Profiling text comprehension impairments in aphasia

Background: Research in aphasia has focused on acquired dyslexias at the single word level, with a paucity of assessment techniques and rehabilitation approaches for individuals with difficulty at the text level. A rich literature from research with paediatric populations and healthy non-brain damaged, skilled adult readers allows the component processes that are important for text reading to be defined and more appropriate assessments to be devised. Aims: To assess the component processes of text reading in a small group of individuals with aphasia who report difficulties reading at the text level. Do assessments of component processes in reading comprehension reveal distinct profiles of text comprehension? To what extent are text comprehension difficulties caused by underlying linguistic and/or cognitive deficits? Methods & Procedures: Four individuals with mild aphasia who reported difficulties reading at the text level took part in a case-series study. Published assessments were used to confirm the presence of text comprehension impairment. Participants completed a range of assessments to provide a profile of their linguistic and cognitive skills, focusing on processes known to be important for text comprehension. We identified the following areas for assessment: reading speed, language skills (single word and sentence), inferencing, working memory and metacognitive skills (monitoring and strategy use). Outcomes & Results: Performance was compared against age-matched adult control data. One participant presented with a trend for impaired abilities in inferencing, with all other assessed skills being within normal limits. The other three had identified linguistic and working memory difficulties. One presented with a residual deficit in accessing single word meaning that affected text comprehension. The other two showed no clear link between sentence processing difficulties and text comprehension impairments. Across these three, data suggested a link between verbal working memory capacity and specific inferencing skills. Conclusions: Successful text reading relies on a number of component processes. In this paper we have made a start in defining those component processes and devising tasks suitable to assess them. From our results, assessment of verbal working memory and inferencing appears to be critical for understanding text comprehension impairments in aphasia. It is possible that rehabilitation input can capitalize on key meta-cognitive skills (monitoring, strategy use) to support functional reading in the face of existing linguistic, text comprehension and memory impairments.

Metacognition and proofreading: the roles of aging, motivation, and interest

Objectives: The current study examined younger and older adults’ error detection accuracy, prediction calibration, and postdiction calibration on a proofreading task, to determine if age-related difference would be present in this type of common error detection task. Method: Participants were given text passages, and were first asked to predict the percentage of errors they would detect in the passage. They then read the passage and circled errors (which varied in complexity and locality), and made postdictions regarding their performance, before repeating this with another passage and answering a comprehension test of both passages. Results: There were no age-related differences in error detection accuracy, text comprehension, or metacognitive calibration, though participants in both age groups were overconfident overall in their metacognitive judgments. Both groups gave similar ratings of motivation to complete the task. The older adults rated the passages as more interesting than younger adults did, although this level of interest did not appear to influence error-detection performance. Discussion: The age equivalence in both proofreading ability and calibration suggests that the ability to proofread text passages and the associated metacognitive monitoring used in judging one’s own performance are maintained in aging. These age-related similarities persisted when younger adults completed the proofreading tasks on a computer screen, rather than with paper and pencil. The findings provide novel insights regarding the influence that cognitive aging may have on metacognitive accuracy and text processing in an everyday task.

Strategy clusters and sources of knowledge in French L2 listening comprehension

This article reports on an exploratory investigation into the listening strategies of lower-intermediate learners of French as an L2, including the sources of knowledge they employed in order to comprehend spoken French. Data from 14 learners were analysed to investigate whether employment of strategies in general and sources of knowledge in particular varied according to the underlying linguistic knowledge of the student. While low linguistic knowledge learners were less likely to deploy effectively certain strategies or strategy clusters, high linguistic knowledge levels were not always associated with effective strategy use. Similarly, while there was an association between linguistic knowledge and learners’ ability to draw on more than one source of knowledge in a facilitative manner, there was also evidence that learners tended to over-rely on linguistic knowledge where other sources, such as world knowledge, would have proved facilitative. We conclude by arguing for a fresh approach to listening pedagogy and research, including strategy instruction, bottom-up skill development and a consideration of the role of linguistic knowledge in strategy use.

Comprehension of wh-questions in a case of mixed dementia

We investigated processing of wh-questions and declarative sentences with differing syntactic complexity in a case of mixed dementia (FA). FA was impaired in her ability to understand syntactically complex declarative sentences and syntactically complex wh-questions beginning with which but not complex who questions. This profile, novel in dementia, is similar to that reported for people with agrammatic aphasia and discerns a ‘‘fault line’’ of the language system along a syntactic/semantic parameter

Comprehension of reflexives and pronouns in sequential bilingual children: do they pattern similarly to L1 children, L2 adults, or children with specific language impairment?

This paper investigates how sequential bilingual (L2) Turkish-English children comprehend English reflexives and pronouns and tests whether they pattern similarly to monolingual (L1) children, L2 adults, or children with Specific Language Impairment (SLI). Thirty nine 6- to 9-year-old L2 children with an age of onset of 30-48 months and exposure to English of 30-72 months and 33 L1 age-matched control children completed the Advanced Syntactic Test of Pronominal Reference-Revised (van der Lely, 1997). The L2 children’s performance was compared to L2 adults from Demirci (2001) and children with SLI from van der Lely & Stollwerck (1997). The L2 children’s performance in the comprehension of reflexives was almost identical to their age-matched controls, and differed from L2 adults and children with SLI. In the comprehension of pronouns, L2 children showed an asymmetry between referential and quantificational NPs, a pattern attested in younger L1 children and children with SLI. Our study provides evidence that the development of comprehension of reflexives and pronouns in these children resembles monolingual L1 acquisition and not adult L2 acquisition or acquisition of children with SLI.

Research review: reading comprehension in developmental disorders of language and communication

Background: Deficits in reading airment (SLI), Down syndrome (DS) and autism spectrum disorders (ASD). Methods: In this review (based on a search of the ISI Web of Knowledge database to 2011), the Simple View of Reading is used as a framework for considering reading comprehension in these groups. Conclusions: There is substantial evidence for reading comprehension impairments in SLI and growing evidence that weaknesses in this domain are common in DS and ASD. Further, in these groups reading comprehension is typically more impaired than word recognition. However, there is also evidence that some children and adolescents with DS, ASD and a history of SLI develop reading comprehension and word recognition skills at or above the age appropriate level. This review of the literature indicates that factors including word recognition, oral language, nonverbal ability and working memory may explain reading comprehension difficulties in SLI, DS and ASD. In addition, it highlights methodological issues, implications of poor reading comprehension and fruitful areas for future research.

Reading comprehension in autism spectrum disorders: The role of oral language and social functioning

Reading comprehension is an area of difficulty for many individuals with autism spectrum disorders (ASD). According to the Simple View of Reading, word recognition and oral language are both important determinants of reading comprehension ability. We provide a novel test of this model in 100 adolescents with ASD of varying intellectual ability. Further, we explore whether reading comprehension is additionally influenced by individual differences in social behaviour and social cognition in ASD. Adolescents with ASD aged 14-16 years completed assessments indexing word recognition, oral language, reading comprehension, social behaviour and social cognition. Regression analyses show that both word recognition and oral language explain unique variance in reading comprehension. Further, measures of social behaviour and social cognition predict reading comprehension after controlling for the variance explained by word recognition and oral language. This indicates that word recognition, oral language and social impairments may constrain reading comprehension in ASD.

Revealing and quantifying the impaired phonological analysis underpinning impaired comprehension in Wernicke’s aphasia

Wernicke’s aphasia is a condition which results in severely disrupted language comprehension following a lesion to the left temporo-parietal region. A phonological analysis deficit has traditionally been held to be at the root of the comprehension impairment in WA, a view consistent with current functional neuroimaging which finds areas in the superior temporal cortex responsive to phonological stimuli. However behavioural evidence to support the link between a phonological analysis deficit and auditory comprehension has not been yet shown. This study extends seminal work by Blumstein et al. (1977) to investigate the relationship between acoustic-phonological perception, measured through phonological discrimination, and auditory comprehension in a case series of Wernicke’s aphasia participants. A novel adaptive phonological discrimination task was used to obtain reliable thresholds of the phonological perceptual distance required between nonwords before they could be discriminated. Wernicke’s aphasia participants showed significantly elevated thresholds compared to age and hearing matched control participants. Acoustic-phonological thresholds correlated strongly with auditory comprehension abilities in Wernicke’s aphasia. In contrast, nonverbal semantic skills showed no relationship with auditory comprehension. The results are evaluated in the context of recent neurobiological models of language and suggest that impaired acoustic-phonological perception underlies the comprehension impairment in Wernicke’s aphasia and favour models of language which propose a leftward asymmetry in phonological analysis.

Variable binding and coreference in sentence comprehension: evidence from eye movements

The hypothesis that pronouns can be resolved via either the syntax or the discourse representation has played an important role in linguistic accounts of pronoun interpretation (e.g. Grodzinsky & Reinhart, 1993). We report the results of an eye-movement monitoring study investigating the relative timing of syntactically-mediated variable binding and discourse-based coreference assignment during pronoun resolution. We examined whether ambiguous pronouns are preferentially resolved via either the variable binding or coreference route, and in particular tested the hypothesis that variable binding should always be computed before coreference assignment. Participants’ eye movements were monitored while they read sentences containing a pronoun and two potential antecedents, a c-commanding quantified noun phrase and a non c-commanding proper name. Gender congruence between the pronoun and either of the two potential antecedents was manipulated as an experimental diagnostic for dependency formation. In two experiments, we found that participants’ reading times were reliably longer when the linearly closest antecedent mismatched in gender with the pronoun. These findings fail to support the hypothesis that variable binding is computed before coreference assignment, and instead suggest that antecedent recency plays an important role in affecting the extent to which a variable binding antecedent is considered. We discuss these results in relation to models of memory retrieval during sentence comprehension, and interpret the antecedent recency preference as an example of forgetting over time.

Production and on-line comprehension of definite articles and clitic pronouns by Greek sequential bilingual children and monolingual children with specific language impairment

The present study compared production and on-line comprehension of definite articles and third person direct object clitic pronouns in Greek-speaking typically developing, sequential bilingual (L2-TD) children and monolingual children with specific language impairment (L1-SLI). Twenty Turkish Greek L2-TD children, 16 Greek L1-SLI children, and 31 L1-TD Greek children participated in a production task examining definite articles and clitic pronouns and, in an on-line comprehension task, involving grammatical sentences with definite articles and clitics and sentences with grammatical violations induced by omitted articles and clitics. The results showed that the L2-TD children were sensitive to the grammatical violations despite low production. In contrast, the children with SLI were not sensitive to clitic omission in the on-line task, despite high production. These results support a dissociation between production and on-line comprehension in L2 children and for impaired grammatical representations and lack of automaticity in children with SLI. They also suggest that on-line comprehension tasks may complement production tasks by differentiating between the language profiles of L2-TD children and children with SLI.

The anterior temporal lobes support residual comprehension in Wernicke’s aphasia

Wernicke’s aphasia occurs following a stroke to classical language comprehension regions in the left temporoparietal cortex. Consequently, auditory-verbal comprehension is significantly impaired in Wernicke’s aphasia but the capacity to comprehend visually presented materials (written words and pictures) is partially spared. This study used fMRI to investigate the neural basis of written word and picture semantic processing in Wernicke’s aphasia, with the wider aim of examining how the semantic system is altered following damage to the classical comprehension regions. Twelve participants with Wernicke’s aphasia and twelve control participants performed semantic animate-inanimate judgements and a visual height judgement baseline task. Whole brain and ROI analysis in Wernicke’s aphasia and control participants found that semantic judgements were underpinned by activation in the ventral and anterior temporal lobes bilaterally. The Wernicke’s aphasia group displayed an “over-activation” in comparison to control participants, indicating that anterior temporal lobe regions become increasingly influential following reduction in posterior semantic resources. Semantic processing of written words in Wernicke’s aphasia was additionally supported by recruitment of the right anterior superior temporal lobe, a region previously associated with recovery from auditory-verbal comprehension impairments. Overall, the results concord with models which indicate that the anterior temporal lobes are crucial for multimodal semantic processing and that these regions may be accessed without support from classic posterior comprehension regions.

Mismatch Negativity (MMN) reveals inefficient auditory ventral stream function in chronic auditory comprehension impairments

Background: Auditory discrimination is significantly impaired in Wernicke’s aphasia (WA) and thought to be causatively related to the language comprehension impairment which characterises the condition. This study used mismatch negativity (MMN) to investigate the neural responses corresponding to successful and impaired auditory discrimination in WA. Methods: Behavioural auditory discrimination thresholds of CVC syllables and pure tones were measured in WA (n=7) and control (n=7) participants. Threshold results were used to develop multiple-deviant mismatch negativity (MMN) oddball paradigms containing deviants which were either perceptibly or non-perceptibly different from the standard stimuli. MMN analysis investigated differences associated with group, condition and perceptibility as well as the relationship between MMN responses and comprehension (within which behavioural auditory discrimination profiles were examined). Results: MMN waveforms were observable to both perceptible and non-perceptible auditory changes. Perceptibility was only distinguished by MMN amplitude in the PT condition. The WA group could be distinguished from controls by an increase in MMN response latency to CVC stimuli change. Correlation analyses displayed relationship between behavioural CVC discrimination and MMN amplitude in the control group, where greater amplitude corresponded to better discrimination. The WA group displayed the inverse effect; both discrimination accuracy and auditory comprehension scores were reduced with increased MMN amplitude. In the WA group, a further correlation was observed between the lateralisation of MMN response and CVC discrimination accuracy; the greater the bilateral involvement the better the discrimination accuracy. Conclusions: The results from this study provide further evidence for the nature of auditory comprehension impairment in WA and indicate that the auditory discrimination deficit is grounded in a reduced ability to engage in efficient hierarchical processing and the construction of invariant auditory objects. Correlation results suggest that people with chronic WA may rely on an inefficient, noisy right hemisphere auditory stream when attempting to process speech stimuli.

Is children's reading “good enough”? Links between online processing and comprehension as children read syntactically ambiguous sentences

We monitored 8- and 10-year-old children’s eye movements as they read sentences containing a temporary syntactic ambiguity to obtain a detailed record of their online processing. Children showed the classic garden-path effect in online processing. Their reading was disrupted following disambiguation, relative to control sentences containing a comma to block the ambiguity, although the disruption occurred somewhat later than would be expected for mature readers. We also asked children questions to probe their comprehension of the syntactic ambiguity offline. They made more errors following ambiguous sentences than following control sentences, demonstrating that the initial incorrect parse of the garden-path sentence influenced offline comprehension. These findings are consistent with “good enough” processing effects seen in adults. While faster reading times and more regressions were generally associated with better comprehension, spending longer reading the question predicted comprehension success specifically in the ambiguous condition. This suggests that reading the question prompted children to reconstruct the sentence and engage in some form of processing, which in turn increased the likelihood of comprehension success. Older children were more sensitive to the syntactic function of commas, and, overall, they were faster and more accurate than younger children.