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PubMed1993

Comprehension deficits elicited by electrical stimulation of Broca's area.

We report on three patients with intractable focal seizures arising from the language-dominant left hemisphere. In the work-up prior to surgical treatment, arrays of subdural electrodes were placed over the left temporal lobe and adjacent supra-Sylvian region. Electrical stimulation of the inferior frontal cortex language region ('Broca's area') produced marked interference with language output functions including speech arrest, slowing of oral reading, paraphasia and anomia. At some cortical language sites in this region cortical stimulation also produced language comprehension deficits, particularly in response to more complex auditory verbal instructions and visual semantic material. The severe impairment of comprehension verbal information was in clear contrast with ability to process non-verbal material, which was not affected.

Adolescent↗
PubMed2003

Language function and dysfunction in corticobasal degeneration.

OBJECTIVE: S: The authors assessed language functioning in corticobasal degeneration (CBD), an area that has received little systematic study. Aphasia has been reported occasionally, and the authors hypothesized that appropriate assessments would reveal at least mild language impairment, particularly affecting phonologic (sound-based) processing, even in cases without frank aphasia. METHODS: A series of 10 unselected patients with CBD (one with pathologic confirmation) were administered neuropsychological tests assessing the following aspects of cognitive functioning: verbal fluency, naming, reading, oral spelling, auditory-verbal short-term memory, phoneme blending and segmentation, visuospatial skills, and semantic memory. RESULTS: Phonologic and spelling impairments were prevalent, even in nonaphasic patients. The prevalence of visuospatial, constructional, and frontal impairments, demonstrated in previous research, was also replicated. A minority of patients had deficits in semantic memory, naming, and reading, but the impairments were usually mild. CONCLUSIONS: The authors found phonologic impairment to be a typical feature of CBD. There is substantial overlap between progressive nonfluent aphasia and CBD, and the linguistic impairment can be thought of as a continuum, with mild phonologic impairment at one end and severe aphasia at the other.

Aged↗
PubMed2005

Toward diagnostic and phenotype markers for genetically transmitted speech delay.

Converging evidence supports the hypothesis that the most common subtype of childhood speech sound disorder (SSD) of currently unknown origin is genetically transmitted. We report the first findings toward a set of diagnostic markers to differentiate this proposed etiological subtype (provisionally termed speech delay-genetic) from other proposed subtypes of SSD of unknown origin. Conversational speech samples from 72 preschool children with speech delay of unknown origin from 3 research centers were selected from an audio archive. Participants differed on the number of biological, nuclear family members (0 or 2+) classified as positive for current and/or prior speech-language disorder. Although participants in the 2 groups were found to have similar speech competence, as indexed by their Percentage of Consonants Correct scores, their speech error patterns differed significantly in 3 ways. Compared with children who may have reduced genetic load for speech delay (no affected nuclear family members), children with possibly higher genetic load (2+ affected members) had (a) a significantly higher proportion of relative omission errors on the Late-8 consonants; (b) a significantly lower proportion of relative distortion errors on these consonants, particularly on the sibilant fricatives /s/, /z/, and //; and (c) a significantly lower proportion of backed /s/ distortions, as assessed by both perceptual and acoustic methods. Machine learning routines identified a 3-part classification rule that included differential weightings of these variables. The classification rule had diagnostic accuracy value of 0.83 (95% confidence limits = 0.74-0.92), with positive and negative likelihood ratios of 9.6 (95% confidence limits = 3.1-29.9) and 0.40 (95% confidence limits = 0.24-0.68), respectively. The diagnostic accuracy findings are viewed as promising. The error pattern for this proposed subtype of SSD is viewed as consistent with the cognitive-linguistic processing deficits that have been reported for genetically transmitted verbal disorders.

Child, Preschool↗
PubMed1984

Differential language characteristics in adult aphasic and schizophrenic subjects.

Sixty-one adult aphasic and 61 noncerebrally involved chronic undifferentiated schizophrenic subjects were tested for impairment in 10 language categories. Results indicated that the language categories of strongest differentiating value were writing of words to dictation, naming, syntax, where aphasic subjects were more impaired in all three, and relevance, where schizophrenic subjects were more impaired. To a lesser extent, other differentiating language features were auditory retention span, and overall language ability, where aphasic subjects were more impaired in both, and fluency, where aphasic subjects were less fluent. Both groups also were tested for apraxia of speech, oral apraxia, limb apraxia, time and place orientation, and ability to respond to questions containing general information.

Adult↗
PubMed2003

French-English bilingual children with SLI: how do they compare with their monolingual peers?

The goal of this study was to determine whether bilingual children with specific language impairment (SLI) are similar to monolingual age mates with SLI, in each language. Eight French-English bilingual children with SLI were compared to age-matched monolingual children with SLI, both English and French speaking, with respect to their use of morphosyntax in language production. Specifically, using the extended optional infinitive (EOI) framework, the authors examined the children's use of tense-bearing and non-tense-bearing morphemes in obligatory context in spontaneous speech. Analyses revealed that the patterns predicted by the EOI framework were borne out for both the monolingual and bilingual children with SLI: The bilingual and monolingual children with SLI showed greater accuracy with non-tense than with tense morphemes. Furthermore, the bilingual and monolingual children with SLI had similar mean accuracy scores for tense morphemes, indicating that the bilingual children did not exhibit more profound deficits in the use of these grammatical morphemes than their monolingual peers. In sum, the bilingual children with SLI in this study appeared similar to their monolingual peers for the aspects of grammatical morphology examined in each language. These bilingual-monolingual similarities point to the possibility that SLI may not be an impediment to learning two languages, at least in the domain of grammatical morphology.

Child↗
PubMed2003

[Developmental consideration on the loss of self-evidence (natürlichen Selbstverständlichkeit) in pervasive developmental disorders].

The "loss of self-evidence" has been noted by many, particularly in our country, as a fundamental dysfunction in schizophrenia. Recent recognition of this "loss of self-evidence" in personality disorders such as borderline cases, and developmental disorders such as autism and Asperger's syndrome is focusing renewed interest on this perspective. It is possible that investigation into this "loss of self-evidence" noted in the pervasive developmental disorders may provide clues into the process of its development and acquisition. This paper takes up the issue of "loss of self-evidence" illustrated through the treatment process of 2 patients (female, adulthood autism, adolescent Asperger's syndrome) the author has treated. The psychopathology of the "loss of self-evidence" seen in the pervasive developmental disorders is discussed through these cases in terms of development from the standpoint of clinical intervention for relationship disturbance. The conclusions are as follows. First, the grave psychopathology pertaining to "self-evidence" in the adult autism and adolescent Asperger's syndrome cases is discussed, wherein difficulty in controlling one's action by one's own will giving rise to serious estrangement between experience and consciousness is noted as the pathology held in common by the two. Next, through examination of the normal acquisition process of words and language, it is shown that the essence of the language disorder seen in pervasive developmental disorders lies in the acquisition of meanings of objects being based upon the absence of common experience between subject and caregiver. As such, words representing meaning and content as we see them are imprinted on such individuals, never harmonizing with their own experiential world, giving rise to serious estrangement between their experience and consciousness. Third, sharing what the child is focusing upon in the outer world and how he/she is relating to it in their experiential world, and approaching them with words appropriate to their interpretation, is pointed out as being of critical importance in the self-evidence. In support of this, it is asserted that the establishment of affective communication characterized by mutual resonance of body and affect, and the development of communication upon this basis will, for the first time, enable transmission of culture to such individuals in favorable form, emphasizing the exceptional importance of attachment formation (amae) as being the key to this process.

Adolescent↗
PubMed2004

GCS: a grammatical coding system for natural language data.

This article presents a rationale and description of GCS, or Grammatical Coding System. GCS is a general-use grammatical coding system designed for research on the language of normal and language-impaired children or adults and is especially useful for studies in which a relatively large number of participants are involved. It implements recent theoretical developments in linguistics to characterize development and/or language disorder in children and adults. In addition to the coding system, a computerized method for reading coded transcripts and calculating relevant descriptive statistics is presented. A full coded transcription is included in the Appendix. A detailed GCS manual may be downloaded from www.psychonomic.org/archive.

Electronic Data Processing↗
PubMed2001

The role of coherence and cohesion in text comprehension: an event-related fMRI study.

Text processing requires inferences for establishing coherence between successive sentences. In neuropsychological studies and brain imaging studies, these coherence-building processes have been ascribed to the right hemisphere. On the other hand, there is evidence for prefrontal brain damage causing non-aphasic language disorders, in which text level processes are impaired. In this study, we used an event-related, whole-head fMRI methodology to evaluate the contributions of prefrontal areas and the right hemisphere to coherence building. We scanned 12 participants while they read 120 sentence pairs and judged their coherence. Four conditions were used, resulting from crossing coherence and cohesion (i.e. the presence of a lexical connection). A behavioral pretest confirmed that cohesion aided establishing coherence, whereas it hindered the detection of coherence breaks. In the fMRI study, all language conditions yielded activation in left frontolateral and temporolateral regions, when compared to a physical control task. The differences due to coherence of the sentence pairs were most evident in larger activation for coherent as compared to incoherent sentence pairs in the left frontomedian wall, but also in posterior cingulate and precuneal regions. Finally, a left inferior prefrontal area was sensitive to the difficulty of the task, and in particular to the increase in processing costs when cohesion falsely indicated coherence. These results could not provide evidence for a special involvement of the right hemisphere during inferencing. Rather, they suggest that the left frontomedian cortex plays an important role in coherence building.

Adult↗
PubMed2002

Statistical analyses of structural magnetic resonance imaging of the head of the caudate nucleus in Colombian children with attention-deficit hyperactivity disorder.

Magnetic resonance imaging (MRI) studies of the caudate nucleus have reported reversal asymmetry and alterations of its size, suggesting a striate cortical disorder related to attention-deficit hyperactivity disorder (ADHD). The objective was to evaluate whether alterations of the asymmetry and size of the caudate nucleus head exist in a sample of well-controlled 7- to 11-year-old Colombian children, with different types of ADHD. Two groups of cases-ADHD of the combined type and ADHD of the inattentive type-and one control group, were selected. Multiple methods for assessing ADHD (rating scales, psychologic.interview, neurologic history and examination, and neuropsychologic evaluation) were used to confirm the diagnoses. Participants with a history of language disorder, learning disabilities, depression, and other major neurologic and psychiatric conditions were excluded. Finally all groups had 15 children, matched by sex (7 male, 8 female), age, socioeconomic status, and grade. Height, weight, head circumference, and encephalic index were statistically controlled. Three T1-weighted volumetric (three-dimensional) MRI slides of the caudate nucleus head were obtained with a 1.5-Tesla Gyroscan apparatus. The control group had a significantly higher Wechsler Full-Scale IQ than the groups with ADHD of the combined type and ADHD of the inattentive type (P < .001). Volumes from the left caudate nucleus head were significantly larger than volumes from the right in all groups (P < .001). There were no group differences when volumes were compared between groups. All of the groups had left caudate nucleus head volumes significantly higher than right, although there were no between-group differences. The results in relation to previous studies are discussed.

Attention Deficit Disorder with Hyperactivity↗
PubMed1990

Disorders of attention and activity level in a referral population.

Of 614 children referred for an evaluation of hyperactivity and inattention, the 422 (68.7%) who qualified for a diagnosis of attention deficit disorder (ADD) were compared with the 192 (31.3%) who did not. The children with ADD had significantly higher full-scale IQ scores, verbal scores, and parental educational levels. They also had a significantly higher incidence of specific learning disabilities (73.7%). The absence of hyperactivity in children with ADD further exaggerated the differences in learning disability between the two groups. Cognitive limitation, severe parental psychopathology, and child neglect/abuse were significantly higher in the group without ADD. The two groups did not differ in the incidence of parental or child depressive symptomatology, motor diagnoses, language disorders, conduct disorders, and psychosomatic complaints. That only 29 children in whom ADD was absent (4.7% of all referrals) had been given a trial of stimulant medication does not support the presence of a major abuse of such drugs in the community.

Adolescent↗
PubMed2004

Speech delay due to a prelinguistic regression of epileptic origin.

A 2-year-old boy presented with an early form of benign partial epilepsy with centro-temporal spikes (BCERS) and a severe speech delay. Family video analysis revealed an early regression of babbling and stagnation since the age of 12 months. Complete recovery occurred with anti-epileptic treatment. The deficit corresponded to a transient speech apraxia attributed to an epileptic disconnection of networks coordinating speech articulation. This observation is, to the best of our knowledge, the first demonstration that delayed emergence of language can be due to an epileptic dysfunction interfering with prelinguistic skills and therefore mimicking a developmental delay.

Child, Preschool↗
PubMed2003

Speech and language in progressive nonfluent aphasia compared with early Alzheimer's disease.

BACKGROUND: Progressive nonfluent aphasia (PA) is a slow deterioration of language that remains relatively isolated from other cognitive or behavioral deficits for at least 2 years. The differentiation of PA from early Alzheimer's disease (AD) is important, given the presence of early language changes in AD. METHODS: A language assessment was administered to 15 patients who met established criteria for PA, 15 patients with clinically probable AD and mild dementia, and 15 normal control subjects. The language battery included verbal fluency, the Boston Naming Test with cuing and recognition, and an aphasia test battery with a motor speech exam. RESULTS: Pronounced literal paraphasic errors distinguished the PA patients from the AD patients. The PA group had anomia, decreased letter fluency, neologisms, difficulty on phrase repetition, decreased phrase length, and a decreased rate of verbal output. Interference from paraphasic anomia accounted for much of their decreased fluency. CONCLUSION: Many patients with PA have a primary defect in accessing sound-based representation of speech (phonemes), similar to conduction aphasia, possibly as a consequence of disturbed white matter tracts in the left superior temporal region.

Aged↗
PubMed2001

Screening for speech and language impairment: a follow-up of true negatives and false positives.

It is important to ascertain the validity of screening and case-finding procedures in terms of long-term outcome, particularly if they constitute the primary mode of accessing services. This study is a follow-up of a group of True Negatives and False Positives from the 'original' study (Laing et al. 2000), which investigated the concurrent validity of a parent-led method and a formal screening method. Nine (29.03%) of the 31 children who were re-assessed fell below the cut-off point for referral and were identified as cases. In particular, as many as eight (57.14%) of the 14 false positives were referred.

False Positive Reactions↗
PubMed1999

A pilot study of verbal fluency in the Zulu speaking population with preliminary application to traumatic brain injury.

This study investigated the semantic verbal fluency (VF) abilities of non-neurologically impaired (NNI) Zulu speaking subjects in order to obtain normative data for this population. The data were analysed in terms of the total number of words generated in one minute, the number of words generated over four fifteen-second time periods and the strategies employed. Where possible, these results were compared to performance of South African English speaking NNI subjects. The responses of three traumatically brain injured (TBI) Zulu speaking subjects on VF tasks were obtained and compared to the NNI subjects. The NNI subjects performed significantly poorer than the current norms and poorer than the South African English speaking population. The TBI subjects generated fewer words than the NNI subjects. The strategies used by the TBI subjects were similar in type but were less efficiently used than the Zulu speaking NNI subjects. The results of this study are particularly relevant to the clinical role of speech pathologists in the multicultural and multilingual population of South Africa.

Adolescent↗