Progressive loss of expressive language in a journalist: What news for dementia?

A 77-year-old man with 8 year progressive language deterioration in the face of grossly intact memory was followed. No acute or chronic physiological or psychological event was associated with symptom onset. CT revealed small left basal ganglia infarct. Mild atrophy, no lacunar infarcts, mild diffuse periventricular changes registered on MRI. Gait normal but slow. Speech hesitant and sparse. Affect euthymic; neurobehavioral disturbance absent. MMSE 26/30; clock incorrect, concrete. Neuropsychological testing revealed simple attention intact; complex attention, processing speed impaired. Visuospatial copying and delayed recall of copy average with some perseveration. Apraxia absent. Recall mildly impaired. Mild deficits in planning, organization apparent. Patient severely aphasic, dysarthric without paraphasias. Repetition of automatic speech, recitation moderately impaired; prosody intact. Understanding of written language, nonverbal communication abilities, intact. Frontal release signs developed over last 12 months. Repeated cognitive testing revealed mild deterioration across all domains with significant further decrease in expressive, receptive language. Neurobehavioral changes remain absent to date; he remains interested, engaged and independent in basic ADLs. Speech completely deteriorated; gait and movements appreciably slowed. Although signs of frontal/executive dysfunction present, lack of behavioral abnormalities, psychiatric disturbance, personality change argue against focal or progressive frontal impairment or dementia. Relative intactness of memory and comprehension argue against Alzheimer’s disease. Lack of findings on neuroimaging argue against CVA or tumor. It is possible that the small basal ganglia infarct has resulted in a mild lateral prefrontal syndrome. However, the absence of depression as well as the relatively circumscribed language problem suggests otherwise. The progressive, severe nature of language impairments, with relatively minor impairments in attention and memory, argues for a possible diagnosis of primary progressive aphasia.

Interhemispheric differences of spectral power in expressive language:a MEG study with clinical applications

In the last decade we have seen an exponential growth of functional imaging studies investigating multiple aspects of language processing. These studies have sparked an interest in applying some of the paradigms to various clinically relevant questions, such as the identification of the cortical regions mediating language function in surgical candidates for refractory epilepsy. Here we present data from a group of adult control participants in order to investigate the potential of using frequency specific spectral power changes in MEG activation patterns to establish lateralisation of language function using expressive language tasks. In addition, we report on a paediatric patient whose language function was assessed before and after a left hemisphere amygdalo-hippocampectomy. Our verb generation task produced left hemisphere decreases in beta-band power accompanied by right hemisphere increases in low beta-band power in the majority of the control group, a previously unreported phenomenon. This pattern of spectral power was also found in the patient's post-surgery data, though not her pre-surgery data. Comparison of pre and post-operative results also provided some evidence of reorganisation in language related cortex both inter- and intra-hemispherically following surgery. The differences were not limited to changes in localisation of language specific cortex but also changes in the spectral and temporal profile of frontal brain regions during verb generation. While further investigation is required to establish concordance with invasive measures, our data suggest that the methods described may serve as a reliable lateralisation marker for clinical assessment. Furthermore, our findings highlight the potential utility of MEG for the investigation of cortical language functioning in both healthy development and pathology.

Expressive versus receptive language skills in specific reading disorder

Despite ample research into the language skills of children with specific reading disorder no studies so far have investigated whether there may be a difference between expressive and receptive language skills in this population. Yet, neuro-anatomical models would predict that children who have specific reading disorder which is not associated with movement or attention difficulties, would have lower receptive language skills than expressive. This study investigates the difference between expressive and receptive language skills in a sample of 17 children with specific reading difficulty aged between 7 and 12 years. They were administered a battery of two receptive and two expressive language measures. The results showed that as the neuro-anatomical model would predict, the children scored significantly lower on tests of receptive than on tests of expressive language skills.

Home Literacy Activities in Latino Immigrant Families: Contributions to Toddlers’ Expressive and Receptive Language Skills

The development of language is a critical component of early childhood, enabling children to communicate their wishes and desires, share thoughts, and build meaning through linguistic interactions with others. A wealth of research has highlighted the importance of children’s early home experiences in fostering language development. This literature emphasizes the importance of a stimulating and supportive home environment in which children are engaged in literacy activities such as reading, telling stories, or singing songs with their parents. This study examined the association between low-income Latino immigrant mothers’ and fathers’ home literacy activities and their children’s receptive and expressive language skills. It also examined the moderating influence of maternal (i.e., reading quality and language quality) and child (engagement during reading, interest in literacy activities) characteristics on this association. This study included observational mother-child reading interactions, child expressive and receptive language assessments, and mother- and father-reported survey data. Controlling for parental education, multiple regression analyses revealed a positive association between home literacy activities and children’s receptive and expressive language skills. The findings also revealed that mothers’ reading quality and children’s engagement during reading (for expressive language skills only) moderated this association. Findings from this study will help inform new interventions, programs, and policies that build on Latino families’ strengths.

Late bloomer or language impaired? Screening the speech of a Spanish-English bilingual toddler for early signs of language impairment

This case study presents corpus data gathered from a Spanish-English bilingual child with expressive language delay. Longitudinal data on the child’s linguistic development was collected from the onset of productive speech at age 1;1 until age 4 over the course of 28 video-taped sessions with the child’s principal caregivers. A literature review focused on the relationship between language delay and persisting disorders—including a discussion of the frequent difficulty in distinguishing between the two at early stages of bilingual development—is followed by an analysis of the child’s productive development in 2 distinct phases. An attempt is made to assess the child’s speech at age 4 for preliminary signs of SLI and to consider techniques for identifying ‘at risk’ bilingual children (that is, those with productive language delay, poor oral fluency, and family history of language problems) based on samples of recorded and transcribed speech.

The validation of CID's Grammatical Analysis of Elicited Language with language delayed children

This paper examines the Central Institute for the Deaf’s "Grammatical Analysis of Elicited Language" (GAEL) test of expressive language and whether it identifies children with language disorders. Also examined is the relative difficulty of each of the grammatical categories sampled on the GAEL in relation to the standardization sample.

Autistic symptomatology and language ability in autism spectrum disorder and specific language impairment

Background: Autism spectrum disorders (ASD) and specific language impairment (SLI) are common developmental disorders characterised by deficits in language and communication. The nature of the relationship between them continues to be a matter of debate. This study investigates whether the co-occurrence of ASD and language impairment is associated with differences in severity or pattern of autistic symptomatology or language profile. Methods: Participants (N = 97) were drawn from a total population cohort of 56,946 screened as part of study to ascertain the prevalence of ASD, aged 9 to 14 years. All children received an ICD-10 clinical diagnosis of ASD or No ASD. Children with nonverbal IQ 80 were divided into those with a language impairment (language score of 77 or less) and those without, creating three groups: children with ASD and a language impairment (ALI; N = 41), those with ASD and but no language impairment (ANL; N = 31) and those with language impairment but no ASD (SLI; N = 25). Results: Children with ALI did not show more current autistic symptoms than those with ANL. Children with SLI were well below the threshold for ASD. Their social adaptation was higher than the ASD groups, but still nearly 2 SD below average. In ALI the combination of ASD and language impairment was associated with weaker functional communication and more severe receptive language difficulties than those found in SLI. Receptive and expressive language were equally impaired in ALI, whereas in SLI receptive language was stronger than expressive. Conclusions: Co-occurrence of ASD and language impairment is not associated with increased current autistic symptomatology but appears to be associated with greater impairment in receptive language and functional communication.

Adaptação transcultural do Preschool Language Assessment Instrument (PLAI-2) em falantes do português brasileiro com desenvolvimento típico de linguagem

Pós-graduação em Fonoaudiologia - FFC

Preschool Language Assessment Instrument, second edition, in Brazilian Portuguese-speaking children

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Neural basis of an inherited speech and language disorder

Investigation of the three-generation KE family, half of whose members are affected by a pronounced verbal dyspraxia, has led to identification of their core deficit as one involving sequential articulation and orofacial praxis. A positron emission tomography activation study revealed functional abnormalities in both cortical and subcortical motor-related areas of the frontal lobe, while quantitative analyses of magnetic resonance imaging scans revealed structural abnormalities in several of these same areas, particularly the caudate nucleus, which was found to be abnormally small bilaterally. A recent linkage study [Fisher, S., Vargha-Khadem, F., Watkins, K. E., Monaco, A. P. & Pembry, M. E. (1998) Nat. Genet. 18, 168–170] localized the abnormal gene (SPCH1) to a 5.6-centiMorgan interval in the chromosomal band 7q31. The genetic mutation or deletion in this region has resulted in the abnormal development of several brain areas that appear to be critical for both orofacial movements and sequential articulation, leading to marked disruption of speech and expressive language.

A Theorical Point of View of Reality, Perception, and Language

It is possible to view the relations between mathematics and natural language from different aspects. This relation between mathematics and language is not based on just one aspect. In this article, the authors address the role of the Subject facing Reality through language. Perception is defined and a mathematical theory of the perceptual field is proposed. The distinction between purely expressive language and purely informative language is considered false, because the subject is expressed in the communication of a message, and conversely, in purely expressive language, as in an exclamation, there is some information. To study the relation between language and reality, the function of ostensibility is defined and propositions are divided into ostensives and estimatives.

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

Language against the odds, or rather not:the weak central coherence hypothesis and language

EV is a child with a talent for learning language combined with Asperger syndrome. EV’s talent is evident in the unusual circumstances of her acquisition of both her first (Bulgarian) and second (German) languages and the unique patterns of both receptive and expressive language (in both the L1 and L2), in which she shows subtle dissociations in competence and performance consistent with an uneven cognitive profile of skills and abilities. We argue that this case provides support for theories of language learning and usage that require more general underlying cognitive mechanisms and skills. One such account, the Weak Central Coherence (WCC) hypothesis of autism, provides a plausible framework for the interpretation of the simultaneous co-occurrence of EV’s particular pattern of cognitive strengths and weaknesses. Furthermore, we show that specific features of the uneven cognitive profile of Asperger syndrome can help explain the observed language talent displayed by EV. Thus, rather than demonstrating a case where language learning takes place despite the presence of deficits, EV’s case illustrates how a pattern of strengths within this profile can specifically promote language learning.

An examination of the effects of a summer book-reading program on the language and early literacy outcomes of toddlers from high risk environments

The current study examined the impact of an early summer literacy program and the mediating effects of the home literacy environment on the language and literacy outcomes of a group of children at-risk for long-term developmental and academic delays. Participating children (n=54) were exposed to an intensive book-reading intervention each summer (June through mid August) over a 3-year period. The current study implemented an ex post facto, quasi-experimental design. This nonequivalent group design involved a pretest and posttest over three time points for a non-randomized treatment group and a matched non-treatment comparison group. Results indicated that literacy scores did improve for the children over the 3-year period; however, language scores did not experience the same rate of change over time. Receptive language was significantly impacted by attendance, and race/ethnicity. Expressive language was impacted significantly by gestational age and attendance. Results also indicated that language outcomes for young children who are exposed to a literacy program were higher than those who did not participate; however, only receptive language yielded significance at the p<.05 level. These study results also found that activities in the home that support literacy and learning do indeed impact language and literacy outcomes for these children, specifically, the age at which a child is read to, the number of books in the home, a child’s enjoyment of reading, and whether a child looks at books on his or her own impact language scores. This study concluded that at-risk young children do benefit from center-based literacy intervention. This literacy experience, however, is also driven by the children's home environment, their attendance to the program, whether they were premature or not and the type of caregiver.

Investigating relative clauses in children with specific language impairment

Background: It is well documented that children with Specific Language Impairment (SLI) experience significant grammatical deficits. While much of the focus in the past has been on their morphosyntactic difficulties, less is known about their acquisition of complex syntactic structures such as relative clauses. The role of memory in language performance has also become increasingly prominent in the literature. Aims: This study aims to investigate the control of an important complex syntactic structure, the relative clause, by school age children with SLI in Ireland, using a newly devised sentence recall task. It also aims to explore the role of verbal and short-termworking memory in the performance of children with SLI on the sentence recall task, using a standardized battery of tests based on Baddeley’s model of working memory. Methods and Procedures: Thirty two children with SLI, thirty two age matched typically developing children (AM-TD) between the ages of 6 and 7,11 years and twenty younger typically developing (YTD) children between 4,7 and 5 years, completed the task. The sentence recall (SR) task included 52 complex sentences and 17 fillers. It included relative clauses that are used in natural discourse and that reflect a developmental hierarchy. The relative clauses were also controlled for length and varied in syntactic complexity, representing the full range of syntactic roles. There were seven different relative clause types attached to either the predicate nominal of a copular clause (Pn), or to the direct object of a transitive clause (Do). Responses were recorded, transcribed and entered into a database for analysis. TheWorkingMemory Test Battery for children (WMTB-C—Pickering & Gathercole, 2001) was administered in order to explore the role of short-term memory and working memory on the children’s performance on the SR task. Outcomes and Results: The children with SLI showed significantly greater difficulty than the AM-TD group and the YTD group. With the exception of the genitive subject clauses, the children with SLI scored significantly higher on all sentences containing a Pn main clause than those containing a transitive main clause. Analysis of error types revealed the frequent production of a different type of relative clause than that presented in the task—with a strong word order preference in the NVN direction indicated for the children with SLI. The SR performance for the children with SLI was most highly correlated with expressive language skills and digit recall. Conclusions and Implications: Children with SLI have significantly greater difficulty with relative clauses than YTD children who are on average two years younger—relative clauses are a delay within a delay. Unlike the YTD children they show a tendency to simplify relative clauses in the noun verb noun (NVN) direction. They show a developmental hierarchy in their production of relative clause constructions and are highly influenced by the frequency distribution of the relative clauses in the ambient language.