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Measuring young children's language abilities.

This article deals with the new challenges put on language diagnosis, and the growing need for good diagnostic instruments for young children. Particularly for Dutch, the original English Reynell Developmental Language Scales were adapted not only to the Dutch idiom, but some general ameliorations and changes in the original scales resulted in a new instrument named the RTOS. The new instrument was standardized on a large population, and psychometrically evaluated. In communicating the experiences with such a language/cultural/psychometric adaptation, we hope that other language-minority groups will be encouraged to undertake similar adaptations.

Belgium↗

Hemispatial visual-searching impairment correlated with decreased contralateral parietal blood flow in Alzheimer disease.

BACKGROUND: Impairment of visuospatial attention in Alzheimer disease (AD) has not been fully investigated. Mendez et al reported that patients with AD showed hemispatial biases on visual search tasks. Parietal lobe involvement might be related to such impairment. The Picture Description Task is one of the most sensitive tests for detecting language disorders and might be also useful in assessing visual search. OBJECTIVE: The applicability of the Picture Description Task for evaluating hemispatial visual search impairment of AD was investigated, as well as whether the hemispheric difference in parietal blood flow is related to such impairment. METHODS: Thirty-four patients with AD and age-matched 16 normal subjects performed the Picture Description Task. The elements of the picture were divided into three portions: the right portions (five elements), the central portions (two elements), and the left portions (five elements), so as to assess the patients' hemispatial visual searching ability. Using single photon emission CT, the absolute regional cerebral blood flow (CBF) values at resting condition were calculated by the method of Kuhl et al. RESULTS: Fourteen patients with AD showed a decreased number of elements pointed out in the left portion of the picture, whereas 12 patients had decreased attention in the right portion. The remaining eight pointed only to the central portion. None of them showed hemispatial neglect on the figure copying tasks. The patients with decreased left spatial attention had lower CBF in the right parietal lobe, and vice versa. A significant negative (biologically meaningful) Spearman correlation was found between the right-left indices of the elements pointed out in the picture and the CBF values. CONCLUSIONS: The results suggest that the Picture Description Task is useful for assessing visual search, and impaired hemispatial visual search in AD is related to decreased contralateral parietal blood flow. The right-left asymmetry of the parietal CBF might be associated with hemispatial visual attention impairments in AD.

Aged↗

[Efficacy and tolerability of long term topiramate in drug resistant epilepsy in adults].

OBJECTIVE: With the objective of evaluating the efficacy and tolerability of topiramate (TPM) in resistant epilepsy, we did a retrospective, open, multicentric analysis of 56 patients aged over 15 years in whom TPM was given as the second, third or fourth drug. All patients had already been on treatment for at least 18 months when topiramate was started. The average follow up was 27.2 months. RESULTS: At the close of the study 16% of the patients were asymptomatic, 23% had a 75% reduction in seizures and 36% a 50% reduction. The drug was withdrawn in 25% of the cases. The adverse effects noted were: nephrolithiasis, asthenia, loss of hair, diarrhoea, weight loss of over 5kg., agitation, aggressiveness, language disorders, ataxia, tremor, somnolence and confusion. The drug had to be suspended when these adverse effects affected the central nervous system moderately or severely, and when there were general effects such as renal calculi in one case and weight loss associated with symptoms which worried the patients in two cases. CONCLUSIONS: Thus, TPM is an effective drug in refractory epilepsy and most patients continue on this treatment. The side effects are typical of the drug, and although there is no risk to life, the patient should be warned of them.

Adolescent↗

Variability in aphasic patients' response times.

Response time studies of acquired language disorders are plagued by tremendous variability in patients' response times. In this brief report we demonstrate how variability itself may provide informative data. Lexical decision response times, generated by nine patients, illustrate how within-patient variability may estimate stability in cognitive dynamics.

Aphasia↗

Production of lexical categories in French children with SLI and in normally developing children matched for MLU.

Free speech recording samples of two groups of French SLI children aged 48 and 62 months (matched for MLU, 1.70) and two groups of French normally developing children aged 26 and 36 month (matched for MLU, 3.2) were compared to determine whether they showed a difference in the use of lexical categories. A category-by-category comparison showed few significant differences. For low MLU children, SLI produced significantly fewer infinitives, past participles, copulas, and demonstrative pronouns. For high MLU children, the difference persisted only in past participles use. As for English SLI children, French SLI children were delayed in their acquisition of verbs. However, the differences in the syntactic structure of English and French ruled out a syntactic explanation of the deficit. Phonetic problems seem to decrease with age, so they cannot be the only explanation behind the difficulties of SLI children, which probably involve cognitive problems such as processing limitations.

Child Language↗

Content mazes and filled pauses in narrative language samples of children with specific language impairment.

Linguistic nonfluencies known as mazes (filled pauses, repetitions, revisions, and abandoned utterances) have been used to draw inferences about processing difficulties associated with the production of language. In children with normal language development (NL), maze frequency in general increases with linguistic complexity, being greater in narrative than conversational contexts and in longer utterances. The same tendency has been found for children with specific language impairment (SLI). However, the frequency of mazes produced by children with NL and SLI has not been compared directly at equivalent utterance lengths in narration. This study compared the frequency of filled pauses and content mazes in narrative language samples of school-age children with SLI. The children with SLI used significantly more content mazes than the children with NL, but fewer filled pauses. Unlike content mazes, the frequency of filled pauses remained stable across samples of different utterance lengths among children with SLI. This indicates that filled pauses and content mazes have different origins and should not be analyzed or interpreted in the same way.

Child↗

[A case of motor neuron disease with progressive aphasia and dementia].

We report a 71-year-old woman showing rapidly progressive non-fluent aphasia and dementia accompanied by motor neuron disease (MND). There was no family history of dementia or motor neuron disease. There was 10 months history of dysarthria and dysphagia. On examination, she showed profound difficulty in articulation. Her comprehension was impaired in that she was unable to obey three-stage command. Her written language was also impaired with phonological spelling errors, syntactic errors, and perseveration. Neuroradiological investigations showed atrophic changes and hypoperfusion of left temporal and bilateral parietal region revealed by MRI and SPECT, respectively. Her subsequent decline was rapid. It might be likely that aphasia is much more common in dementia with bulbar MND than is currently recognized because bulbar palsy might mask the language disorder.

Aged↗

Fetal alcohol syndrome in developmental age. Neuropsychiatric aspects.

Alcohol constitutes one of the main risk factors for the health of the newborn infant and is also one of the leading causes of cognitive deficit. The distinctive pattern of abnormalities that characterizes fetal alcohol syndrome (FAS) includes: pre- and postnatal growth retardation, cognitive deficit, behavior and language disorders, cerebral malformations (schizencephaly, polymicrogyria, agenesis of the corpus callosum), facial changes (short palpebral fissures, low nasal bridge, anomalies of the auricle, maxillary hypoplasia, cleft lip and palate) and organ anomalies (heart defects, renal and skeletal malformations). As occurs with any teratogenic agent, the variability of phenotypic expression is wide and depends on dose, gestational stage, duration of exposure, maternal and fetal metabolism and other environmental and genetic factors. This study describes 6 subjects with FAS who express various characteristics of the clinical spectrum of the syndrome.

Abnormalities, Multiple↗

[N400 event-related potentials of semantic matching of sentence-ending words in healthy Chinese subjects].

OBJECTIVE: To investigate of changes in N400 event-related potentials (ERPs) in recognition of semantically matching ending words of Chinese sentences for analysis of the characteristics of Chinese sentence N400 in healthy subjects. METHODS: Fifteen healthy right-handed volunteers aging from 21 to 36 years old were tested for N400 when they were asked to read Chinese sentences with semantically matching or mismatching ending words. RESULTS: Significant differences were found in N400 latencies and amplitudes when the subjects were reading the carefully designed Chinese sentences (P<0.05). The latencies of N400 were delayed and the amplitudes increased when the subjects were confronted with mismatching ending words, in the event of which N400 amplitudes were higher in the left than in the right hemisphere of the brain. CONCLUSIONS: N400 in Chinese sentence-ending word matching test is close by related to the semantic context of the word recognition, and possesses clinically valuable recognition potential for assessing language disorders.

Adult↗

[A clinicopathological study on 13 cases of motor neuron disease with dementia].

Thirteen patients suffering from motor neuron disease with dementia were studied to analyze the clinicopathological spectrum. The diagnosis of the disease was made on the basis of a clinical history of progressive dementia and motor neuron involvement. The mean age at onset of 11 sporadic cases was 54.9 years (range, 43 to 69 years), with a mean duration of disease of 25 months (range, 11 to 47 months). The initial symptoms were dementia in 7 cases, motor neuron involvement in 2 cases, and both dementia and motor neuron involvement in 2 cases. The clinical picture of motor neuron disturbance in sporadic cases represented bulbar-type of amyotrophic lateral sclerosis (ALS). Bulbar palsy was the initial symptom in 7 sporadic cases and all 11 patients developed bulbar palsy with advancing course of illness. Muscular wasting and fasciculation were more predominant in the upper limbs, shoulder girdle and anterior chest. Fasciculation was more extensively and frequently observed in those portions than that of classical ALS. In contrast, muscle strength in the lower limbs was well preserved so that all patients could walk even when respiratory failure developed. Hyperreflexia including jaw jerk was found in all cases and positive Babinski sign in 7 cases. Parkinsonism appeared in the initial stage in one sporadic case and in two familial cases. The type of dementia with uninhibited behavior and personality change closely mimicked that of Pick's disease. The degree of dementia was mild or moderate in 8 cases and severe in 3 cases. Language disorder was characterized by progressive reduction of speech output, leading finally to mutism in 5 cases. Perseveration was observed in 10 cases. Visuospatial disorder was absent even in the advanced stage. Mild memory disturbance was noted in the early stage in 10 cases. Pathological examination was performed in 7 cases including one familial case, revealing frontal atrophy in 3 cases, frontotemporal atrophy in 2 cases and temporal atrophy in 2 cases. On microscopic examination there were mild neuronal loss, gliosis, mild spongy state of the cortical superficial layers and fibrous gliosis in the frontotemporal white matter. The scattered senile plaques in one case did not justify a diagnosis of Alzheimer's type dementia. Neither circumscribed atrophy nor Pick body was found in any case. The nucleus basalis of Meynert showed no neuronal loss. The substantia nigra showed a mild to severe loss of nerve cells without Lewy bodies in all cases.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

Training and generalization of expressive syntax in nonfluent aphasia.

Generalization of treatment effects remains a consistent goal of clinicians who treat aphasic adults. Specifically, various types of stimulus/response generalization designs are available, depending on the level of generalization desired. We have reviewed training matrices designed to elicit gestural subject-plus-verb targets and treatment studies designed to answer more global questions regarding treatment efficacy. As Kearns (1989) so eloquently states, "clinical accountability cannot, in fact, be fully achieved without documentation of communication skills trained in the clinic generalized to other settings and situations." Although the studies cited and data reviewed in this article did not meet this standard specifically, an attempt was made to provide a brief prelude to the data now emerging in the aphasiology literature. Additionally, with an increasing data base in the literature specific to generalization, more efficacious treatment paradigms will be made available. Clinicians treating aphasic adults thus should have the opportunity to choose the treatments shown to be most effective for a specific type and severity of aphasia.

Aged↗

Do children with developmental delays use more frequent and diverse language in verbal routines?

The current study is the first to test the hypotheses that children with developmental delays use more frequent language and more diverse vocabulary in routines than in nonroutines. The 19 child participants were in Brown's (1973) first stage of language learning. Using a novel method of measuring routines, 18 of the parents identified at least one routine in a videotaped play session with their children. Results support both hypotheses and provide descriptive information about the content of the routines displayed by the parents and children in the free-play context. The importance of replicating the findings in the context of an experimental design before concluding that "routineness" caused the children to talk more often and with more diverse vocabulary was emphasized.

Child↗

Neuropsychological profiles of children diagnosed as specific language impaired with and without hyperlexia.

This study compared the neuropsychological profiles of 46 children with Specific Language Impairment (SLI) and 16 children with SLI and Hyperlexia (SLI + H). The results indicated that the essential feature of Hyperlexia is Specific Language Impairment and not reading disability. Thus, Hyperlexia would be best conceptualized as a subgroup of Developmental Language Disorder rather than as a subgroup of Developmental Dyslexia. Further, the SLI + H group exhibited significantly better developed visual/spatial memory which, along with average visual perceptual skills, appears to be the major contributing factor to their elevated word recognition and spelling ability. Finally, it should be noted that both groups of children exhibited decreasing performance on tasks of immediate auditory/verbal memory as the language/semantic demands of the memory task increased. This finding appears to be the result of a limited capacity for immediate verbal processing and not the result of a deficit in verbal learning and recall.

Journal Article↗