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PubMed2003

Mental correlates of neuromotoric deviation in 6-year-olds at heightened risk for schizophrenia.

The meaning and relevance of the increased rates of neuromotoric deviation (ND) observed in patients with schizophrenia and their biological relatives remain unclear. ND could represent free-floating, independent characteristics of individuals in these families vs. signs of an increased risk for current or future mental disorder. The co-temporaneous relationship between ND and mental disorder at 6 years of age was investigated among 31 children with an increased risk for schizophrenia and similar psychoses, defined as having a mother with a history of schizophrenia or unspecified functional psychosis. As compared with high-risk cases with a low level of ND, the subgroup of 10 high-risk offspring showing notably increased rates of ND had significantly more frequent psychiatric diagnoses (typically language disorders and enuresis), poor functioning on global assessment, poor interpersonal competency and high anxiety proneness. Neuromotoric items representing "overflow" (e.g., choreatic movements, tremor) were significantly positively related to each of these mental characteristics. Among high-risk offspring, an increased rate of ND is very clearly associated with increased rates of current mental disorder, and might potentially identify a subgroup with an especially high risk for serious mental disorder in the future.

Adult↗
PubMed2005

An interpreter's interpretation: sign language interpreters' view of musculoskeletal disorders.

INTRODUCTION: Sign language interpreters are at increased risk for musculoskeletal disorders associated with work. Previous studies have used survey techniques to identify potential risk factors and approaches to their medical management. Little is known about risk factors and management of symptoms in this group from the perspective of the interpreter. Such qualitative information should help inform future research related to this professional group. METHOD: One thousand ninety-two sign language interpreters recruited from the Registry of Interpreters for the Deaf completed an open-ended question that was a component of a national prevalence survey. Responses were evaluated using content analysis. Inter and intra rater reliability were high (.88 and .92, respectively). RESULTS: Risk factors for initiation and/or exacerbation of symptoms included: difficult job, interpreting setting (educational), interpreting style (e.g., posture, self generated force), and emotional and physical stressors. Exercise (e.g., stretching, aerobics) was a common prevention strategy. Conventional medical treatment was used as the first line approach to symptom control. Self-care methods such as exercise, diet and warm up prior to interpreting were also reported. While massage and chiropractic care was used as commonly as in the general population, acupuncture was found to be used more often. Coping strategies that were more active (e.g. exercise, diet, more control over work schedule) were also reported as useful. CONCLUSIONS: These findings provide a description of factors that interpreters view as important in the development and exacerbation of hand and wrist pain. The results also indicate that interpreters used many self-management approaches. Future research should carefully investigate the utility of such approaches using well-controlled designs. Also, because of its widespread use in this group the evaluation of acupuncture in the management of these symptoms appears warranted. The qualitative approach used in the present study permitted an analysis of the worker perspectives regarding risk and management of these work related symptoms. This information can be used to further inform future research.

Adult↗
PubMed2004

Association between the FOXP2 gene and autistic disorder in Chinese population.

Several genomewide screens indicated that chromosome 7q was linked to autistic disorder. FOXP2, located on 7q31, is a putative transcription factor containing a polyglutamine tract and a forkhead DNA binding domain. It is one member of the forkhead family who are known to be key regulators of embryogenesis. A point mutation at a highly conserved residue within the forkhead domain co-segregated with affected status in the KE family who was a unique three generation pedigree with a severe speech and language disorder and FOXP2 was directly disrupted by a translocation in an individual who had similar deficits as those of the KE family. Several studies have investigated the role of FOXP2 polymorphisms in autism and none of them found positive association. We performed a family-based association study of three single nucleotide polymorphisms (SNPs) of FOXP2 in 181 Chinese Han trios using the analyses of transmission/disequilibrium test (TDT) and haplotype. We found a significant association between autistic disorder and one SNP, as well as with specific haplotypes formed by this SNP with two other SNPs we investigated. Our findings suggest that the FOXP2 gene may be involved in the pathogenesis of autism in Chinese population.

Alleles↗
PubMed1998

A dimensional classification of autism spectrum disorder by social communication domains.

OBJECTIVE: To investigate whether "social communication" could be used to assess severity of symptoms in autism spectrum disorder. Social communication refers to the communication of cognitive and emotional information through facial expression, gesture, and prosody and through implicit understanding of pragmatics and of theory of mind. METHOD: Subjects were evaluated by raters using the Autism Diagnostic interview-Revised and either the Autism Diagnostic Observation Schedule or the Pre-Linguistic Autism Diagnostic Observation Schedule. Two investigators independently diagnosed autism, Asperger's disorder, or pervasive developmental disorder-not otherwise specified in 63 subjects. Items from the Autism Diagnostic Interview-Revised that were judged to represent social communication behaviors were factor-analyzed. RESULTS: Three factors were identified: affective reciprocity, joint attention, and theory of mind. Comparing this new classification approach to DSM-IV led to suggestions for possible changes in the latter: (1) Vocabulary and grammar deficiencies in autistic persons should be coded under developmental language disorder, (2) The diagnosis of Asperger's disorder may not be needed. (3) Requiring that all persons with autism spectrum disorder have a symptom from the "restrictive, repetitive, and stereotypic" list may need to be reconsidered. CONCLUSIONS: The DSM-IV category of pervasive developmental disorder may be ideal for diagnosing "classic" autism, but it may be inadequate for diagnosing less severe forms of the disorder.

Adolescent↗
PubMed1993

Cortical DC-potentials in identification of the language-dominant hemisphere: linguistical and clinical aspects.

In order to find a non-invasive method for determining the hemispheric dominance for language, we studied cortical activation patterns during language processing by means of electrophysiological techniques: DC-potentials were recorded from frontal, central, temporal and parietal electrode positions in 28 right-handed normal subjects and in 16 patients with a history of transient loss of speech and known hemispheric dominance. Subjects were asked to find as many synonyms as possible within 6 seconds to either a concrete or an abstract noun. This task caused a highly significant left-hemispheric lateralization over frontal and central, but not over temporal and parietal cortical areas. Search for synonyms to abstract nouns yielded frontal left-hemispheric dominance in 93% of all normal subjects, search for synonyms to concrete nouns in 85%. Inter-electrode correlation coefficients were higher during processing of abstract word categories than during processing of concrete categories. In all patients, frontal and central lateralization corresponded to their hemispheric dominance as determined from clinical data. Advantages as well as inconveniences of this technique are discussed and compared to other invasive and noninvasive tools of assessing speech lateralization.

Adolescent↗
PubMed1984

Screening Kit of Language Development: a preschool language screening instrument.

The Screening Kit of Language Development ( SKOLD ) was designed to meet the following criteria: Validity for 2.5-4 year old children, standardization for speakers of standard and Black English, and appropriateness for paraprofessional screeners . This paper describes the development, content, administration, scoring, reliability, and validity of SKOLD .

Child, Preschool↗
PubMed1993

Treatment of Wernicke's aphasia with jargon: a case study.

This case study concerns an adult with Wernicke's aphasia characterized by neologistic jargon and a severe auditory comprehension deficit. No communicative or linguistic improvements had been observed after eight months poststroke. Up until this time, therapeutic intervention was aimed at managing the patient's rambling communicative style and improving auditory comprehension skills. A therapeutic regimen was introduced that focused on visual/written information and included a hierarchy of visual word and sentence comprehension tasks. All auditory/verbal stimulus presentation was eliminated. After two months on the program, improvement was noted in naming abilities and general ability to communicate in conversation, including a reduction of neologistic jargon and an increase in semantic jargon. No improvement was noted in auditory comprehension. The visual program may have facilitated the patient's general attentional set, thereby possibly contributing to her improvement in communicative style and sensitivity to conversational interactions with others.

Aged↗
PubMed1977

Language and memory disorders following closed head trauma.

Patients who suffer closed head trauma may demonstrate communication disorders which have been variously described as aplasia, severe memory impairments, traumatic aphasia, or confusion. The memory and language skills of 14 patients who had suffered closed head trauma were documented after they regained ocnsciousness and at one-month intervals for four monts utilizing the Porch Index of Communicative Ability and the Wechsler Memory Scale. Results indicated that patients initially suffered both reduced memory and language skills. After four months, expressive and receptive language skills were grossly functional for conversational purposes, and all memory taskd with the exception of orientation skills were within normal limits. Significant improvement in both language and memory functioning most often occurred during the first month after regaining consciousness, although gradual improvement in both language and memory skills was noted beyond the one-month period. No significant correlations existed between the length of unconsciousness and the initial and final language and memory scores.

Adult↗
PubMed2006

Standardised speech-language tests and students with intellectual disability: a review of normative data.

BACKGROUND: Before a school speech-language pathologist (SLP) utilises a standardised speech-language test with a student with intellectual disability (ID), the clinician should carefully consider the purpose of the test and whether the test includes students with ID in the normative group. METHOD: This project reviewed 49 tests published between 1994 and 2004 and their applicability to students with ID. RESULTS: Students with mild ID were included in the norm group for 23 of the tests, but no tests included students with more significant ID. Separate norms for students with mild ID were included in 15 tests, but none met Salvia & Ysseldyke's (1995) suggested requirement that at least 100 students be included to represent a specific subgroup. A majority of the tests assessed receptive and expressive vocabulary, syntax, and grammar but no recent test measured a student's pragmatic communication. CONCLUSIONS: Clinicians are encouraged to supplement standardised tests with non-standardised procedures to document students' pragmatic, social, and functional communication abilities.

Humans↗
PubMed1977

[Psychological tasks in phoniatry (author's transl)].

Multidiscipline roles in diagnostics and therapy of speech and voice disorders of childhood are practised by the otorhinolaryngologist, the psychologist and the logopedist. The psychologist in the phoniatric practise had additional tasks which include preparing the patient for the examination, consultation and prevention. As a contribution to the differential diagnosis, psychological examination of a patient's intelligence and the level of his learned vocabulary are necessary. The psychodiagnostics of cerebral dysfunctions are of great importance and are discussed in depth in studying language disorders of childhood.

Child↗
PubMed2005

Neuropsychophysiological findings in a case of long-standing overt ventriculomegaly (LOVA).

Long-standing overt ventriculomegaly in adults (LOVA) is a clinical entity characterized by chronic hydrocephalus with infant onset, slow evolution and clinical disturbances during adulthood. Few cases are reported in literature describing the evident contrast between the severity of hydrocephalus and the relatively spared neurological functioning and cognitive aspects. The authors describe a 59-year-old man with congenital hydrocephalus complaining of persistent gait impairment. Neurological examination showed a mild paraparesis, severe higher cortical function impairment but relatively sparing of daily living activity. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed a very remarkable ventriculomegaly compressing the brain cortex but sparing the cerebellum and the brainstem. Brain Single Photon Emission Computer Tomography (SPECT) showed a prevalent cerebellar perfusion as well. Neuropsychological testing was consistent with severe cognitive deterioration and attention disorders. Language and praxis functions seemed to be preserved. Auditory oddball ERPs (P300) showed morphological abnormalities especially of late components. This case report demonstrates in vivo the level of adaptation to which human brain can reach under chronic mechanic stress conditions. The striking poor cerebral parenchyma representation and the relatively spared language and praxic abilities account for a functional reorganization of residual structures due to the neural plasticity.

Cerebral Ventricles↗
PubMedDate not supplied

[Crossed aphasia: considerations on a clinical case].

A right-handed patient with no family history of either neurological disorders or of left-handedness was affected by crossed aphasia due to a focal hemorrhagic lesion in the right hemisphere at the level of the basal ganglia. The CAT-scan revealed the site of the brain change. Our case is uncommon in that the aphasia. Assessed by neuropsychological tests, was associated with impairment of right functions such as visual and spatial cognition. Thus he does not fit the classic description of crossed aphasia, exhibiting instead language disorders similar to those following deep brain lesions. Various hypotheses were considered in attempting to explain the pathogenesis of our neurological data, none of which proved adequate to account for all the reported findings.

Aged↗
PubMed1996

Discourse connectedness in manic and schizophrenic patients: associations with derailment and other clinical thought disorders.

The language performance of hospitalised manic ( n = 12) and schizophrenic (n=15) patients was compared in order to test hypotheses based on previous models of communication disorder in these patient groups. It was hypothesised that the derailments of manic and schizophrenic patients were discriminable by virtue of differences in the level of connectedness of the speech during this type of language disorder. Previous hypotheses have suggested that manics derail because they discuss multiple concurrent topics and schizophrenics derail as a pattern of general vagueness and poorly interconnected speech. These hypotheses were supported by the finding that manic patients manifested a higher level of overall discourse connectedness during derailments, even when the overall increased amount of speech was accounted for. Manics were not simply more competent overall, because they failed to differ from schizophrenics in their discourse connectedness during nondisordered segments. These results are discussed in terms of their implications for clinical and linguistic differentiation of the language of psychotic patients.

Journal Article↗
PubMed1992

Slowed lexical access in nonfluent aphasia: a case study.

A list priming paradigm (LPP) was used to examine the hypothesis that nonfluent aphasics are literally slowed down in automatic access to lexical information. In this paradigm, words are presented visually, and the subject's task is to make a lexical decision on each word as quickly as possible after its presentation. As soon as a lexical decision is made on one word, that word is removed and, after a predetermined interword interval, the next word is presented. In this way, a continuous "list" effect is obtained. Prior studies with both college-age and elderly subjects using the LPP have shown that, independently of age, on the LPP, priming obtains at interword delays of 500 to 800 msec, but not at either shorter or longer interword delays. In the study reported here, the LPP was used to examine delays at which priming obtained for LD, a nonfluent aphasic with a lesion primarily in the left frontal region. Examining interword delays ranging from 500 to 1800 msec, the subject showed priming only at a delay of 1500 msec, a considerably longer delay than that at which neurologically intact subjects have shown priming. Based on these results, it is argued that while automatic access is retained, that access is much slower in a nonfluent aphasic than in neurologically intact elderly subjects. These results are discussed in terms of how slowed lexical access might impact on discourse comprehension.

Aphasia, Broca↗
PubMed1993

The relationship between speech-language impairments and reading disabilities.

A group of children with speech-language impairments was identified in kindergarten and given a battery of speech-language tests and measures of phonological awareness and rapid automatized naming. Subjects were followed in first and second grades and administered tests of written word recognition and reading comprehension. The children with speech-language impairments were found to perform less well on reading tests than a nonimpaired comparison group. Subjects' performance on standardized measures of language ability in kindergarten was observed to be closely related to reading outcome, especially reading comprehension. Measures of phonological awareness and rapid automatized naming, on the other hand, were found to be the best predictors of written word recognition. The implications of these findings for the early identification and remediation of reading disabilities are discussed.

Child↗
PubMed1999

Issues to consider in the evaluation of speech and language therapy for preschool children.

This paper reviews some of the methodological issues involved in the design of a randomized controlled trial currently underway in Bristol. The trial compares the progress of preschool children randomly allocated to a 'watching-waiting' control group with the experimental group who have immediate access to therapy. This paper reviews a number of relevant studies, which have either followed up preschool children with early language delays or have investigated the effects of therapy with this age group. The basic design of the trial is outlined along with a discussion of the sample, the measurements used and the therapy given.

Child, Preschool↗
PubMedDate not supplied

Reliability of speech and language therapists using therapy outcome measures.

The Therapy Outcome Measure (TOM) aims to provide Speech and Language Therapists (SLT) with a practical tool to measure outcomes of care by providing a quick and simple measure which can be used over time with patients and clients in a routine clinical setting. The TOM allows therapists to reflect their clinical judgement on the dimensions of impairment, disability/activity, handicap/participation and well-being on an 11-point ordinal scale. The purpose of this paper is to examine the reliability and the influences on reliability of SLT using this measure. Three studies are presented and give information on 73 SLT using the measure with different client groups. Study one assesses the degree of reliability of six SLT using the TOM following training and practice. Reliability was studied on three occasions and the results demonstrate the influence of training and practice. Study two included 56 SLT to examine reliability over a broader range of client groups and to investigate the effect of the SLT specializing on rating patients from within or -out that specialism. Eleven therapists were included in the study, which examined the influence of a specific training approach. The participating SLT achieved a substantial-moderate level of reliability; this was established in all domains. The degree of reliability achieved on the TOM was affected by some, but not extensive, training and experience.

Clinical Protocols↗