| In the present long-term study, we analyzed language disorders in four patients with landau-kleffner syndrome. Their common first symptoms were disability in understanding spoken words, followed by inarticulation and a decreased amount of speech. All patients showed auditory verbal agnosia to some degree at some stage of their illness. However, one patient showed typical sensory aphasia as the first symptom, and another patient showed nonverbal auditory agnosia followed by pure word deafness. Thus, patients with landau-kleffner syndrome show sequential and sometimes hierarchical language disorders beginning with sensory aphasia, followed by auditory agnosia, and finally word deafness during their disease process. During long-term follow-up (20 to 30 years), all patients showed marked recovery in language without any intellectual handicap, but with some disability in spoken language, auditory verbal perception, and a discrepancy between Wechsler Verbal and Performance IQ scores. ( info) |
2/352. Syntax PAL: a system to improve the written syntax of language-impaired users. In our work with children who have difficulty with spelling or with the physical action of writing, we have found a number of children who also have difficulty with written grammar. As an extension of PAL, an existing predictive spelling and typing aid, we have developed a writing aid to help these children with sentence construction. The enhanced system uses the syntax of the initial part of a sentence to enhance the position in the prediction list of syntactically correct words. It was postulated that this would discourage the use of incorrect syntax and encourage the use of correct syntax. In two case studies, the use of Syntax PAL significantly improved the quality and quantity of one child's written output, but had little effect on the other child's work. ( info) |
3/352. Subclinical hyperthyroidism and hyperkinetic behavior in children. The authors report three children who exhibited developmental learning disabilities (DLDs) associated with behavioral disturbances, such as attention deficit, hyperactivity, and autistic features. The thyroid function tests performed as a part of routine endocrinologic evaluation of children with DLDs revealed a hormonal profile consistent with hyperthyroidism. These children had no systemic signs of hyperthyroidism. Treatment with neomercazole resulted in good control of their hyperkinetic behavior and subsequent improvement in language function attributable to an increased attention span, thereby facilitating speech therapy. Although routine screening of all children with DLDs for thyroid dysfunction may not be cost-effective, selective screening of children with familial attention-deficit hyperactivity disorder and those with attention-deficit and hyperactivity in association with DLDs and pervasive developmental disorders appears to be justified. ( info) |
4/352. Linguistic impairment after right cerebellar stroke: a case report. Increasing evidence suggests the involvement of the cerebellum in non-motor functions. We describe a patient who presented speech deficits after a right cerebellar infarction without other cognitive impairments. 99mTc-HMPAO single-photon emission computed tomography showed a marked hypoperfusion in the right cerebellar hemisphere, but did not show crossed cerebellar- cerebral diaschisis. The absence of neuroradiological evidence of structural supratentorial lesions supports the cerebellar role in modulating not only the motor system, but also higher order functions. ( info) |
5/352. Language sample analysis in the 21st century. time requirements inherent in transcription and analysis of spontaneous language samples represent a significant barrier to the regular use of language sample analysis in clinical settings. Taking advantage of the options provided by new large, fast, and affordable personal microcomputers, two language analysis programs, the Systematic Analysis of Language Transcripts and The child language Data Exchange System have been developed to provide automated analysis of a wide range of language indices, as well as tools designed to reduce and simplify the time-intensive process of transcribing and analyzing children's language samples from both typical and clinical populations. In this article we provide a historical context for the development of these language analysis programs and a brief introduction to the transcription editors and language sample databases for both systems. In addition, a case study highlighting the interactive use of both analysis systems is provided. ( info) |
6/352. technology applications in the assessment of children's language. technology can assist both standardized and nonstandardized language assessment. Standardized test records can be rapidly and accurately scored, and the potential exists for entirely computerized test administration. Sounds and images can be captured and then played or displayed on a computer, creating stimulus sets that elicit language for nonstandardized analysis. Clinician learning of linguistic principles and methods can be enhanced through software that offers systematic practice and corrective feedback. Once analytical skill is acquired, language assessment can be facilitated with software for evaluating a child's level of development and linguistic productivity in the subsystems of grammer, semantic relations, vocabulary, narrative, and prosody. The basic operations performed by language analysis software are tallying and searching of codes. However, in different programs those codes may result entirely from human user input or they may result from codes partly generated by intelligent software. ( info) |
7/352. Use of technology in phonological assessment: evaluation of early meaningful speech and prelinguistic vocalizations. Technologies that assist in the assessment of phonological abilities in early meaningful speech and prelinguistic vocalizations are discussed. Computerized assessment of phonological abilities (CAP) software offers significant time savings for basic analyses and makes possible the completion of more detailed analyses. The programs discussed in this article allow flexibility in determining not only the most appropriate analyses for an individual client, but also the design of the optimal symbol system for representing the client's productions. Case studies are included to illustrate the clinical benefits of CAP technology. ( info) |
8/352. "What" and "how": evidence for the dissociation of object knowledge and mechanical problem-solving skills in the human brain. patients with profound semantic deterioration resulting from temporal lobe atrophy have been reported to use many real objects appropriately. Does this preserved ability reflect (i) a separate component of the conceptual knowledge system ("action semantics") or (ii) the operation of a system that is independent of conceptual knowledge of specific objects, and rather is responsible for general mechanical problem-solving skills, triggered by object affordances? We contrast the performance of three patients-two with semantic dementia and focal temporal lobe atrophy and the third with corticobasal degeneration and biparietal atrophy-on tests of real object identification and usage, picture-based tests of functional semantic knowledge, and a task requiring selection and use of novel tools. The patient with corticobasal degeneration showed poor novel tool selection and impaired use of real objects, despite near normal semantic knowledge of the same objects' functions. The patients with semantic dementia had the expected deficit in object identification and functional semantics, but achieved flawless and effortless performance on the novel tool task. Their attempts to use this same mechanical problem-solving ability to deduce (sometimes successfully but often incorrectly) the use of the real objects provide no support for the hypothesis of a separate action-semantic system. Although the temporal lobe system clearly is necessary to identify "what" an object is, we suggest that sensory inputs to a parietal "how" system can trigger the use of objects without reference to object-specific conceptual knowledge. ( info) |
9/352. Making requests: illustrations of how right-hemisphere brain damage can affect discourse production. This article examines several factors that influence the production of requests for behavior. Using a role-play methodology, we elicited request productions from well-recovered patients with right-hemisphere brain damage (RHD) and from non brain-damaged control participants. The stimulus items represented variation both on interpersonal factors based on characteristics of the people in the interaction and on situational factors based on what was being requested. A large corpus of responses was elicited from each patient. Responses were coded for request directness, amount of explanatory material over and above the request proper (a relatively demanding method for manipulating the tone of a request), and use of "please" (a relatively simple device for signaling a request). Case-by-case analysis of the patients' performances revealed some common areas of abnormality and also some idiosyncratic features. Some patients produced less explanatory supportive material than control participants, and they tended not to vary the amount of explanatory material as a function of the request scenario. Of interest is that some of the same patients overused "please," and varied their use of this simple device as a function of request scenarios. The discourse strategies observed were likely due to deficits both in pragmatic awareness and in planning utterances. One implication of these results concerns an apt description of the abnormal discourse of RHD patients. The relative lack of supportive explanatory material in their requests may result in patients' seeming rude or inappropriate. ( info) |
10/352. 'Speaking in tongues'. Paradoxical fixation on a non-native language following anaesthesia. An intriguing case of transient language disturbance following anaesthesia is described which may throw some light on the way languages are stored in the brain. A review of the existing literature and its relevance to this unique case is discussed. ( info) |