed2002

The benefit of assessment-based language and reading instruction: perspectives from a case study.

We present a case study of the language and literacy development of a deaf child, Marcy, from preschool through sixth grade. The purpose of the project was to examine the connection between language and reading and to provide insight into the relationships between them. To compile the case study, we analyzed data from nine years of follow-up, including listening, speech articulation, semantic, syntactic, reading, and writing information drawn from a number of informal and formal assessments. Annual evaluation of language and literacy skills was used to select educational placements, as well as instructional methods, strategies, and materials. Given that Marcy began school at 4 years of age, mute and without expressive language of any form (oral or sign), it may at first appear remarkable that she read narrative and expository text as did her hearing peers by sixth grade, because a substantial body of research shows that most deaf students read at the fourth-grade level by high school graduation (review by Paul, 1998). However, those responsible for Marcy's education prevented reading failure by carefully planning, instituting, and monitoring elements of language and literacy instruction. We present Marcy's progress and instruction by grade level and discuss it within the framework of phases/stages of reading development. We hope that the resulting case study may serve as an example of the language-reading connection, an awareness important not only for the literacy instruction of deaf and language-challenged children but for hearing students as well.

Journal Article↗