High-level language competencies and Theory of Mind in a group of children with Klinefelter syndrome.

Klinefelter syndrome (KS) is a genetic anomaly involving the presence of one or more supernumerary X chromosomes in male individuals. In the cognitive profile of these individuals, strengths are found in nonverbal abilities, whereas weaknesses are observed in executive function, language, and academic performance. Our study is based on a comparison between eight children diagnosed with KS (47,XXY) (age range: 9-13 years; IQ range: 80-123), with no delay in language development, and eight typically developing (TD) controls. We explored a range of high-level language competencies and Theory of Mind (ToM) in addition to basic language competency. High-level language competencies were assessed by a battery that measures pragmatic language skills and a metaphor comprehension test (MCT). To assess ToM, we administered the corresponding subtest of the NEPSY II. Basic language competence was assessed by the NEPSY II Comprehension of Instructions subtest. Although basic language performance did not differentiate the individuals with KS from the TD controls, relevant differences appeared in some of the high-level language competencies as well as in the ToM task. All tasks in which the individuals with KS performed less well were characterized by complex inferential processes. Some possible clinical and educational implications are discussed.

Insights into Oral and Written Competencies in Neurodevelopmental Disorders.

The study of language abilities offers privileged insights to access the multifaceted world of neurodevelopmental disorders (NDD, henceforth), showing how particular aspects of language may be handled differently as a function of typical neuropsychological features of specific disorders [...].

An Experimental Study on Sarcasm Comprehension in School Children: The Possible Role of Contextual, Linguistics and Meta-Representative Factors.

Understanding sarcasm is a complex ability, which includes several processes. Previous studies demonstrated the possible roles of linguistic and meta-representative factors in understanding sarcasm in school children, while the influence of specific contextual variables still needs to be investigated. Here, we present two studies investigating the possible role of contextual, linguistics, and meta-representative factors in understanding sarcasm in school children. In Study 1, we investigated sarcasm comprehension in 8-9-year-old school children in three different contexts, in which both familiarity and authority were manipulated. We found that understanding sarcasm was facilitated when the conversational partner was characterized by a high level of authority and familiarity (the mother) rather than when the conversational partner was an adult with a lower level of both authority and familiarity (the cashier of a food store). In Study 2, we replicated and extended Study 1 by investigating the possible influence of the same contextual factors but in a more sizeable sample and at different ages: first, third, and fifth grades of primary school. We found that understanding sarcasm improved significantly with age. The results of both studies indicated that understanding sarcasm is influenced by contextual factors. Children at any age better understood sarcasm produced by a speaker with a high level of both familiarity and authority. This ability improved with age. These results expand our understanding of how children infer a speaker's intentions in sarcasm. This might be particularly of interest to develop possible interventions for children on the Autism Spectrum, who are known to misunderstand sarcasm at different levels of complexity.

Analyzing Qualitative Changes in Metalinguistic Processing in Typically Developing 5- to 7-Year-Old Children.

This study was based on an analysis of some of the qualitative aspects underlying the findings of previous research into the metalinguistic abilities in 160 Italian-speaking, typically developing children aged from 5 to 7 years. This previous research had used six metalinguistic tasks, a nonverbal intelligence test, and two lexical- and grammar-comprehension tests. The outcomes showed a significant improvement in all the dependent variables in the age range considered, measured by a series of ANOVAs, with high correlation between all the variables and a strong homogeneity between the metalinguistic tasks, as revealed by a factor analysis. Using generalized estimating equation (GEE) analysis, the current study analyzed the cognitive levels of response that constituted the total score of each task, at each age (5-6, 6-7, and 7-8 years). Although based on the different distribution of the cognitive levels at each age and in each task, the results of this analysis further confirmed the significance of the developmental changes, and showed different developmental trajectories as a function of the specific task. These results are discussed in light of the different involvement of cognitive processes and literacy skills in the transitional phase between kindergarten and the first two years of primary school.

Analysis of Psychological and Social Functioning in Undergraduate Students with a Specific Learning Disorder (SLD).

It is considered to be particularly interesting to enrich the scientific overview investigating the comorbidities of specific learning disorders (SLDs) in young adults. Therefore, this study aims to investigate the psychosocial and relational profiles associated with the presence of learning difficulties in a population of university students. The hypothesis is that young adults with SLDs have lower psychological and socio-relational functioning than their typical-development peers. We further hypothesized that the socio-relational difficulties of students with SLDs could be explained not only by referring to the presence of a learning disorder, but also by considering some variables that may follow the experience of students with SLDs. The results highlighted that students with SLDs, compared to their typical-development peers, have low self-efficacy, high academic anxiety scores, emotional problems, and issues with peers. We finally suggest considering these aspects as early as the diagnostic process to facilitate an effective treatment plan for learning disorders to prevent, in terms of developmental trajectory, the manifestation of these aspects in adulthood.

Becoming the Metalinguistic Mind: The Development of Metalinguistic Abilities in Children from 5 to 7.

The object of this study is the development of metalinguistic abilities in an age range-5 to 7 years-where an important turn takes place in education, namely the transition between kindergarten and primary school. Based on the literature starting from the 70's of the last century, embryonic forms of awareness of how language variation can be manipulated to convey variation in meaning are widely attested in preschoolers. These forms, however, denote an intuitive and implicit level of awareness and will attain a "meta-level", based on more systematic and explicit reflectiveness, later in development in correlation with cognitive, linguistic, and educational factors. To measure the development of these abilities across the above age range, we recruited 160 native Italian-speaking children from 5 to 7, with comparable numerosity at each age, gender balance, average socio-cultural background, and no cognitive nor neuropsychological impairment. We used 6 metalinguistic tasks, the Raven's CPM, a lexical and grammatical ability tests. The results showed a significant increase in all the measures across the span considered and correlations between all the measures. A factor analysis on the metalinguistic tasks showed that a single factor accounted for a large part of the common variance.

How Is Working Memory Related to Reading Comprehension in Italian Monolingual and Bilingual Children?

This study explored how working memory resources contributed to reading comprehension using tasks that focused on maintenance of verbal information in the phonological store, the interaction between the central executive and the phonological store (WMI), and the storage of bound semantic content in the episodic buffer (immediate narrative memory). We analysed how performance in these tasks was related to text decoding (reading speed and accuracy), listening and reading comprehension. The participants were 62 monolingual and 36 bilingual children (mean age nine years, SD = 9 months) enrolled in the same Italian primary school. Bilingual children were born to immigrant parents and had a long history of exposure to Italian as a second language. The regression analyses showed that reading accuracy and listening comprehension were associated with reading comprehension for monolingual and bilingual children. Two working memory components-WMI and immediate narrative memory-exhibited indirect effects on reading comprehension through reading accuracy and listening comprehension, respectively. Such effects occurred only for monolingual children. We discuss the implications of such findings for text reading and comprehension in monolinguals and bilinguals.

Improving the Ability to Write Persuasive Texts in a Boy with Autism Spectrum Disorder: Outcomes of an Intervention.

In this paper, we describe an intervention implemented to assist a 13.2-year-old boy with Autism Spectrum Disorder, G, without intellectual disability, aimed at improving his ability to compose persuasive texts. There was an initial assessment (baseline), an intermediate assessment after two weeks, a six-session intervention phase, and a post-intervention assessment. Our intervention applied two procedures. The first aimed at enhancing general composition abilities in terms of picking (P) ideas, organizing (O) notes, and writing (W) them down (POW), while the second specified the steps to write a persuasive text addressing a possible reader: a topic sentence (T), reasons (R), an explanation (E) for the reasons and the end of the sentence (E) (TREE). These procedures were termed POW + TREE. To analyze G's texts, three types of measures were used by two raters at baseline, intermediate and post-test time: (a) the presence of the TREE components; (b) the quality of the reasons and explanations for the reasons; (c) the number of mental state terms. All these measures showed relevant quantitative improvements, as well as qualitative changes. In addition, when G's performance at the end of the intervention was compared to that of typically developing controls, no statistical difference appeared. The results are discussed in light of the potentialities offered by the type of intervention described here.

Case Report: Theory of Mind and Figurative Language in a Child With Agenesis of the Corpus Callosum.

In this case report, we studied Theory of Mind (ToM) and figurative language comprehension in a 7.2-year-old child, conventionally named RJ, with isolated and complete agenesis of the corpus callosum (ACC), a rare malformation due to the absence of the corpus callosum, the major tract connecting the two brain hemispheres. To study ToM, which is the capability to infer the other's mental states, we used the classical false belief tasks, and to study figurative language, i.e., those linguistic usages involving non-literal meanings, we used tasks assessing metaphor and idiom comprehension. RJ's intellectual level and his phonological, lexical, and grammatical abilities were all adequate. In both the ToM false belief tasks and novel sensory metaphor comprehension, RJ showed a delay of 3 years and a significant gap compared to a typically developing control group, while in idioms, his performance was at the border of average. These outcomes suggest that RJ has a specific pragmatic difficulty in all tasks where he must interpret the other's communicative intention, as in ToM tasks and novel sensory metaphor comprehension. The outcomes also open up interesting insights into the relationships between ToM and figurative language in children with isolated and complete ACC.

Understanding Novel Metaphors: A Milestone in the Developmental Trajectory of Children with Agenesis of the Corpus Callosum?

This study explores novel metaphor comprehension in a 7.2-year-old child (conventionally called RJ) with complete and isolated agenesis of the corpus callosum (ACC). RJ's cognitive level was adequate for his age as well as most of his linguistic competencies. The child's performance was compared to typically developing (TD) controls on a test assessing novel metaphor comprehension for preschoolers. RJ's performance showed a delay of about three years in relation to the expected level for his age, and also a significant gap compared to the TDs. The results highlighted the possibility to detect weaknesses in understanding novel metaphors in children with ACC, in spite of their apparently adequate linguistic capabilities. An early detection of a weakness in this area can pave the way to neurolinguistic treatment in order to enhance the understanding of nonliteral meaning, which, in the developmental trajectory, will be increasingly involved in everyday life communication. Future research should explore more in-depth a capability that intrinsically requires high interconnectivity, such as novel metaphor comprehension, in a brain in development where the major tract connecting the two hemispheres is missing.

Executive functioning, adaptive skills, emotional and behavioral profile: A comparison between autism spectrum disorder and phenylketonuria.

INTRODUCTION: Influential theories maintain that some of Autism Spectrum Disorder (ASD) core symptoms may arise from deficits in executive functions (EF). EF deficits are also considered a neuropsychological marker of early treated individuals with phenylketonuria (PKU). Aims of this study were: to verify the occurrence and patterns of specific EF impairments in both clinical groups; to explore the coexistence of EF alterations with adaptive, behavioral and emotional problems in each clinical condition. MATERIAL AND METHODS: We assessed EF, adaptive, behavioral and emotional profile in 21 participants with ASD, 15 early treated PKU individuals, comparable for age and IQ, and 14 controls, comparable for age to the clinical groups (age range: 7-14 years). RESULTS: ASD and PKU participants presented two different, but partially overlapping patterns of EF impairment. While ASD participants showed a specific deficit in cognitive flexibility only, PKU individuals showed a more extensive impairment in EF with a weaker performance in two core EF domains (inhibition, cognitive flexibility) as compared to healthy controls. Psychological and adaptive profile was typical in PKU participants, while ASD participants experienced behavioral (externalizing symptoms), emotional (internalizing symptoms) and adaptive disorders (general, practical, social domains). CONCLUSIONS: Present results support the view of a relative disengagement of adaptive and emotional-behavioral profile with respect to EF skills and suggest that other dysfunctions contribute to the multidimensional phenotype of ASD participants.

Reasoning on Figurative Language: A Preliminary Study on Children with Autism Spectrum Disorder and Klinefelter Syndrome.

In this study we explored metaphor and idiom competencies in two clinical populations, children with autistic spectrum disorder (ASD) and children with Klinefelter syndrome (KS), (age range: 9⁻12), compared to typically developing (TD) children of the same age. These three groups were tested with two multiple-choice tests assessing idiom comprehension through iconic and verbal alternatives and a metaphor comprehension test composed of novel, physical-psychological metaphors, requesting verbal explanations. To these instruments, another test was added, assessing basic sentence comprehension. Performances on the different linguistic tasks were examined by means of discriminant analysis which showed that idiom comprehension had a very small weight in distinguishing children with ASD from TD controls, whereas metaphor explanation did distinguish them. This study suggests that figurative language comprehension is not a "core deficit" per se in individuals with ASD. Only when the task requires to explicitly construct and explain a semantic mapping between the two terms of a metaphor does the performance of children with ASD significantly deviate from the typical population. These results are interpreted in terms of a difficulty in children with ASD and KS with complex cognitive and linguistic processes and also in relation with clinical assessment.

Beyond the Literal Meaning of Words in Children with Klinefelter Syndrome: Two Case Studies.

Literature on children with Klinefelter Syndrome (KS) points to general linguistic difficulties in both comprehension and production among other cognitive functions, and in the majority of cases, these coexist with an intellectual level within the norms. In these conditions, children having language delay generally engage in language therapy and are systematically monitored across ages. In this article, we present the profiles of two children with KS (47, XXY), aged 9.1 (Child S) and 13 (Child D), whose language development was assessed as adequate at age 3, and for this reason, did not receive any language treatment. At the present stage, their IQ, as measured by Wechsler Scales (Child S: 92; Child D: 101), is within the norm, but they both present marked weaknesses in pragmatic skills such as figurative language comprehension. The analysis of these two cases points to the need to go beyond global indexes of verbal abilities, as the same global index may mask a wide diversification of individual profiles. In addition, this study underlines the importance of monitoring the developmental trajectories of children like Child D and Child S, because weaknesses in pragmatic skills that are relevant for both academic achievement and social adaptation could emerge at later stages.

Sensory and Physico-Psychological Metaphor Comprehension in Children with ASD: A Preliminary Study on the Outcomes of a Treatment.

Recent research into difficulties in figurative language in children with ASD highlighted that it is possible to devise training interventions to overcome these difficulties by teaching specific strategies. This study describes how children with ASD can improve their capability to explain metaphors with a treatment. Two types of metaphors, in the "X is Y" form, were addressed: sensory and physico-psychological. To face the difficulties posed by these metaphors, the adult taught two strategies: inserting the connective "is like" between "X" and "Y", which transforms the metaphor into a simile; comparing "X" and "Y" by means of thinking maps. Two tests of metaphor comprehension were used, one based on sensory and the other on physico-psychological metaphors. Sixteen 10 year-old children participated into the study, including an experimental group formed by 8 children with ASD (n = 4) which had received the treatment, and a control group (n = 4) which had not, and 8 typically-developing (TD) children. At the post-test, the experimental group significantly outperformed the controls in explaining both types of metaphors, but only in the sensory metaphors did their performances reach TD children's levels. These results illuminate how clinical treatment can positively influence the developmental trajectories of metaphor comprehension.

Novel Metaphors Comprehension in a Child with High-Functioning Autism Spectrum Disorder: A Study on Assessment and Treatment.

Until the first decade of the current millennium, the literature on metaphor comprehension highlighted typical difficulties in children with high-functioning Autism Spectrum Disorder (ASD). More recently, some scholars have devised special programs for enhancing the capability of understanding metaphors in these children. This article presents a case study based on a treatment aiming at enhancing novel metaphor comprehension in a high-functioning child with ASD. M.M., a pseudoacronym for an 8;10 year-old boy, diagnosed with high-functioning ASD, was first assessed with a metaphor comprehension test. This testing (at time T0) highlighted a rigid refusal of metaphors and a marked tendency toward literal interpretation. A baseline treatment (8 sessions of 45-60 min each, twice a week) was implemented, based on a series of recognition, denomination and emotion comprehension activities. M.M.'s metaphor comprehension was assessed a second time (T1), followed by the experimental treatment (same duration and frequency as the first one), specifically focused on metaphor comprehension. Finally, a third assessment of metaphor comprehension took place (T2), followed by a last assessment 4 months later (follow-up, T3). The comparison between the performances at the metaphor comprehension test across the four assessments, from T0 to T3, showed that the baseline treatment produced no effect at all, whereas a significant improvement appeared at T2, just after the experimental treatment, later confirmed at the follow up. Both quantitative and qualitative results showed an evident improvement in the way M.M. handled the semantic issues posed by the metaphors of the test, in line with the strategies he was taught during the treatment.

Treating verbal working memory in a boy with intellectual disability.

The present case study investigates the effects of a cognitive training of verbal working memory that was proposed for Davide, a 14-year-old boy diagnosed with mild intellectual disability. The program stimulated attention, inhibition, switching, and the ability to engage either in verbal dual tasks or in producing inferences after the content of a short passage had been encoded in episodic memory. Key elements in our program included (1) core training of target cognitive mechanisms; (2) guided practice emphasizing concrete strategies to engage in exercises; and (3) a variable amount of adult support. The study explored whether such a complex program produced "near transfer" effects on an untrained dual task assessing verbal working memory and whether effects on this and other target cognitive mechanisms (i.e., attention, inhibition, and switching) were long-lasting and produced "far transfer" effects on cognitive flexibility. The effects of the intervention program were investigated with a research design consisting of four subsequent phases lasting 8 or 10 weeks, each preceded and followed by testing. There was a control condition (phase 1) in which the boy received, at home, a stimulation focused on the visuospatial domain. Subsequently, there were three experimental training phases, in which stimulation in the verbal domain was first focused on attention and inhibition (phase 2a), then on switching and simple working memory tasks (phase 2b), then on complex working memory tasks (phase 3). A battery of neuropsychological tests was administered before and after each training phase and 7 months after the conclusion of the intervention. The main finding was that Davide changed from being incapable of addressing the dual task request of the listening span test in the initial assessment to performing close to the normal limits of a 13-year-old boy in the follow-up assessment with this test, when he was 15 years old.

Executive functions, impulsivity, and inhibitory control in adolescents: A structural equation model.

Background. Adolescence represents a critical period for brain development, addressed by neurodevelopmental models to frontal, subcortical-limbic, and striatal activation, a pattern associated with rise of impulsivity and deficits in inhibitory control. The present study aimed at studying the association between self-report measures of impulsivity and inhibitory control with executive function in adolescents, employing structural equation modeling. Method. Tests were administered to 434 high school students. Acting without thinking was measured through the Barratt Impulsiveness Scale and the Dickman Impulsivity Inventory, reward sensitivity through the Behavioral Activation System, and sensation seeking through the Zuckerman-Kuhlman-Aluja Personali- ty Questionnaire. Inhibitory control was assessed through the Behavioral Inhibition System. The performance at the Wisconsin Card Sorting Task indicated executive function. Three models were specified using Sample Covariance Matrix, and the estimated parameters using Maximum Likelihood. Results. In the final model, impulsivity and inhibitory control predicted executive function, but sensation seeking did not. The fit of the model to data was excellent. Conclusions. The hypothesis that inhibitory control and impulsivity are predictors of executive function was supported. Our results appear informative of the validity of self-report measures to examine the relation between impulsivity traits rather than others to regulatory function of cognition and behavior.