General language abilities following management of childhood supratentorial tumour: Part 1

Background. To date few studies have investigated the impact of management for supratentorial tumour on the language abilities of children. In reporting children with brain tumour as part of a larger cohort of various aetiologies of brain injury, such studies have failed to differentiate between the causes of acquired childhood language disorders, or specifically report associated information relating to site and treatment. Material and methods. The present study examined the general language abilities of six children managed for supratentorial tumour, using a comprehensive standardized general language assessment battery, including receptive and expressive components, receptive vocabulary, and naming. Results. At a group level, children managed for supratentorial tumour performed below an individually matched control group in the area of general expressive language. However, at an individual case level it was revealed that only two cases exhibited specific language deficits. Reduced performance in the area of expressive language and syntax was evident in the language profile of one child treated surgically for a left parietal astrocytoma, while a child treated surgically for an optic nerve glioma demonstrated difficulties in receptive semantic abilities. The remaining four cases with similar treatments and locations demonstrated intact general language abilities. Conclusions. Factors such as site, long-term presence of tumour prior to diagnosis, young age at diagnosis, and variations in time post treatment were considered to have contributed to the findings. The need for long-term monitoring of language abilities post treatment as well as larger group sizes and the investigation of higher-level abilities was highlighted

Successes and failures in assessing acquired language disorders using an Internet-based telerehabilitation system

We have used a telerehabilitation system (eREHAB) to remotely assess acquired language disorders via the Internet. The system was used to establish a 128 kbit/s videoconference between two sites and allowed a remote language assessment to be conducted using the standardized Boston Diagnostic Aphasia Examination (BDAE). The system had the capacity to display text and images, and could play pre-recorded instructions to the participant via various built-in tools. A touch screen allowed tasks involving picture identification to be completed easily. Eighteen participants with a diagnosis of an acquired language disorder were simultaneously assessed using the eREHAB system, and in the traditional face-to-face manner by two speech pathologists. There was very high agreement between the two assessors, with weighted kappa scores of 0.8–1.0 for 88% of the sub-tests of the BDAE. There was also high agreement (80–100%) and high kappa scores (0.67–0.90) between assessors on the six rating scales relating to language characteristics. The agreement between the two assessors for the diagnosis of the type of aphasia was 83%. Limitations of the system related mainly to problems inherent in IP videoconferencing. The inability to maintain the preferred speed of 128 kbit/s for the duration of the videoconference and the resultant increase in video and audio breakup and latency affected the clinician’s ability to administer the BDAE with the same ease and accuracy as in face-to-face administration. These difficulties were exacerbated when participants presented with a moderate to severe language disorder, auditory comprehension deficits or significant hearing loss. Despite these limitations, a valid assessment of language disorder was found to be feasible via this telerehabilitation application.

The mismatch negativity (MMN) response to complex tones and spoken words in individuals with aphasia

Background: The mismatch negativity (MMN) is a fronto-centrally distributed event-related potential (ERP) that is elicited by any discriminable auditory change. It is an ideal neurophysiological tool for measuring the auditory processing skills of individuals with aphasia because it can be elicited even in the absence of attention. Previous MMN studies have shown that acoustic processing of tone or pitch deviance is relatively preserved in aphasia, whereas the basic acoustic processing of speech stimuli can be impaired (e.g., auditory discrimination). However, no MMN study has yet investigated the higher levels of auditory processing, such as language-specific phonological and/or lexical processing, in individuals with aphasia. Aims: The aim of the current study was to investigate the MMN response of normal and language-disordered subjects to tone stimuli and speech stimuli that incorporate the basic auditory processing (acoustic, acoustic-phonetic) levels of non-speech and speech sound processing, and also the language-specific phonological and lexical levels of spoken word processing. Furthermore, this study aimed to correlate the aphasic MMN data with language performance on a variety of tasks specifically targeted at the different levels of spoken word processing. Methods M Procedures: Six adults with aphasia (71.7 years +/- 3.0) and six healthy age-, gender-, and education-matched controls (72.2 years +/- 5.4) participated in the study. All subjects were right-handed and native speakers of English. Each subject was presented with complex harmonic tone stimuli, differing in pitch or duration, and consonant-vowel (CV) speech stimuli (non-word /de:/versus real world/deI/). The probability of the deviant for each tone or speech contrast was 10%. The subjects were also presented with the same stimuli in behavioural discrimination tasks, and were administered a language assessment battery to measure their auditory comprehension skills. Outcomes O Results: The aphasic subjects demonstrated attenuated MMN responses to complex tone duration deviance and to speech stimuli (words and non-words), and their responses to the frequency, duration, and real word deviant stimuli were found to strongly correlate with performance on the auditory comprehension section of the Western Aphasia Battery (WAB). Furthermore, deficits in attentional lexical decision skills demonstrated by the aphasic subjects correlated with a word-related enhancement demonstrated during the automatic MMN paradigm, providing evidence to support the word advantage effect, thought to reflect the activation of language-specific memory traces in the brain for words. Conclusions: These results indicate that the MMN may be used as a technique for investigating general and more specific auditory comprehension skills of individuals with aphasia, using speech and/or non-speech stimuli, independent of the individual's attention. The combined use of the objective MMN technique and current clinical language assessments may result in improved rehabilitative management of aphasic individuals.

Quel role pour la langue de reference dans les representations des apprenants? Le cas de l'evaluation en langue etrangere

This research project explores learner’s representations of strategic L1 use in the foreign language classroom and highlights both the positive or negative roles attributed to the L1 in the language learning process - particularly with respect to language assessment - continuing to explore the relatively understudied domain of student representations within a scholarly context. Surveying a population of Australian (N=18) and French students (N=25), this study uses both questionnaire and interview responses in order to analyse the roles allocated to the L1 with respect to learning outcomes. The results indicate that students have a very balanced view of the L1 with respect to the learning of grammar, vocabulary and social aspects, yet its use in assessment aspects appears much more advantageous. The importance of this study and its findings is in recognizing the complex nature of learner representations in order to facilitate a discussion that is based more on the reality of language teaching, with the hope of renewing classroom practices.

Evaluating the role of speech-language pathology with patients with communication disability in the acute hospital setting using the ICF

The practice of speech-language pathology in the acute care hospital setting has changed dramatically over the last 20 years. Speech-language pathologists now routinely assess and manage patients with dysphagia as well as patients with acquired communication disorders. In practice, clinicians have tended to direct their limited resources toward the assessment and management of patients with dysphagia before addressing the needs of patients with acquired communication disorders. This practice has resulted in a decline in speech-language pathology services for patients with communication disorders and has led some clinicians to question the role of the speech-language pathologist in the acute care hospital setting. This article continues this discussion by evaluating the role of the speech-language pathologist in the acute care hospital setting within the context of the World Health Organization's (WHO) International Classification of Functioning, Disability and Health (ICF; WHO, 2001). It argues that by adopting the ICF, speech-language pathologists have a sound rationale for broadening their role to identify the communication needs of all hospital inpatients who experience communication difficulties in the acute care hospital setting.

The performance of South African English first language child speakers on a "low linguistically loaded" central auditory processing test protocol

The lack of standardized tests of central auditory processing disorder (CAPD) in South Africa (SA) led to the formation of a SA CAPD Taskforce, and the interim development of a "low linguistically loaded" CAPD test protocol using test recordings from the 'Tonal and Speech Materials for Auditory Perceptual Assessment Disc 2.0'. This study inferentially compared the performance of 16 SA English first, and 16 SA English second, language adult speakers on this test protocol, and descriptively compared their performances to previously published American normative data. Comparisons between the SA English first and second language speakers showed a poorer right ear performance (p < .05) by the second language speakers on the two-pair dichotic digits test only. Equivalent performances (p < .05) were observed on the left ear performance on the two pair dichotic digits test, and the frequency patterns test, the duration patterns test, the low-pass filtered speech test, the 45% time compressed speech test, the speech masking level difference test, and the consonant vowel consonant (CVC) binaural fusion test. Comparisons between the SA English and the American normative data showed many large differences (up to 37.1% with respect to predicted pass criteria as calculated by mean-2SD cutoffs), with the SA English speakers performing both better and worse depending on the test involved. As a result, the American normative data was not considered appropriate for immediate use as normative data in SA. Instead, the preliminary data provided in this study was recommended as interim normative data for both SA English first and second language adult speakers, until larger scale SA normative data can be obtained.

Dynamic occupational therapy cognitive assessment for children: Perceived utility in Australian occupational therapy practice

Background and Aim: The Dynamic Occupational Therapy Cognitive Assessment for Children (DOTCA-Ch), recently developed in Israel, assesses the cognitive areas: orientation, spatial perception, praxis, visuomotor construction and thinking operations of 6- to 12-year-old children. The dynamic aspect, which incorporates mediation and prompting, has been presented as a valuable clinical feature of this new assessment. This study investigated the cultural suitability, dynamic nature and comprehensiveness of the DOTCA-Ch as a single cognitive assessment for occupational therapy practice in Australia. Methods: Twenty-three paediatric occupational therapists participated in three tutorial and video demonstrations, which were then followed by a group interview. Results and Conclusion: Thematic analysis of transcripts identified four main themes: appropriateness of assessment tasks, language, mediation and clinical utility. Within each theme, the participants raised both positive and negative features. This paper highlights occupational therapists' mixed views on the clinical utility of this assessment in Australia. Limitations of this study and areas for further research are suggested

Using student feedback to construct an assessment rubric for a concept map in physiology

Constructing quality assessment rubrics can be challenging, especially when they are used for integrated, group-centered, applied learning. We describe a collaborative assessment task in which groups of second-year dentistry students developed a complex concept map. In groups of four, the students were given a written, simulated, medical history of a patient and required to construct a concept map illustrating relevant pathophysiological concepts and pharmacological interventions. This report describes a research project aimed at making educational goals of the task more explicit through investigating student and faculty member understandings of the criteria that might be used to assess the concept map. Information was gathered about the perceptions of students in relation to the learning goals associated with the task. These were compared with faculty member perceptions. The findings were used to develop an assessment rubric intended to be more accessible to learners. The new rubric used the language of both faculty members and students to more clearly represent expectations of each criterion and standard. This assessment rubric will be used in 2005 for the next phase of the project.

An Internet-based telerehabilitation system for the assessment of motor speech disorders: A pilot study

Purpose: This pilot study explored the feasibility and effectiveness of an Internet-based telerehabilitation application for the assessment of motor speech disorders in adults with acquired neurological impairment. Method: Using a counterbalanced, repeated measures research design, 2 speech-language pathologists assessed 19 speakers with dysarthria on a battery of perceptual assessments. The assessments included a 19-item version of the Frenchay Dysarthria Assessment (FDA; P. Enderby, 1983), the Assessment of Intelligibility of Dysarthric Speech (K. M. Yorkston & D. R. Beukelman, 1981), perceptual analysis of a speech sample, and an overall rating of severity of the dysarthria. One assessment was conducted in the traditional face-to-face manner, whereas the other assessment was conducted using an online, custom-built telerehabilitation application. This application enabled real-time videoconferencing at 128 kb/s and the transfer of store-and-forward audio and video data between the speaker and speech-language pathologist sites. The assessment methods were compared using the J.M.Bland and D.G.Altman (1986, 1999) limits-of-agreement method and percentage level of agreement between the 2 methods. Results: Measurements of severity of dysarthria, percentage intelligibility in sentences, and most perceptual ratings made in the telerehabilitation environment were found to fall within the clinically acceptable criteria. However, several ratings on the FDA were not comparable between the environments, and explanations for these results were explored. Conclusions: The online assessment of motor speech disorders using an Internet-based telerehabilitation system is feasible. This study suggests that with additional refinement of the technology and assessment protocols, reliable assessment of motor speech disorders over the Internet is possible. Future research methods are outlined.

The effects of assessment type on verbal ratings of conditional stimulus valence and contingency judgments: Implications for the extinction of evaluative learning

Recent research on causal learning found (a) that causal judgments reflect either the current predictive value of a conditional stimulus (CS) or an integration across the experimental contingencies used in the entire experiment and (b) that postexperimental judgments, rather than the CS's current predictive value, are likely to reflect this integration. In the current study, the authors examined whether verbal valence ratings were subject to similar integration. Assessments of stimulus valence and contingencies responded similarly to variations of reporting requirements, contingency reversal, and extinction, reflecting either current or integrated values. However, affective learning required more trials to reflect a contingency change than did contingency judgments. The integration of valence assessments across training and the fact that affective learning is slow to reflect contingency changes can provide an alternative interpretation for researchers' previous failures to find an effect of extinction training on verbal reports of CS valence.