Profiles of language and communication abilities in adolescents with fetal alcohol spectrum disorders.

OBJECTIVE: Language and communication are largely understudied among youth with fetal alcohol spectrum disorders (FASD). Findings have been mixed, and have generally focused on more severely affected (i.e., children with FAS alone) or younger children. This study aimed to elucidate the profiles of language (i.e., receptive, expressive, general language) and communication (i.e., functional, social) abilities in adolescents with FASD. METHOD: Participants aged 12-17 years with (AE = 31) and without (CON = 29) prenatal alcohol exposure were included. Receptive and expressive language were measured by the Clinical Evaluation of Language Fundamentals - Fifth Edition (CELF-5). Parents or caregivers completed the Children's Communication Checklist - Second Edition as a subjective measure of general language skills. Functional communication was measured by the Student Functional Assessment of Verbal Reasoning and Executive Strategies and parents or caregivers completed the Social Skills Improvement System Rating Scales as a measure of social communication. Multivariate analysis of variance determined the overall profiles of language and communication and whether they differed between groups. RESULTS: The AE group performed significantly lower than the CON group on receptive language and parent report of general language while groups did not significantly differ on expressive language. Groups did not significantly differ on functional communication while social communication was significantly lower in the AE group. CONCLUSIONS: Results of this study provide important information regarding the overall profile of basic language abilities and higher-level communication skills of adolescents with FASD. Ultimately, improving communication skills of youth with FASD may translate to better overall functioning.

The effect of time on lexical and syntactic processing in aphasia.

Processing deficits at the lexical level, such as delayed and reduced lexical activation, have been theorized as the source of breakdowns in syntactic operations and thus contribute to sentence comprehension deficits in individuals with aphasia (IWA). In the current study, we investigate the relationship between lexical and syntactic processing in object-relative sentences using eye-tracking while listening in IWA. We explore whether manipulating the time available to process a critical lexical item (the direct-object noun) when it is initially heard in a sentence has an immediate effect on lexical access as well as a downstream effect on syntactic processing. To achieve this aim, we use novel temporal manipulations to provide additional time for lexical processing to occur. In addition to exploring these temporal effects in IWA, we also seek to understand the effect that additional time has on sentence processing in neurotypical age-matched adults (AMC). We predict that the temporal manipulations designed to provide increased processing time for critical lexical items will 1) enhance lexical processing of the target noun, 2) facilitate syntactic integration, and 3) improve sentence comprehension for both IWA and AMC. We demonstrate that strengthening lexical processing via the addition of time can affect lexical processing and facilitate syntactic retrieval of the target noun and lead to enhanced interference resolution in both unimpaired and impaired systems. In aphasia, additional time can mitigate impairments in spreading activation thereby improving lexical access and reducing interference during downstream dependency linking. However, individuals with aphasia may require longer additions of time to fully realize these benefits.

Using lexical semantic cues to mitigate interference effects during real-time sentence processing in aphasia.

We examined the auditory sentence processing of neurologically unimpaired listeners and individuals with aphasia on canonical sentence structures in real-time using a visual-world eye-tracking paradigm. The canonical sentence constructions contained multiple noun phrases and an unaccusative verb, the latter of which formed a long-distance dependency link between the unaccusative verb and its single argument (which was base generated in the object position and then displaced to the subject position). To explore the likelihood of similarity-based interference during the real time linking of the verb and the sentence's subject noun, we manipulated the animacy feature of the noun phrases (matched or mismatched). The study's objectives were to examine whether (a) reducing the similarity-based interference by mismatching animacy features would modulate the encoding and retrieval dynamics of noun phrases in real-time; and (b) whether individuals with aphasia would demonstrate on time sensitivity to this lexical-semantic cue. Results revealed a significant effect of this manipulation in individuals both with and without aphasia. In other words, the mismatch in the representational features of the noun phrases increased the distinctiveness of the unaccusative verb's subject target at the time of syntactic retrieval (verb offset) for individuals in both groups. Moreover, individuals with aphasia were shown to be sensitive to the lexical-semantic cue, even though they appeared to process it slower than unimpaired listeners. This study extends to the cue-based retrieval model by providing new insight on the real-time mechanisms underpinning sentence comprehension.

The Neuroanatomy of Speech Processing: A Large-scale Lesion Study.

The neural basis of language has been studied for centuries, yet the networks critically involved in simply identifying or understanding a spoken word remain elusive. Several functional-anatomical models of critical neural substrates of receptive speech have been proposed, including (1) auditory-related regions in the left mid-posterior superior temporal lobe, (2) motor-related regions in the left frontal lobe (in normal and/or noisy conditions), (3) the left anterior superior temporal lobe, or (4) bilateral mid-posterior superior temporal areas. One difficulty in comparing these models is that they often focus on different aspects of the sound-to-meaning pathway and are supported by different types of stimuli and tasks. Two auditory tasks that are typically used in separate studies-syllable discrimination and word comprehension-often yield different conclusions. We assessed syllable discrimination (words and nonwords) and word comprehension (clear speech and with a noise masker) in 158 individuals with focal brain damage: left (n = 113) or right (n = 19) hemisphere stroke, left (n = 18) or right (n = 8) anterior temporal lobectomy, and 26 neurologically intact controls. Discrimination and comprehension tasks are doubly dissociable both behaviorally and neurologically. In support of a bilateral model, clear speech comprehension was near ceiling in 95% of left stroke cases and right temporal damage impaired syllable discrimination. Lesion-symptom mapping analyses for the syllable discrimination and noisy word comprehension tasks each implicated most of the left superior temporal gyrus. Comprehension but not discrimination tasks also implicated the left posterior middle temporal gyrus, whereas discrimination but not comprehension tasks also implicated more dorsal sensorimotor regions in posterior perisylvian cortex.

The organization of words and environmental sounds in the second year: Behavioral and electrophysiological evidence.

The majority of research examining early auditory-semantic processing and organization is based on studies of meaningful relations between words and referents. However, a thorough investigation into the fundamental relation between acoustic signals and meaning requires an understanding of how meaning is associated with both lexical and non-lexical sounds. Indeed, it is unknown how meaningful auditory information that is not lexical (e.g., environmental sounds) is processed and organized in the young brain. To capture the structure of semantic organization for words and environmental sounds, we record event-related potentials as 20-month-olds view images of common nouns (e.g., dog) while hearing words or environmental sounds that match the picture (e.g., "dog" or barking), that are within-category violations (e.g., "cat" or meowing), or that are between-category violations (e.g., "pen" or scribbling). Results show both words and environmental sounds exhibit larger negative amplitudes to between-category violations relative to matches. Unlike words, which show a greater negative response early and consistently to within-category violations, such an effect for environmental sounds occurs late in semantic processing. Thus, as in adults, the young brain represents semantic relations between words and between environmental sounds, though it more readily differentiates semantically similar words compared to environmental sounds.

The Neurobiology of Agrammatic Sentence Comprehension: A Lesion Study.

Broca's area has long been implicated in sentence comprehension. Damage to this region is thought to be the central source of "agrammatic comprehension" in which performance is substantially worse (and near chance) on sentences with noncanonical word orders compared with canonical word order sentences (in English). This claim is supported by functional neuroimaging studies demonstrating greater activation in Broca's area for noncanonical versus canonical sentences. However, functional neuroimaging studies also have frequently implicated the anterior temporal lobe (ATL) in sentence processing more broadly, and recent lesion-symptom mapping studies have implicated the ATL and mid temporal regions in agrammatic comprehension. This study investigates these seemingly conflicting findings in 66 left-hemisphere patients with chronic focal cerebral damage. Patients completed two sentence comprehension measures, sentence-picture matching and plausibility judgments. Patients with damage including Broca's area (but excluding the temporal lobe; n = 11) on average did not exhibit the expected agrammatic comprehension pattern-for example, their performance was >80% on noncanonical sentences in the sentence-picture matching task. Patients with ATL damage ( n = 18) also did not exhibit an agrammatic comprehension pattern. Across our entire patient sample, the lesions of patients with agrammatic comprehension patterns in either task had maximal overlap in posterior superior temporal and inferior parietal regions. Using voxel-based lesion-symptom mapping, we find that lower performances on canonical and noncanonical sentences in each task are both associated with damage to a large left superior temporal-inferior parietal network including portions of the ATL, but not Broca's area. Notably, however, response bias in plausibility judgments was significantly associated with damage to inferior frontal cortex, including gray and white matter in Broca's area, suggesting that the contribution of Broca's area to sentence comprehension may be related to task-related cognitive demands.

Proform-Antecedent Linking in Individuals with Agrammatic Aphasia: A Test of the Intervener Hypothesis.

PURPOSE: To evaluate processing and comprehension of pronouns and reflexives in individuals with agrammatic (Broca's) aphasia and age-matched control participants. Specifically, we evaluate processing and comprehension patterns in terms of a specific hypothesis -- the Intervener Hypothesis - that posits that the difficulty of individuals with agrammatic (Broca's) aphasia results from similarity-based interference caused by the presence of an intervening NP between two elements of a dependency chain. METHODS: We used an eye tracking-while-listening paradigm to investigate real-time processing (Experiment 1) and a sentence-picture matching task to investigate final interpretive comprehension (Experiment 2) of sentences containing proforms in complement phrase and subject relative constructions. RESULTS: Individuals with agrammatic aphasia demonstrated a greater proportion of gazes to the correct referent of reflexives relative to pronouns and significantly greater comprehension accuracy of reflexives relative to pronouns. CONCLUSIONS: These results provide support for the Intervener Hypothesis, previous support for which comes from studies of Wh- questions and unaccusative verbs, and we argue that this account provides an explanation for the deficits of individuals with agrammatic aphasia across a growing set of sentence constructions. The current study extends this hypothesis beyond filler-gap dependencies to referential dependencies and allows us to refine the hypothesis in terms of the structural constraints that meet the description of the Intervener Hypothesis.

Modulating Complex Sentence Processing in Aphasia Through Attention and Semantic Networks.

PURPOSE: Lexical processing impairments such as delayed and reduced activation of lexical-semantic information have been linked to syntactic processing disruptions and sentence comprehension deficits in individuals with aphasia (IWAs). Lexical-level deficits can also preclude successful lexical encoding during sentence processing and amplify the processing costs of similarity-based interference during syntactic retrieval. We investigate whether two manipulations to engage attention and pre-activate semantic features of a target (to-be-retrieved) noun will (a) boost lexical activation during initial lexical encoding and (b) facilitate syntactic dependency linking through improved resolution of interference in IWAs and neurologically unimpaired age-matched controls (AMCs). METHOD: Eye-tracking-while-listening with a visual world paradigm was used to investigate whether semantic and attentional manipulations modulated initial lexical processing and downstream syntactic retrieval of the direct-object noun in object-relative sentences. RESULTS: In the attention and semantic manipulations, the AMC group showed no changes in initial lexical access levels; however, gaze patterns revealed clear facilitations in dependency linking and interference resolution. In the IWA group, the attentional cue increased and maintained activation of N1 with modest facilitations in dependency linking. In the semantic condition, IWA results showed a greater degree of facilitation during dependency linking. CONCLUSIONS: The results suggest that attention and semantic activation are parameters that may be manipulated to strengthen encoding of lexical representations to facilitate retrieval (i.e., dependency linking) and mitigate similarity-based interference. In IWAs, these manipulations may help to reduce lexical processing deficits that can preclude successful encoding.

Bridging the Divide: Brain and Behavior in Developmental Language Disorder.

Developmental language disorder (DLD) is a heterogenous neurodevelopmental disorder that affects a child's ability to comprehend and/or produce spoken and/or written language, yet it cannot be attributed to hearing loss or overt neurological damage. It is widely believed that some combination of genetic, biological, and environmental factors influences brain and language development in this population, but it has been difficult to bridge theoretical accounts of DLD with neuroimaging findings, due to heterogeneity in language impairment profiles across individuals and inconsistent neuroimaging findings. Therefore, the purpose of this overview is two-fold: (1) to summarize the neuroimaging literature (while drawing on findings from other language-impaired populations, where appropriate); and (2) to briefly review the theoretical accounts of language impairment patterns in DLD, with the goal of bridging the disparate findings. As will be demonstrated with this overview, the current state of the field suggests that children with DLD have atypical brain volume, laterality, and activation/connectivity patterns in key language regions that likely contribute to language difficulties. However, the precise nature of these differences and the underlying neural mechanisms contributing to them remain an open area of investigation.

It's about time! Time as a parameter for lexical and syntactic processing: an eye-tracking-while-listening investigation.

We examined the time-course of lexical activation, deactivation, and the syntactic operation of dependency linking during the online processing of object-relative sentence constructions using eye-tracking-while-listening. We explored how manipulating temporal aspects of the language input affects the tight lexical and syntactic temporal constraints found in sentence processing. The three temporal manipulations were (1) increasing the duration of the direct object noun, (2) adding the disfluency uh after the noun, and (3) replacing the disfluency with a silent pause. The findings from this experiment revealed that the disfluent and silence temporal manipulations enhanced the processing of subject and object noun phrases by modulating activation and deactivation. The manipulations also changed the time-course of dependency linking (increased reactivation of the direct object). The modulated activation dynamics of these lexical items are thought to play a role in mitigating interference and suggest that deactivation plays a beneficial role in complex sentence processing.

Effect of Lexical-Semantic Cues during Real-Time Sentence Processing in Aphasia.

Using a visual world eye-tracking paradigm, we investigated the real-time auditory sentence processing of neurologically unimpaired listeners and individuals with aphasia. We examined whether lexical-semantic cues provided as adjectives of a target noun modulate the encoding and retrieval dynamics of a noun phrase during the processing of complex, non-canonical sentences. We hypothesized that the real-time processing pattern of sentences containing a semantically biased lexical cue (e.g., the venomous snake) would be different than sentences containing unbiased adjectives (e.g., the voracious snake). More specifically, we predicted that the presence of a biased lexical cue would facilitate (1) lexical encoding (i.e., boosted lexical access) of the target noun, snake, and (2) on-time syntactic retrieval or dependency linking (i.e., increasing the probability of on-time lexical retrieval at post-verb gap site) for both groups. For unimpaired listeners, results revealed a difference in the time course of gaze trajectories to the target noun (snake) during lexical encoding and syntactic retrieval in the biased compared to the unbiased condition. In contrast, for the aphasia group, the presence of biased adjectives did not affect the time course of processing the target noun. Yet, at the post-verb gap site, the presence of a semantically biased adjective influenced syntactic re-activation. Our results extend the cue-based parsing model by offering new and valuable insights into the processes underlying sentence comprehension of individuals with aphasia.

Are mirror neurons the basis of speech perception? Evidence from five cases with damage to the purported human mirror system.

The discovery of mirror neurons in macaque has led to a resurrection of motor theories of speech perception. Although the majority of lesion and functional imaging studies have associated perception with the temporal lobes, it has also been proposed that the 'human mirror system', which prominently includes Broca's area, is the neurophysiological substrate of speech perception. Although numerous studies have demonstrated a tight link between sensory and motor speech processes, few have directly assessed the critical prediction of mirror neuron theories of speech perception, namely that damage to the human mirror system should cause severe deficits in speech perception. The present study measured speech perception abilities of patients with lesions involving motor regions in the left posterior frontal lobe and/or inferior parietal lobule (i.e., the proposed human 'mirror system'). Performance was at or near ceiling in patients with fronto-parietal lesions. It is only when the lesion encroaches on auditory regions in the temporal lobe that perceptual deficits are evident. This suggests that 'mirror system' damage does not disrupt speech perception, but rather that auditory systems are the primary substrate for speech perception.

Defining Hypoperfusion in Chronic Aphasia: An Individualized Thresholding Approach.

Within the aphasia literature, it is common to link location of lesioned brain tissue to specific patterns of language impairment. This has provided valuable insight into the relationship between brain structure and function, but it does not capture important underlying alterations in function of regions that remain structurally intact. Research has demonstrated that in the chronic stage of aphasia, variable patterns of reduced cerebral blood flow (CBF; hypoperfusion) in structurally intact regions of the brain contribute to persisting language impairments. However, one consistent issue in this literature is a lack of clear consensus on how to define hypoperfusion, which may lead to over- or underestimation of tissue functionality. In the current study, we conducted an exploratory analysis in six individuals with chronic aphasia (>1 year post-onset) using perfusion imaging to (1) suggest a new, individualized metric for defining hypoperfusion; (2) identify the extent of hypoperfused tissue in perilesional bands; and (3) explore the relationship between hypoperfusion and language impairment. Results indicated that our individualized metric for defining hypoperfusion provided greater precision when identifying functionally impaired tissue and its effects on language function in chronic aphasia. These results have important implications for intervention approaches that target intact (or impaired) brain tissue.

An arterial spin labeling investigation of cerebral blood flow deficits in chronic stroke survivors.

Although the acute stroke literature indicates that cerebral blood flow (CBF) may commonly be disordered in stroke survivors, limited research has investigated whether CBF remains aberrant in the chronic phase of stroke. A directed study of CBF in stroke is needed because reduced CBF (hypoperfusion) may occur in neural regions that appear anatomically intact and may impact cognitive functioning in stroke survivors. Hypoperfusion in neurologically-involved individuals may also affect BOLD signal in FMRI studies, complicating its interpretation with this population. The current study measured CBF in three chronic stroke survivors with ischemic infarcts (greater than 1 year post-stroke) to localize regions of hypoperfusion, and most critically, examine the CBF inflow curve using a methodology that has never, to our knowledge, been reported in the chronic stroke literature. CBF data acquired with a Pulsed Arterial Spin Labeling (PASL) flow-sensitive alternating inversion recovery (FAIR) technique indicated both delayed CBF inflow curve and hypoperfusion in the stroke survivors as compared to younger and elderly control participants. Among the stroke survivors, we observed regional hypoperfusion in apparently anatomically intact neural regions that are involved in cognitive functioning. These results may have profound implications for the study of behavioral deficits in chronic stroke, and particularly for studies using neuroimaging methods that rely on CBF to draw conclusions about underlying neural activity.

Parallelism effects and verb activation: the sustained reactivation hypothesis.

This study investigated the processes underlying parallelism by evaluating the activation of a parallel element (i.e., a verb) throughout and-coordinated sentences. Four points were tested: (1) approximately 1,600 ms after the verb in the first conjunct (PP1), (2) immediately following the conjunction (PP2), (3) approximately 1,100 ms after the conjunction (PP3), (4) at the end of the second conjunct (PP4). The results revealed no activation at PP1, suggesting activation related to the initial presentation had decayed by this point; however, activation was observed at PP2, PP3, and PP4, suggesting the conjunction elicits reactivation that is sustained throughout the second conjunct. These findings support a specific hypothesis about parallelism, the sustained reactivation hypothesis. This hypothesis claims that, in conjoined structures, a cue that is associated with parallelism elicits the reactivation of material from the first conjunct and that this activation is sustained until integration with the second conjunct can be completed.

The time course of priming in aphasia: An exploration of learning along a continuum of linguistic processing demands.

This study investigates learning in aphasia as manifested through automatic priming effects. There is growing evidence that people with aphasia have impairments beyond language processing that could affect their response to treatment. Therefore, better understanding these mechanisms would be beneficial for improving methods of rehabilitation. This study assesses semantic and repetition priming effects at varied interstimulus intervals, using stimuli that are both non-linguistic and linguistic in tasks that range from requiring nearly no linguistic processing to requiring both lexical and semantic processing. Results indicate that people with aphasia maintain typical patterns of learning across both linguistic and non-linguistic tasks as long as the implicit prime-target relationship does not depend on deep levels of linguistic processing. As linguistic processing demands increase, those with agrammatic aphasia may require more time to take advantage of learning through implicit prime-target relationships, and people with both agrammatic and non-agrammatic aphasia are more susceptible to breakdown of the semantic networks as processing demands on that system increase.

Auditory Sentence Processing in Bilinguals: The Role of Cognitive Control.

A number of research studies have shown that the unique need in bilinguals to manage both of their languages positively impacts their cognitive control processes. Yet, due to a dearth of studies at the sentence level, it is still unclear if this benefit extends to sentence processing. In monolinguals and bilinguals, cognitive control helps in reinterpretation of garden path sentences but it is still unknown how it supports the real-time resolution of interference during parsing, such as the type of interference seen in the processing of object relative (OR) sentences. In this study, we compared monolinguals and bilinguals during online spoken OR sentence processing and examined if both groups used cognitive control to resolve interference. In this eye-tracking visual world (ETL-vw) study, OR sentences were aurally presented to 19 monolingual and 21 Spanish-English bilingual adults while gaze patterns were captured throughout the time course of the sentence. Of particular interest was the post-verb position, where the listener connects the verb to its direct object. In OR constructions (e.g., "The man that the boy pushes__ has a red shirt."), the verb ('pushes') links to its syntactically licensed direct object ('the man') at verb offset. During syntactic linking, the parser crosses over an intervening noun phrase (NP, 'the boy') and the two NP activations create interference. The nature of this paradigm allows us to measure interference and its resolution between the intervening NP and the displaced object in real-time. By relating sentence processing patterns with cognitive control measures, high- and no- conflict N-Back tasks, we investigated group differences in the use of cognitive control during sentence processing. Overall, bilinguals showed less interference than monolinguals from the intervening NP during the real time processing of OR sentences. This interference effect and its resolution was significantly predicted by cognitive control skills for bilingual, but not monolingual listeners. This enhanced effect in bilinguals extends previous findings of interference resolution to real time spoken sentence processing suggesting that bilinguals are more efficient than monolinguals at managing interference during complex sentence processing.

There's more to emotion than meets the eye: A processing bias for neutral content in the domain of emotional prosody.

Research on emotion processing in the visual modality suggests a processing advantage for emotionally salient stimuli, even at early sensory stages; however, results concerning the auditory correlates are inconsistent. We present two experiments that employed a gating paradigm to investigate emotional prosody. In Experiment 1, participants heard successively building segments of Jabberwocky "sentences" spoken with happy, angry, or neutral intonation. After each segment, participants indicated the emotion conveyed and rated their confidence in their decision. Participants in Experiment 2 also heard Jabberwocky "sentences" in successive increments, with half discriminating happy from neutral prosody, and half discriminating angry from neutral prosody. Participants in both experiments identified neutral prosody more rapidly and accurately than happy or angry prosody. Confidence ratings were greater for neutral sentences, and error patterns also indicated a bias for recognising neutral prosody. Taken together, results suggest that enhanced processing of emotional content may be constrained by stimulus modality.