Processing of rapid auditory stimuli in school-age children referred for evaluation of learning disorders.

Tallal hypothesized that reading disabled children have a domain-general deficit in processing rapidly occurring auditory stimuli that degrades speech perception, thereby limiting phonologic awareness and thus reading acquisition. She predicted they would be disproportionately affected by rapidly presented auditory stimuli. In this study, one hundred 7- to 11-year-old children with learning impairment (LI) and 243 non-learning impaired (NLI) children were evaluated on a two-tone auditory discrimination paradigm. LI committed more errors, but effects of timing were comparable. The same result was obtained for a subsample of good and poor readers. Task performance predicted reading, spelling, and calculation. Neural processes underlying perception of speech and other auditory stimuli may be less effective in poor readers; however, contrary to Tallal's hypothesis, rate may not be specifically affected.

Diminished motor timing control in children referred for diagnosis of learning problems.

Disabled readers exhibit motor timing control (MTC) deficits in bimanual coordination relative to average readers. This article evaluates to what extent poor MTC is specific to reading or if it is related to learning problems in general. Children (7 to 11 years of age) referred for learning impairment (LI; n = 100) and same-age children nonlearning impaired (NLI; n = 243) performed a paced finger-tapping task. Greater variability of interresponse intervals was associated with poorer reading, spelling, and arithmetic achievement. The LI group performed more poorly than the NLI group, a difference that persisted even after adjusting for reading skill. Poor MTC is associated with poor reading but may also be a characteristic of children referred for learning problems, possibly signaling increased vulnerability of underlying neural integrative processes relevant to the child's adaptation to academic demands, including reading.

Rapid automatized naming in children referred for evaluation of heterogeneous learning problems: how specific are naming speed deficits to reading disability?

Because the Rapid Automatized Naming (RAN) test reliably predicts reading skill, it is typically viewed as a diagnostic indicator of risk for reading disability (RD). Since most of the work on naming speed has been undertaken within the framework of reading research, however, the extent to which poor RAN is specifically associated with RD or with learning impairment (LI) in general is uncertain. We tested the hypothesis that slow naming speed is specific to RD. Participants were 188 children (ages 7 to 11) referred for evaluation of learning problems. Receiver operating characteristic (ROC) analysis was used to evaluate the utility of the RAN task for classifying children in diagnostic groups. RAN was an excellent tool for detecting risk for learning problems in general, but it was much less effective at distinguishing LI children with and without RD from each other.

The orphans of Eritrea: a five-year follow-up study.

A group of 4-7-year-old war orphans were examined for the first time while living in an institution (the Solomuna Orphanage) during a protracted war between Eritrea and Ethiopia. At that time, they were compared to a group of refugee children living in a nearby camp with one or both parents. The orphans exhibited significantly more behavioral symptoms than the refugee children, but performed the cognitive tests at a more advanced level. Five years later, the orphans were re-examined; and they were compared to unaccompanied 9-12-year-children living in one of two residential settings that differed qualitatively in their social climate, principles of child care, and patterns of staff-child interactions. Although the severity of their behavioral symptoms had diminished, the orphans still exhibited many symptoms of emotional distress. On the other hand, they performed the cognitive measures as well as, or better than, unaccompanied children who had been protected from the terrors of war. The cross-sectional comparisons indicated that a residential setting that respects the individuality of children and promotes their close personal ties with at least one staff member can ameliorate many of the more serious psychological sequelae of having lost both parents and being exposed to the physical dangers of the war. The implications for war orphans in other Third World countries are discussed.

A candidate phenotype for familial dyslexia.

The probative analysis of genotype-phenotype relations in familial dyslexia requires operationally defined psychobiological outcome variables that are not confounded by cultural differences of orthography or other factors that may influence the clinical ascertainment and diagnosis of dyslexia. Timing precision, as expressed in coordinated motor action, was used as an objective behavioral measure that can be mapped on current knowledge of central nervous system functions as well as on the most salient non-reading deficits in developmental dyslexia. Dyslexia families with four distinct pedigrees and a normally reading reference group were the study subjects. The results indicated that impaired timing precision in bimanual coordination and in motor speech were transmitted vertically in affected members of about half of dyslexia families. Motor coordination deficits were associated with a disposition to make dysphonemic spelling errors. It is proposed that impaired timing precision identifies a behavioral phenotype in some familial dyslexia subtypes. The detailed analysis of coarticulation in speech production may be one pathway by which impaired timing precision in motor action impinges on reading and writing deficits in developmental dyslexia.

The orphans of Eritrea: are orphanages part of the problem or part of the solution?

OBJECTIVE: This study compared the mental health and cognitive development of 9- to 12-year-old Eritrean war orphans living in two orphanages that differed qualitatively in patterns of staff interaction and styles of child care management. METHOD: The directors and several child care workers at each institution were asked to complete staff organization and child management questionnaires. The psychological state of 40 orphans at each institution was evaluated by comparing their behavioral symptoms and performance on cognitive measures. RESULTS: Orphans who lived in a setting where the entire staff participated in decisions affecting the children, and where the children were encouraged to become self-reliant through personal interactions with staff members, showed significantly fewer behavioral symptoms of emotional distress than orphans who lived in a setting where the director made decisions, daily routines were determined by explicit rules and schedules, and interactions between staff members and the children were impersonal. CONCLUSIONS: When orphanages are the only means of survival for war orphans, a group setting where the staff shares in the responsibilities of child management, is sensitive to the individuality of the children, and establishes stable personal ties with the children serves the emotional needs and psychological development of the orphans more effectively than a group setting that attempts to create a secure environment through an authoritative style of management with explicit rules and well-defined schedules.

The development of interlimb coordination during bimanual finger tapping.

Normal subjects aged 7-25 years were asked to tap the index fingers of both hands: a) in four different patterns of interlimb coordination; b) at two different response frequencies; and c) both before and after the entraining metronome was turned off. The outcome variables of primary interest were the within-subject variability of interresponse intervals (IRI) as an index of timing precision; and deviations from prescribed response frequency, as an index of temporal tracking accuracy. Stability of timing precision and accuracy of temporal tracking increased significantly from 7 to 9 and from 9 to 11 years, with only minor advances thereafter. There were significant right-left performance asymmetries in all bimanual tasks; variability of IRI and deviations from prescribed rate were greater at the faster of the two response frequencies tested; and stability of IRI and accuracy of temporal tracking were greater with than without the metronome. Stability of IRI and accuracy of temporal tracking were strongly correlated in some bimanual tasks. The findings are discussed in terms of the two major theoretical perspectives on human brain-behavior relationships that have specifically addressed the issue of bimanual coordination.

A functional analysis of human mirror movements.

In this report, an experimental method for investigating the effect of variations in force, amplitude, and frequency of oscillations of the isometric pincer grasp on mirror movements (MM) is described. Normal adults (N = 24) were used as experimental subjects. The magnitude of MM was greater at relatively high static force levels maintained by the passive hand (26% of maximum volitional force or MVF) than at low force levels (4% MVF) in the passive hand. By contrast, the magnitude of MM was smaller at relatively large (20.5% MVF) than at small (9.5% MVF) mean force levels of the active hand when the static force in the passive hand as well as the amplitude and range of oscillation frequencies of the active hand were held constant. The magnitude of MM relative to active hand oscillation was smaller when the active hand oscillated around a relatively large amplitude (22% of MVF) than when it did so around a small amplitude (8% of MVF) at constant mean force levels and oscillation frequencies. The absolute magnitude of MM was not affected by this change in oscillation amplitude. In all experiments, the magnitude of MM was consistently less at relatively high than at low frequencies of oscillation in the active hand. Intrinsic variables of motor control have a major effect on the inducation and modulation of MM, and their contribution may be as great as that of subject variables. The present results differed substantially from those of others who have used similar experimental paradigms. The major difference was the direction of change in power transfer from the active to the passive hand with changes of force in the active hand. Possible reasons for these differences are discussed.

Family patterns of developmental dyslexia. Part III: Spelling errors as behavioral phenotype.

The major trends in current research on developmental dyslexia assume that impaired phonological processing is the core deficit in this disorder. Our earlier studies indicated that half of all dyslexic persons have significant deficits of bimanual motor coordination, and that impaired temporal resolution in motor action may identify a vertically transmitted behavioral phenotype in familial dyslexia. This report examines the relationship between spelling errors as a measure of impaired phonological processing and motor coordination deficits in the same dyslexia families. Affected family members with motor coordination deficits made significantly more dysphonetic spelling errors than dyslexic family members without motor deficits, but there was no evidence that dysphonetic spelling is vertically transmitted in dyslexia families. On the other hand, affected offspring of affected parents with motor coordination deficits made relatively more dysphonetic spelling errors than the affected offspring of parents without motor coordination deficits. We suggest that dysphonetic spelling may be one outward expression of a vertically transmitted behavioral phenotype of impaired temporal resolution that is clearly expressed in coordinated motor action.

The irrelevance of infant observations for psychoanalysis.

The current consensus among psychoanalysts holds that direct infant observations are one means for testing the developmental propositions of psychoanalytic theory; that the observations have already falsified some of the theory's basic propositions; and that they hold the key to a qualitatively different developmental theory of psychoanalysis. The consensus, although not universal, has motivated a wide range of research programs on early infancy, whose findings are commonly interpreted as disclosing psychoanalytic metapsychology and clinical theory in an entirely new light. This essay examines some of the assumptions that have motivated such investigations, as well as the research strategies by which the new versions of theory are promulgated. On the basis of these explorations it is concluded that psychoanalytically informed infant observations may be the source for new theories of social-emotional development, but that they are essentially irrelevant for psychoanalysis as a psychology of meanings, unconscious ideas, and hidden motives.

Family patterns of developmental dyslexia, part II: behavioral phenotypes.

The motor control of bimanual coordination and motor speech was compared between first degree relatives from families with at least 2 dyslexic family members, and families where probands were the only affected family members. Half of affected relatives had motor coordination deficits; and they came from families in which probands also showed impaired motor coordination. By contrast, affected relatives without motor deficits came from dyslexia families where probands did not have motor deficits. Motor coordination deficits were more common and more severe among affected offspring in families where both parents were affected than among affected offspring in families where only one parent was affected. However, motor coordination deficits were also more common and more severe in affected parents when both parents were affected than among affected parents in families where only one parent was affected. We conclude that impaired temporal resolution in motor action identifies a behavioral phenotype in some subtypes of developmental dyslexia. The observed pattern of transmission for motor deficits and reading impairment in about half of dyslexia families was most congruent with a genetic model of dyslexia in which 2 codominant major genes cosegregate in dyslexia pedigrees where the proband is also motorically impaired.

The orphans of Eritrea: a comparison study.

The social-emotional state and cognitive development was compared between a group of 74 4-7-year-old Eritrean orphans and refugee children living in families. Both groups had been exposed to the chronic stresses of war and drought, and the orphans had, in addition, lost both parents to the violence of war, and were living in an overcrowded orphanage. Contrary to expectations, there were relatively few clinically significant differences between comparison groups. The orphans showed more behavioral symptoms of emotional distress, but performed at a more advanced level on cognitive and language performance measures. The findings suggest that when group care is child-centered, it can under some circumstances be a viable solution for unaccompanied children in countries where adoption and foster care are not realistic alternatives.

The Solomuna Orphanage: a historical survey.

The social-emotional status and behavioral symptoms of Eritrean war orphans were compared before and after a major social reorganization of the institution had been implemented. The comparison was based on direct clinical observations and behavior checklist questionnaires. Two years after the orphanage was restructured, the emotional state of the orphans had improved dramatically. The findings suggest that even when financial and technical resources are severely limited, it is possible to provide humane group care for severely traumatized orphans by applying basic clinical principles of child development.

Family patterns of developmental dyslexia: clinical findings.

Two separate groups of dyslexia families were ascertained through probands attending special schools for dyslexic students. An additional control group of families was ascertained through randomly selected students attending public schools. The 3 groups were interviewed by questionnaire about the family's demographic characteristics, and about the incidence of reading and spelling disorders in all first and second order relatives. One group of dyslexia families was also examined by standardized intelligence and academic achievement tests. Developmental dyslexia was found to aggregate in families; there were 4-5 times as many affected males as females among clinically identified students attending the special schools, but the sex ratio of affected relatives after probands had been excluded was approximately 1.4 males for every female. Sibs were at greater risk for reading difficulties when one parent was affected than when neither parent was affected. Sibs were also at greater risk for academic difficulties, and affected sibs were more severely impaired, when the father rather than the mother was the affected parent. In dyslexia families with 2 affected parents, the sibs were at greater risk, and the affected sibs were more severely impaired, than in families where only one parent was affected. Moreover, in families with 2 affected parents, both of the parents were more severely impaired in reading and spelling than parents of the same sex in families with one affected parent. Some indirect evidence is presented that assortative mating may codetermine patterns of affectedness in dyslexia families.

The dynamics of bimanual coordination in developmental dyslexia.

The temporal organization of symmetric and asymmetric bimanual coordination tasks was compared between dyslexic adults and normally reading controls by means of a dynamical systems research strategy. Both groups demonstrated the influence of the intrinsic dynamics of rhythmic motor behavior on the performance of asymmetric bimanual tasks. In normal readers, manual asymmetries of motor control had a significant effect on the relative phasing of finger movements; no such effects were observed in dyslexic subjects. Group differences are discussed in terms of the interaction between neurological constraints and dynamic principles of spontaneous pattern formation.

Rate variables and automatized naming in developmental dyslexia.

The rate variable in rapid automatized naming (RAN) was investigated in 50 adolescent and 40 adult students with developmental dyslexia, in matched normal controls, and in learning-disabled students without reading difficulties. Visual stimuli depicting familiar colors and common objects were presented in isolation at three film speeds and three exposure times. Film speed and exposure time contributed as independent variables to error rate; and dyslexic subjects of both age groups made significantly more naming errors than controls. Dyslexic subjects also responded with longer naming latencies than controls when the same RAN stimuli were presented in a continuous sequential mode as a matrix of rows and columns. Naming latencies in the sequential presentation were highly correlated with naming errors in the film version. The implications of reduced naming rates for nongraphological stimuli in developmental dyslexia are discussed.

The timing of syllable repetitions in developmental dyslexia.

The temporal organization of motor speech was examined in dyslexic adolescents and adults without overt speech difficulties, matched normal readers, and learning disabled adolescents without reading difficulties. Subjects were asked to repeat nonsense two- and three-syllable strings in time to each of four metronome speeds. Speech samples were analyzed for repetition rates, time coherence between prescribed and actual performance, and serial ordering of three-syllable strings. Dyslexic subjects deviated more from the prescribed rate, repeated syllables too slowly at all metronome speeds, and made more speech sequencing errors than normal or learning disabled controls. Repetition rate and syllable sequencing contributed as independent variables to the temporal organization of motor speech. The relevance of motor speech deficits for reading impairment in dyslexia is discussed.

The greeting behavior of fragile X males.

Mentally retarded males with a fragile site on the X chromosome (Xq27) were observed to exhibit a highly idiosyncratic but well-coordinated, stereotypic form of gaze avoidance during greeting ceremonies that involved the whole upper body. A comparison group of persons with other etiologically defined syndromes of mental retardation did not. Results suggest that the aberrant greeting behavior may be uniquely associated with one syndrome of mental retardation with a defined genetic etiology. The behavior pattern does not appear until middle childhood, however, and its developmental induction remains to be explained.

Cost-related variables: a pilot study.

The advent of prospective payment systems prompts nurses to examine cost-related factors in demonstrating savings resulting from quality care. The clinical nurse specialist plays an active role in the examination of variables influencing costs for patients within the specialty. This pilot study utilized a retrospective chart audit of 142 women falling within Diagnostic-related Group 355 (non-radical hysterectomy, age less than 70 years, without comorbid condition or complication) during 1985 to identify demographic, illness/treatment-related, and discharge variables related to charge variance. Independent (length of stay, p less than 0.001 and previous admission, p = 0.066) predictors of charge variance were found among the 14 variables studied. The value of the research as a model for other practitioners is discussed.