The Multilingual Naming Test (MINT) as a Measure of Picture Naming Ability in Alzheimer's Disease.

OBJECTIVE: The present study investigated the ability of the Multilingual Naming Test (MINT), a picture naming test recently added to the National Alzheimer's Coordinating Center's (NACC) Uniform Data Set neuropsychological test battery, to detect naming impairment (i.e., dysnomia) across stages of Alzheimer's disease (AD). METHOD: Data from the initial administration of the MINT were obtained on NACC participants who were cognitively normal (N = 3,981) or diagnosed with mild cognitive impairment (N = 852) or dementia (N = 1,148) with presumed etiology of AD. Dementia severity was rated using the Clinical Dementia Rating (CDR) scale. RESULTS: Cross-sectional multiple regression analyses revealed significant effects of diagnostic group, sex, education, age, and race on naming scores. Planned comparisons collapsing across age and education groups revealed significant group differences in naming scores across levels of dementia severity. ROC curve analyses showed good diagnostic accuracy of MINT scores for distinguishing cognitively normal controls from AD dementia, but not from MCI. Within the cognitively normal group, there was a robust interaction between age and education such that naming scores exhibited the most precipitous drop across age groups for the least educated participants. Additionally, education effects were stronger in African-Americans than in Whites (a race-by-education interaction), and race effects were stronger in older than in younger age groups (a race-by-age interaction). CONCLUSIONS: The MINT successfully detects naming deficits at different levels of cognitive impairment in patients with MCI or AD dementia, but comparison to age, sex, race, and education-corrected norms to determine impairment is essential.

Sentence Recall by Children With SLI Across Two Nonmainstream Dialects of English.

PURPOSE: The inability to accurately recall sentences has proven to be a clinical marker of specific language impairment (SLI); this task yields moderate-to-high levels of sensitivity and specificity. However, it is not yet known if these results hold for speakers of dialects whose nonmainstream grammatical productions overlap with those that are produced at high rates by children with SLI. METHOD: Using matched groups of 70 African American English speakers and 36 Southern White English speakers and dialect-strategic scoring, we examined children's sentence recall abilities as a function of their dialect and clinical status (SLI vs. typically developing [TD]). RESULTS: For both dialects, the SLI group earned lower sentence recall scores than the TD group with sensitivity and specificity values ranging from .80 to .94, depending on the analysis. Children with SLI, as compared with TD controls, manifested lower levels of verbatim recall, more ungrammatical recalls when the recall was not exact, and higher levels of error on targeted functional categories, especially those marking tense. CONCLUSION: When matched groups are examined and dialect-strategic scoring is used, sentence recall yields moderate-to-high levels of diagnostic accuracy to identify SLI within speakers of nonmainstream dialects of English.

The Effects of Visual Stimuli on the Spoken Narrative Performance of School-Age African American Children.

PURPOSE: This study investigated the fictional narrative performance of school-age African American children across 3 elicitation contexts that differed in the type of visual stimulus presented. METHOD: A total of 54 children in Grades 2 through 5 produced narratives across 3 different visual conditions: no visual, picture sequence, and single picture. Narratives were examined for visual condition differences in expressive elaboration rate, number of different word roots (NDW) rate, mean length of utterance in words, and dialect density. The relationship between diagnostic risk for language impairment and narrative variables was explored. RESULTS: Expressive elaboration rate and mean length of utterance in words were higher in the no-visual condition than in either the picture-sequence or the single-picture conditions. NDW rate was higher in the no-visual and picture-sequence conditions than in the single-picture condition. Dialect density performance across visual context depended on the child's grade, so that younger children produced a higher rate of African American English in the no-visual condition than did older children. Diagnostic risk was related to NDW rate and dialect density measure. CONCLUSION: The results suggest the need for narrative elicitation contexts that include verbal as well as visual tasks to fully describe the narrative performance of school-age African American children with typical development.

Neuropsychological Language Tests in Dementia Diagnosis in English-Speaking Hispanic and Non-Hispanic White Outpatients.

Neuropsychological language tests have limitations (e.g., unrepresentative norms) when applied to "Hispanics" and clinicians are likely aware that these tests may lead to inaccurate dementia diagnoses. Therefore, it was hypothesized that language tests would be weaker diagnostic predictors in Hispanics versus "Non-Hispanic Whites." Participants included 436 English-speaking Hispanic and 436 Non-Hispanic White (randomly selected from 10,937) outpatients classified as having dementia or normal cognition at initial evaluation. When covarying for age, sex, education, and functional abilities, vegetable fluency significantly predicted diagnosis among Non-Hispanic Whites (odds ratio = 0.80, 95% confidence interval [0.69, 0.94], p < .01). Animal fluency and an abbreviated (30-item) Boston Naming Test (BNT) comparably predicted diagnosis across groups. Results remained similar when covarying for primary language among Hispanics. Findings suggest that vegetable fluency, but not animal fluency, was relatively unimportant in diagnosis for the English-speaking Hispanics in this study possibly because of cultural influences on the familiarity, salience, and relevance of this category's items. Additionally, clinicians may have informally adjusted Hispanics' 30-item BNT and animal fluency scores and discounted vegetable fluency to account for their limitations. Animal fluency and BNT may be preferable language tests when assessing dementia in English across groups, as they comparably predicted diagnosis in both groups.

Common variation near ROBO2 is associated with expressive vocabulary in infancy.

Twin studies suggest that expressive vocabulary at ~24 months is modestly heritable. However, the genes influencing this early linguistic phenotype are unknown. Here we conduct a genome-wide screen and follow-up study of expressive vocabulary in toddlers of European descent from up to four studies of the EArly Genetics and Lifecourse Epidemiology consortium, analysing an early (15-18 months, 'one-word stage', N(Total) = 8,889) and a later (24-30 months, 'two-word stage', N(Total)=10,819) phase of language acquisition. For the early phase, one single-nucleotide polymorphism (rs7642482) at 3p12.3 near ROBO2, encoding a conserved axon-binding receptor, reaches the genome-wide significance level (P=1.3 × 10(-8)) in the combined sample. This association links language-related common genetic variation in the general population to a potential autism susceptibility locus and a linkage region for dyslexia, speech-sound disorder and reading. The contribution of common genetic influences is, although modest, supported by genome-wide complex trait analysis (meta-GCTA h(2)(15-18-months) = 0.13, meta-GCTA h(2)(24-30-months) = 0.14) and in concordance with additional twin analysis (5,733 pairs of European descent, h(2)(24-months) = 0.20).

Resourcing speech-language pathologists to work with multilingual children.

Speech-language pathologists play important roles in supporting people to be competent communicators in the languages of their communities. However, with over 7000 languages spoken throughout the world and the majority of the global population being multilingual, there is often a mismatch between the languages spoken by children and families and their speech-language pathologists. This paper provides insights into service provision for multilingual children within an English-dominant country by viewing Australia's multilingual population as a microcosm of ethnolinguistic minorities. Recent population studies of Australian pre-school children show that their most common languages other than English are: Arabic, Cantonese, Vietnamese, Italian, Mandarin, Spanish, and Greek. Although 20.2% of services by Speech Pathology Australia members are offered in languages other than English, there is a mismatch between the language of the services and the languages of children within similar geographical communities. Australian speech-language pathologists typically use informal or English-based assessments and intervention tools with multilingual children. Thus, there is a need for accessible culturally and linguistically appropriate resources for working with multilingual children. Recent international collaborations have resulted in practical strategies to support speech-language pathologists during assessment, intervention, and collaboration with families, communities, and other professionals. The International Expert Panel on Multilingual Children's Speech was assembled to prepare a position paper to address issues faced by speech-language pathologists when working with multilingual populations. The Multilingual Children's Speech website ( http://www.csu.edu.au/research/multilingual-speech ) addresses one of the aims of the position paper by providing free resources and information for speech-language pathologists about more than 45 languages. These international collaborations have been framed around the World Health Organization's International Classification of Functioning, Disability and Health (ICF-CY) and have been established with the goal of supporting multilingual children to participate in society.

The relationship between mathematics and language: academic implications for children with specific language impairment and English language learners.

PURPOSE: The present study examined the relationship between mathematics and language to better understand the nature of the deficit and the academic implications associated with specific language impairment (SLI) and academic implications for English language learners (ELLs). METHOD: School-age children (N = 61; 20 SLI, 20 ELL, 21 native monolingual English [NE]) were assessed using a norm-referenced mathematics instrument and 3 experimental computer-based mathematics games that varied in language demands. Group means were compared with analyses of variance. RESULTS: The ELL group was less accurate than the NE group only when tasks were language heavy. In contrast, the group with SLI was less accurate than the groups with NE and ELLs on language-heavy tasks and some language-light tasks. Specifically, the group with SLI was less accurate on tasks that involved comparing numerical symbols and using visual working memory for patterns. However, there were no group differences between children with SLI and peers without SLI on language-light mathematics tasks that involved visual working memory for numerical symbols. CONCLUSION: Mathematical difficulties of children who are ELLs appear to be related to the language demands of mathematics tasks. In contrast, children with SLI appear to have difficulty with mathematics tasks because of linguistic as well as nonlinguistic processing constraints.

Literacy skills of Australian Indigenous school children with and without otitis media and hearing loss.

This study examined the relationship between reading, spelling, and the presence of otitis media (OM) and co-occurring hearing loss (HL) in metropolitan Indigenous Australian children, and compared their reading and spelling outcomes with those of their non-Indigenous peers. OM and HL may hinder language development and phonological awareness skills, but there is little empirical evidence to link OM/HL and literacy in this population. Eighty-six Indigenous and non-Indigenous children attending pre-primary, year one and year two at primary schools in the Perth metropolitan area participated in the study. The ear health of the participants was screened by Telethon Speech and Hearing Centre EarBus in 2011/2012. Participants' reading and spelling skills were tested with culturally modified sub-tests of the Queensland University Inventory of Literacy. Of the 46 Indigenous children, 18 presented with at least one episode of OM and one episode of HL. Results indicated that Indigenous participants had significantly poorer non-word and real word reading and spelling skills than their non-Indigenous peers. There was no significant difference between the groups of Indigenous participants with OM and HL and those with normal ear health on either measure. This research provides evidence to suggest that Indigenous children have ongoing literacy development difficulties and discusses the possibility of OM as one of many impacting factors.

The cultural appropriateness and diagnostic usefulness of standardized language assessments for Indigenous Australian children.

Speech-language pathologists experience uncertainty about how to interpret standardized assessment results for Indigenous Australian children. There are risks for inappropriate diagnosis: both over- and under-diagnosis of language impairment may occur due to a convergence of linguistic features which causes difficulty in distinguishing between impairment and difference. While the literature suggests that standardized assessments are inappropriate for Indigenous Australian children, there is an absence of empirical documentation to show how Indigenous children perform on standardized tests of language ability. This study examined the performance of 19 Indigenous Australian children, aged 8;01-13;08, from one school on the Clinical Evaluation of Language Fundamentals, Fourth Edition, Australian Standardized Edition. Standardized scores were compared with teacher ratings of children's oral language skills. Analysis showed poor alignment between teacher ratings and language assessment, and assessment scores were negatively influenced by features of Aboriginal English. Children rated with above average language skills presented with different linguistic profiles from the children rated with average and below average language abilities. The inappropriateness of current standardized language assessments for Indigenous children and the need for further research to guide appropriate assessment are discussed.

Speech-language pathologists' assessment and intervention practices with multilingual children.

Within predominantly English-speaking countries such as the US, UK, Canada, New Zealand, and Australia, there are a significant number of people who speak languages other than English. This study aimed to examine Australian speech-language pathologists' (SLPs) perspectives and experiences of multilingualism, including their assessment and intervention practices, and service delivery methods when working with children who speak languages other than English. A questionnaire was completed by 128 SLPs who attended an SLP seminar about cultural and linguistic diversity. Approximately one half of the SLPs (48.4%) reported that they had at least minimal competence in a language(s) other than English; but only 12 (9.4%) reported that they were proficient in another language. The SLPs spoke a total of 28 languages other than English, the most common being French, Italian, German, Spanish, Mandarin, and Auslan (Australian sign language). Participants reported that they had, in the past 12 months, worked with a mean of 59.2 (range 1-100) children from multilingual backgrounds. These children were reported to speak between two and five languages each; the most common being: Vietnamese, Arabic, Cantonese, Mandarin, Australian Indigenous languages, Tagalog, Greek, and other Chinese languages. There was limited overlap between the languages spoken by the SLPs and the children on the SLPs' caseloads. Many of the SLPs assessed children's speech (50.5%) and/or language (34.2%) without assistance from others (including interpreters). English was the primary language used during assessments and intervention. The majority of SLPs always used informal speech (76.7%) and language (78.2%) assessments and, if standardized tests were used, typically they were in English. The SLPs sought additional information about the children's languages and cultural backgrounds, but indicated that they had limited resources to discriminate between speech and language difference vs disorder.

Schizophrenia, culture and neuropsychology: sensory deficits, language impairments and social functioning in Chinese-speaking schizophrenia patients.

BACKGROUND: While 20% of schizophrenia patients worldwide speak tonal languages (e.g. Mandarin), studies are limited to Western-language patients. Western-language patients show tonal deficits that are related to impaired emotional processing of speech. However, language processing is minimally affected. In contrast, in Mandarin, syllables are voiced in one of four tones, with word meaning varying accordingly. We hypothesized that Mandarin-speaking schizophrenia patients would show impairments in underlying basic auditory processing that, unlike in Western groups, would relate to deficits in word recognition and social outcomes. METHOD: Altogether, 22 Mandarin-speaking schizophrenia patients and 44 matched healthy participants were recruited from New York City. The auditory tasks were: (1) tone matching; (2) distorted tunes; (3) Chinese word discrimination; (4) Chinese word identification. Social outcomes were measured by marital status, employment and most recent employment status. RESULTS: Patients showed deficits in tone-matching, distorted tunes, word discrimination and word identification versus controls (all p<0.0001). Impairments in tone-matching across groups correlated with both word identification (p<0.0001) and discrimination (p<0.0001). On social outcomes, tonally impaired patients had 'lower-status' jobs overall when compared with tonally intact patients (p<0.005) and controls (p<0.0001). CONCLUSIONS: Our study is the first to investigate an interaction between neuropsychology and language among Mandarin-speaking schizophrenia patients. As predicted, patients were highly impaired in both tone and auditory word processing, with these two measures significantly correlated. Tonally impaired patients showed significantly worse employment-status function than tonally intact patients, suggesting a link between sensory impairment and employment status outcome. While neuropsychological deficits appear similar cross-culturally, their consequences may be language- and culture-dependent.

Phonological fluency is uniquely impaired in Japanese-speaking schizophrenia patients: confirmation study.

In alphabet-based language-speaking patients with schizophrenia, category fluency is disproportionately disturbed as compared with phonological fluency. Deficits in category and phonological fluency observed in Japanese patients, however, were similar. The aim of the present study was to replicate these findings by modifying the task to minimize the influence of lack of motivation and concentration in the patients. Similar deficits were found in both types of fluency in Japanese patients. Patients who speak Japanese have deficits in phonological fluency, compared with patients who speak alphabet-based languages, suggesting that the pattern of impairment in verbal fluency in schizophrenia is dependent on the specific language system.

A review of developmental and applied language research on African American children: from a deficit to difference perspective on dialect differences.

PURPOSE: The contemporary practices of delivering speech, language, and hearing services in schools reflect palpable gains in professional sensitivity to linguistic and cultural diversity. METHOD: This article reviews the dominant research themes on the oral language of African American preschoolers who contribute to such diversity in the United States. Specifically, it contrasts the historical and current frameworks that have guided studies of (a) such children's acquisition and use of English and (b) the strategies used to assess and modify their language. CONCLUSION: Research initiatives that can expand knowledge about this group are proposed.

Multicultural issues in test interpretation.

Designing the ideal test or series of tests to assess individuals who speak languages other than English is difficult. This article first describes some of the roadblocks-one of which is the lack of identification criteria for language and learning disabilities in monolingual and bilingual populations in most countries of the non-English-speaking world. This lag exists, in part, because access to general education is often limited. The second section describes tests that have been developed in the United States, primarily for Spanish-speaking individuals because they now represent the largest first-language majority in the United States (80% of English-language learners [ELLs] speak Spanish at home). We discuss tests developed for monolingual and bilingual English-Spanish speakers in the United States and divide this coverage into two parts: The first addresses assessment of students' first language (L1) and second language (L2), usually English, with different versions of the same test; the second describes assessment of L1 and L2 using the same version of the test, administered in the two languages. Examples of tests that fit a priori-determined criteria are briefly discussed throughout the article. Suggestions how to develop tests for speakers of languages other than English are also provided. In conclusion, we maintain that there will never be a perfect test or set of tests to adequately assess the communication skills of a bilingual individual. This is not surprising because we have yet to develop an ideal test or set of tests that fits monolingual Anglo speakers perfectly. Tests are tools, and the speech-language pathologist needs to know how to use those tools most effectively and equitably. The goal of this article is to provide such guidance.

Effects of age, gender, education and race on two tests of language ability in community-based older adults.

BACKGROUND: Neuropsychological tests, including tests of language ability, are frequently used to differentiate normal from pathological cognitive aging. However, language can be particularly difficult to assess in a standardized manner in cross-cultural studies and in patients from different educational and cultural backgrounds. This study examined the effects of age, gender, education and race on performance of two language tests: the animal fluency task (AFT) and the Indiana University Token Test (IUTT). We report population-based normative data on these tests from two combined ethnically divergent, cognitively normal, representative population samples of older adults. METHODS: Participants aged > or =65 years from the Monongahela-Youghiogheny Healthy Aging Team (MYHAT) and from the Indianapolis Study of Health and Aging (ISHA) were selected based on (1) a Clinical Dementia Rating (CDR) score of 0; (2) non-missing baseline language test data; and (3) race self-reported as African-American or white. The combined sample (n = 1885) was 28.1% African-American. Multivariate ordinal logistic regression was used to model the effects of demographic characteristics on test scores. RESULTS: On both language tests, better performance was significantly associated with higher education, younger age, and white race. On the IUTT, better performance was also associated with female gender. We found no significant interactions between age and sex, and between race and education. CONCLUSIONS: Age and education are more potent variables than are race and gender influencing performance on these language tests. Demographically stratified normative tables for these measures can be used to guide test interpretation and aid clinical diagnosis of impaired cognition.

Flexibility and variability in lexicon usage among Yoruba-speaking Nigerian outpatients with schizophrenia: a controlled study.

BACKGROUND: The studies on language dysfunction in schizophrenia are few, inconclusive and have all been done in the western culture. There may be cross-cultural and cross-lingual differences in problems with speeches of patients with schizophrenia. This study aims to examine the flexibility or variability in the use of words among a group of Nigerian patients with schizophrenia compared with healthy controls. SAMPLING AND METHODS: The spoken samples of 48 outpatients with schizophrenia and 48 matched controls were assessed using the mean segmental type-token ratio (MSTTR). The sociodemographic and clinical variables of the patients with schizophrenia were also compared with their MSTTR scores. RESULTS: The MSTTR score for the patients with schizophrenia was significantly lower compared with that of healthy controls (p < 0.001). The factors independently associated with a lower MSTTR in patients with schizophrenia include younger age at onset of illness, presence of negative formal thought disorder and simple or hebephrenic subtype of schizophrenia. CONCLUSIONS: The problem with flexibility and variability in lexicon usage among patients with schizophrenia is a cross-cultural phenomenon. The MSTTR may have value in predicting clinical judgements of thought disorder or in identifying deviant language. These may have broad potentials for application in longitudinal and pathogenetic studies of schizophrenia.

Specific linguistic and pragmatic deficits in Italian patients with schizophrenia.

OBJECTIVE: Verbal communication impairments are prominent features of schizophrenia. The grammatical and pragmatic components of expressive and receptive verbal abilities were systematically examined, for the first time, in Italian patients with schizophrenia. Indeed, most of the language literature is composed of studies on English speaking people. METHOD: Elicited narrative production, and syntactic and pragmatic receptive abilities were analyzed in a cohort of 37 patients with schizophrenia and 37 healthy controls. Furthermore, a conversational speech production task was administered to an age- and gender-matched subset of this population. The level of significance was set at p