Monthly Archives: January 2009
Treating Visual Speech Perception to Improve Speech Production in Nonfluent Aphasia
Background and Purpose—Several recent studies have revealed modulation of the left frontal lobe speech areas not only during speech production but also for speech perception. Crucially, the frontal lobe areas highlighted in these studies are the same ones that are involved in nonfluent aphasia. Based on these findings, this study examined the utility of targeting visual speech perception to improve speech production in nonfluent aphasia.
Methods—Ten patients with chronic nonfluent aphasia underwent computerized language treatment utilizing picture–word matching. To examine the effect of visual speech perception on picture naming, 2 treatment phases were compared—one that included matching pictures to heard words and another in which pictures were matched to heard words accompanied by a video of the speaker’s mouth presented on the computer screen.
Results—The results revealed significantly improved picture naming of both trained and untrained items after treatment when it included a visual speech component (ie, seeing the speaker’s mouth). In contrast, the treatment phase in which pictures were only matched to heard words did not result in statistically significant improvement of picture naming.
Conclusions—The findings suggest that focusing on visual speech perception can significantly improve speech production in nonfluent aphasia and may provide an alternative approach to treat a disorder in which speech production seldom improves much in the chronic phase of stroke.
from Stroke
The Veterans Health Administration System of Care for Mild Traumatic Brain Injury: Costs, Benefits, and Controversies
The Veterans Health Administration’s (VHA’s) Polytrauma System of Care, developed in response to a new cohort of patients back from Iraq and Afghanistan, is described with particular focus on the assessment and treatment of mild traumatic brain injury (mild TBI). The development of systemwide TBI screening within the VHA has been an ambitious and historic undertaking. As with any population-wide screening tool, there are benefits and costs associated with it. The purpose of this article is to identify and discuss the strengths and weaknesses of the VHA’s TBI clinical reminder and subsequent evaluation and treatment processes. Complicating factors such as increased media attention and other contextual factors are discussed.
Framing ideas in aphasia: the need for thinking therapy
This paper argues that some of the patterns seen in aphasia may reflect difficulties in the cognitive preparations for language. In particular, some individuals might be unable to carry out processes of ‘Thinking for Speaking’ (Slobin 1996), which frame thoughts for language production. Evidence to support this proposal is presented, together with signs that such thinking can be assisted with cues and therapy. It is argued that these preliminary data need to be pursued via a more comprehensive investigation of thinking therapy.
from the International Journal of Language and Communication Disorders
Increasing prevalence of specific language impairment (SLI) in primary healthcare of a Finnish town, 1989-99
Background: The increasing prevalence of specific language impairment (SLI) is a matter of current debate.
Aims: Speech and language therapists and other authorities in Finland have discussed the prevalence of SLI since the 1990s. This discussion has been based on international studies because of the lack of national studies. This paper presents the first Finnish prevalence study of SLI in primary healthcare and, thus, participates in the international discussion on the prevalence of SLI. Furthermore, two samples of delayed language development (DLD) were studied.
Methods & Procedures: This is a retrospective study from 1989-1999. It was conducted on the population of one of the biggest towns in Finland, and was collected from the statistical records of speech and language therapists.
Outcomes & Results: The prevalence of SLI increased, and this increase was statistically significant. The prevalence of SLI was less than 1% in age group 0-6 years and, thus, presents a much lower prevalence than international discussion has suggested. SLI seems to be present particularly in boys though it was also increasing in girls. Furthermore, children with SLI seem to be more affected by receptive difficulties over the period studied. Particularly important is the observation that the prevalence of DLD was also increasing, and together with SLI they suggest a prevalence rate of 2.5% in Finland.
Conclusions: The low prevalence of SLI in this study might be a consequence of the path of intervention that effectively separates SLI from delayed language development. Furthermore, the questions of language specific features needs to be emphasized. The findings of this study suggest that the prevalence of SLI increased as did the prevalence of DLD. The range of prevalence estimates of SLI in different studies raises the need for national and international epidemiological studies of SLI with equal criteria of assessment in each language.
from the International Journal of Language and Communication Disorders
Specific language impairment and school outcomes. II: Educational context, student satisfaction, and post-compulsory progress
Background: This investigation is the second paper of a companion set reporting the outcomes of secondary schooling for young people who have been participating in the Manchester Language Study.
Aims: To examine the school context of educational results at 16 years of age and to provide information on the adolescents’ post-16 activities.
Methods & Procedures: A total of 120 adolescents with a history of specific language impairment (SLI) and 121 adolescents with typical development (TD) in their final year of compulsory secondary schooling (mean age = 17;4 years) participated in the study. Data on educational placement, special education support and provision of statement of special educational needs (SEN) were collected, along with the provision of access arrangements during examinations. Adolescents were interviewed about their levels of expectation and satisfaction with their examination results and their subsequent post-16 activities.
Outcomes & Results: Only a small proportion of adolescents attended special units/schools throughout their secondary schooling; a larger proportion consistently attended mainstream schools. Those in receipt of a statement of SEN performed more poorly in their examinations than those without a statement. Around 60% of the adolescents with SLI were provided with some type of access arrangements during their core examinations. The majority (88%) of adolescents with SLI reported that they were satisfied with their educational outcomes. Most adolescents with SLI (91%), regardless of school placement at 16 years, remained in education post-16, with the majority in college settings.
Conclusions: Adolescents with a history of SLI have continued difficulties throughout secondary schooling, with three-quarters of the sample receiving some form of special education in a variety of settings. Educational attainment varied across different groups of adolescents but was consistently poorer than the attainment of typically developing peers. Young people with SLI in the 2000s appear to have more opportunities to remain in education post-16 than they did in the 1990s.
from the International Journal of Language and Communication Disorders
Specific language impairment and school outcomes. I: Identifying and explaining variability at the end of compulsory education
Background: This investigation reports the results of national educational examinations in secondary schooling for young people who have been participating in the Manchester Language Study.
Aims: The emphasis of the study is on furthering understanding of educational outcomes at the end of compulsory education.
Methods & Procedures: A total of 120 adolescents with a history of specific language impairment (SLI) and 121 adolescents with typical development (TD) who were in their final year of compulsory secondary schooling (mean age = 17;4 years) participated. National educational examination results throughout secondary schooling were collected along with a range of psycholinguistic skills from 11 to 16/17 years.
Outcomes & Results: Forty-four per cent of young people with SLI obtained at least one of the expected qualifications at the end of secondary education, indicating some improvements compared with reports on earlier cohorts. Regression analyses revealed that literacy and language skills were predictive of educational attainment after controlling for IQ and maternal education. Nearly one-quarter of the sample of adolescents with SLI was not entered for any examinations at the end of compulsory education. A very strong association between earlier patterns of entry for examinations and patterns of examination entry at school leaving age was found.
Conclusions: In addition to performance IQ, concurrent and early literacy and language skills have significant effects on the academic attainments of young people with a history of SLI. The transition from primary to secondary schooling is a crucial time for assessment and evaluation of individual children’s needs and levels of support required.
from the International Journal of Language and Communication Disorders
Voices of young people with a history of specific language impairment (SLI) in the first year of post-16 education
Background: Giving young people more and better opportunities to have their voices heard is a key feature of current educational policy and research internationally and in the UK.
Aims: To examine the views of young people with a history of specific language impairment (SLI) as they entered post-16 education.
Methods & Procedures: A total of 54 students identified as having SLI at 8 years of age were followed up through primary and secondary school to post-16 destinations. Most had been educated in mainstream schools. The young people were interviewed individually in relation to their perceptions of their special educational needs, their views on service provision, the role of family and friends as support systems, and their aspirations and barriers to future education at the early stages of post-16 education, training and work.
Outcomes & Results: The young people were able to offer accurate accounts of their history of special educational needs and to explore issues related to their development. Most young people were aware of the specific difficulties they experienced and had positive views about the support offered to them during their schooling. All the young people had at least one person in their family or friendship circle to whom they could talk about their joys and concerns, and friendships were an important and positive element in their lives. Additionally, most had a positive view of their post-16 courses, with comparable numbers hoping to undertake further study or training, or to go into work. They also had optimistic hopes for their futures five years ahead.
Conclusions: The current study has demonstrated that young people with a history of SLI have an awareness of their difficulties and of the impact that these needs have on different aspects of their lives. They were also able to provide valuable views of service provision, both in terms of evaluating the support they received and suggesting ways of improving it. Ascertaining the views of younger children with SLI and including them in decision-making about their education and lives should be an important aspect of the role of those professionals working with this group of children. The study supports the importance of gaining the views of young people with SLI not only as a matter of rights, but also for the practical benefits that can ensue.
from the International Journal of Language and Communication Disorders
Relation between Videofluoroscopy of the Esophagus and the Quality of Esophageal Speech
The goal of the current study was to compare the quality of esophageal speech and voice to videofluoroscopic features of the esophagus and pharyngoesophageal (PE) segment. The speech and voice characteristics of 30 laryngectomized patients were rated by 5 speech-language pathologists. Based on these ratings, patients were divided into 3 categories: fluent (n = 9), moderately fluent (n = 10) and nonfluent (n = 11). Videofluoroscopy of the PE region was then performed during both swallowing and voice production. An insufflation test and percutaneous pharyngeal plexus block were required in 9 patients to determine the etiology of poor esophageal voice production. The strongest videofluoroscopic indicators of nonfluent speakers were: (1) small or absent air reservoir and (2) lack of a vibrating PE segment. Fluent speakers presented with shorter PE segments (1.17 mm) compared to moderately fluent speakers (17.1-29.9 mm). Perceptually, fluent speakers presented with a predominantly rough vocal quality. In contrast, moderately fluent speakers presented with a tense quality. In addition, stoma blast noise was reduced in fluent speakers. Videofluoroscopic findings highly correlated with the quality of esophageal speech.
Research Grants Fund New Studies on Breast and Childhood Cancers, Hearing Loss, Tuberculosis
Newswise — Finding cures for hearing loss, breast cancer and childhood cancer and a way to identify people at risk for tuberculosis are goals of the first recipients of grants from the Virginia and L.E. Simmons Family Foundation Collaborative Research Fund. The fund, a $3 million initiative to discover new ways to diagnose and treat diseases, supports collaboration among researchers at Rice University, Texas Children’s Hospital and The Methodist Hospital Research Institute.
from Newswise.com
Electrophysiological and behavioral evidence of syntactic priming in sentence comprehension.
Event-related potentials and eye tracking were used to investigate the nature of priming effects in sentence comprehension. Participants read 2 sentences (a prime sentence and a target sentence), both of which had a difficult and ambiguous sentence structure. The prime and target sentences contained either the same verb or verbs that were very close in meaning. Priming effects were robust when the verb was repeated. In the event-related potential experiment, the amplitude of the P600 was reduced in target sentences that followed prime sentences with the same verb but not in prime sentences with a synonymous verb. In the eye-tracking experiment, total reading times on the disambiguating region were reduced when the targets followed prime sentences with the same verb but not when targets followed prime sentences with a synonymous verb. The fact that verb overlap greatly boosted priming effects in reduced relative sentences may indicate that verb argument structures play an important role in online parsing. (PsycINFO Database Record (c) 2009 APA, all rights reserved)
from the Journal of Experimental Psychology: Learning, Memory, and Cognition
Exploiting degrees of inflectional ambiguity: Stem form and the time course of morphological processing.
The authors compared sublexical and supralexical approaches to morphological processing with unambiguous and ambiguous inflected words and words with ambiguous stems in 3 masked and unmasked priming experiments in Finnish. Experiment 1 showed equal facilitation for all prime types with a short 60-ms stimulus onset asynchrony (SOA) but significant facilitation for unambiguous words only with a long 300-ms SOA. Experiment 2 showed that all potential readings of ambiguous inflections were activated under a short SOA. Whereas the prime-target form overlap did not affect the results under a short SOA, it significantly modulated the results with a long SOA. Experiment 3 confirmed that the results from masked priming were modulated by the morphological structure of the words but not by the prime-target form overlap alone. The results support approaches in which early prelexical morphological processing is driven by morph-based segmentation and form is used to cue selection between 2 candidates only during later processing. (PsycINFO Database Record (c) 2009 APA, all rights reserved)
from the Journal of Experimental Psychology: Learning, Memory, and Cognition
Selective short-term memory deficits arise from impaired domain-general semantic control mechanisms.
Semantic short-term memory (STM) patients have a reduced ability to retain semantic information over brief delays but perform well on other semantic tasks; this pattern suggests damage to a dedicated buffer for semantic information. Alternatively, these difficulties may arise from mild disruption to domain-general semantic processes that have their greatest impact on demanding STM tasks. In this study, mild semantic processing impairments were demonstrated in 2 semantic STM patients. They performed well on untimed semantic tasks but were deficient in accuracy and reaction times on speeded tasks. Demanding semantic production tasks were also affected. These patients were compared with a case series of individuals with semantic aphasia whose multimodal semantic difficulties stemmed from poor cognitive control. STM and semantic performance were more impaired in this group, but there were qualitative similarities to the semantic STM patients. The difference between the 2 patient types may be a matter of degree. In semantic aphasia, severe disruption to semantic control leads to global semantic impairments, whereas in semantic STM milder disruption might impact mainly on STM tests because of the high control demands of these tasks. (PsycINFO Database Record (c) 2009 APA, all rights reserved)
from the Journal of Experimental Psychology: Learning, Memory, and Cognition
The cross-script length effect: Further evidence challenging PDP models of reading aloud.
The interaction between length and lexical status is one of the key findings used in support of models of reading aloud that postulate a serial process in the orthography-to-phonology translation (B. S. Weekes, 1997). However, proponents of parallel models argue that this effect arises in peripheral visual or articulatory processes. The authors addressed this possibility using the special characteristics of the Serbian and Japanese writing systems. Experiment 1 examined length effects in Serbian when participants were biased to interpret phonologically bivalent stimuli in the alphabet in which they are words or in the alphabet in which they are nonwords (i.e., the visual characteristics of stimuli were held constant across lexical status). Experiment 2 examined length effects in Japanese kana when words were presented in the kana script in which they usually appear or in the script in which they do not normally appear (i.e., the phonological characteristics of stimuli were held constant across lexical status). Results in both cases showed a larger length effect when stimuli were treated as nonwords and thus offered strong support to models of reading aloud that postulate a serial component. (PsycINFO Database Record (c) 2009 APA, all rights reserved)
from the Journal of Experimental Psychology: Learning, Memory, and Cognition
Trial-to-trial carryover in auditory short-term memory.
Using a short-term recognition memory task, the authors evaluated the carryover across trials of 2 types of auditory information: the characteristics of individual study sounds (item information) and the relationships between the study sounds (study set homogeneity). On each trial, subjects heard 2 successive broadband study sounds and then decided whether a subsequently presented probe sound had been in the study set. On some trials, the similarity of the probe item to stimuli presented on the preceding trial was manipulated. This item information interfered with recognition, and false alarms increased from 0.4% to 4.4%. Moreover, the interference was tuned so that only stimuli that were very similar to each other interfered. On other trials, the relationship among stimuli was manipulated to alter the criterion subjects used in making recognition judgments. The effect of this manipulation was confined to the trial on which the criterion change was generated and did not affect the subsequent trial. These results demonstrate the existence of a sharply tuned carryover of auditory item information but no carryover of the effects of study set homogeneity. (PsycINFO Database Record (c) 2009 APA, all rights reserved)
from the Journal of Experimental Psychology: Learning, Memory, and Cognition
