Productive syntax abilities in Huntington's and Parkinson's diseases.

This study examined syntactic changes in the spoken discourse of patients with Huntington's (HD) or Parkinson's disease (PD) and explored possible relationships between their syntactic changes and concomitant cognitive and motoric symptoms. Patient and control groups participated in a conversational discourse activity and completed a battery of standardized speech and cognitive tests. The HD group used shorter and fewer grammatically complete utterances than their healthy, age-matched peers, whereas there were no significant syntactic differences between PD patients and their healthy, age-matched peers or between PD and HD patients. Productive syntax abilities in HD and PD were meaningfully related to both neuropsychological and motor speech changes. These findings indicate that patients with subcortical disease, at least those with HD, may present with language production deficits and that these deficits are most likely the product of not only motor speech limitations (i.e., dysarthria) but also underlying cognitive impairments.

Memory impairments in adults with neurogenic communication disorders.

Over the past few decades, there has been increasing interest in the nonlinguistic, cognitive abilities of adults with neurogenic communication disorders. In particular, a growing literature has documented deficits in a number of memory functions in this population. The purpose of this article is to summarize that literature and provide an overview of the presence and nature of memory impairments in aphasia, right hemisphere disorders, traumatic brain injury, and dementia. Ways that memory impairments may interact with the communication abilities of individuals with neurogenic communication disorders also are discussed.

Assessment of memory in neurogenic communication disorders.

The evaluation of memory in adults with neurogenic communication disorders is complicated by the fact that traditional memory assessment emphasizes verbal content. Also, standardized test procedures often include long and complex instructions that place heavy comprehension demands on clients. This article provides an overview of these and other issues to consider when assessing memory in adults with neurogenic communication disorders. Specifically, this article will include (1) a description of the concept of memory for clinical assessment and definitions of common terms; (2) a general review of assessment methods and selected tests; and (3) considerations for assessing adults with neurogenic communication disorders.

A comparison of relaxation training and syntax stimulation for chronic nonfluent aphasia.

UNLABELLED: This study examined the effects of relaxation training and syntax stimulation on the spoken language abilities of a 59-year-old male with chronic, nonfluent aphasia of moderate severity. Relaxation training consisted of progressive muscle relaxation (PMR) and guided imagery (GI), whereas the syntax stimulation was a modified version of the Helm Elicited Program for Syntax Stimulation (HELPSS) [(1981). Helm Elicited Language Program for Syntax Stimulation. Austin, TX: Pro-Ed.]. These treatments were applied in the context of a single-subject alternating treatments plus baseline design. Results indicated that although both treatments produced improvements in spoken language, syntax stimulation was associated with larger improvements, particularly in terms of the proportions of grammatical utterances, correct information units (CIUs), and successful utterances produced by the participant. Analysis of treatment order, however, indicated that the participant's best performances of the syntax treatment and of the probe tasks occurred when relaxation training preceded syntax stimulation. These findings suggest that the simplicity and psychological benefits of relaxation training make it a complementary component to traditional linguistic programs for aphasia. EDUCATIONAL OBJECTIVES: (1) The reader will understand how psychological responses to stress may affect the language processing abilities of adults with aphasia. (2) The reader will be able to describe how relaxation training complements a traditional language treatment approach for remediating spoken language abilities of adults with chronic nonfluent aphasia.

Addressing the needs of adolescent children when a parent becomes aphasic: one family's experiences.

There are several reports of the psychosocial effects of aphasia on family members and of factors that may influence a family's emotional adjustment. Most of these, however, have included only spouses or the adult children of individuals with aphasia. Therefore, to address how children of adolescent age or younger react to and cope with parental aphasia, this article provides an account of one family's experiences with stroke and aphasia. Specifically, the impact of a father's aphasia on his adolescent daughter as well as how the parents attempted to help their daughter adjust during acute and chronic recovery phases are described.

Assessing the executive function abilities of adults with neurogenic communication disorders.

Whereas it is known that executive function abilities are often impaired in clients having neurogenic communication disorders, few assessments of this cognitive domain are available that consider the speech and language deficits of this population. This article provides an overview of current procedures for assessing executive functions including a discussion of team approaches to assessment, a review of currently available neuropsychological and functional tests of executive function abilities, as well as a critique of those assessment procedures. In addition, suggestions are provided for how best to use or modify appropriately current tests of executive functioning for clients having acquired speech and language disorders as a result of brain damage.

The effects of varying attentional demands on the word retrieval skills of adults with aphasia, right hemisphere brain damage, or no brain damage.

Adults with mild aphasia, right hemisphere brain damage (RBD), or no brain damage (NBD) provided one-word phrase completions under isolation, focused attention, and divided attention conditions and in response to relatively constrained or unconstrained phrase stems. Despite comparable word retrieval accuracy among groups during the isolation condition, aphasic and RBD groups performed less accurately than the NBD group during focused and divided attention conditions. Across conditions, there were no significant differences between aphasic and RBD groups. Only aphasic subjects demonstrated a significant effect of phrase type, responding more accurately when completing constrained versus unconstrained stimuli. For aphasic and RBD groups, error type analysis indicated that semantic and phonological aspects of word retrieval were influenced by increased attentional demands. These findings suggest that for adults with aphasia or RBD, there is a negative relation between attention impairments and word retrieval abilities.

Spoken language production in Huntington's and Parkinson's diseases.

The purpose of this study was to investigate the presence and nature of spoken language deficits in Huntington's (HD) and Parkinson's (PD) diseases. Specifically, the study examined whether (a) the spoken language abilities of patients with HD or PD differ from those of age-matched control participants with no brain damage, (b) HD and PD are associated with similar spoken language profiles, and (c) the spoken language abilities of patients with HD or PD are related to the severity of their motor speech deficits, cognitive impairments, or both. All participants completed picture description tasks and a battery of cognitive and motor speech tests. Syntactic, quantitative, and informativeness measures of spoken language were analyzed. In terms of syntax, patients with HD produced shorter utterances, a smaller proportion of grammatical utterances, a larger proportion of simple sentences, and fewer embeddings per utterance than their non-brain-damaged peers. The HD group also produced utterances that were shorter and syntactically simpler than those of the PD group, despite similar performances on the cognitive and motor speech tests. The only syntactic difference between the PD group and their control group was that patients with PD produced a smaller proportion of grammatical sentences. Although the patient and control participants tended to produce similar amounts of verbal output, less of what the patients said was considered informative. Correlations between language measures and test battery results suggested that the spoken language abilities of patients with HD or PD are related to a variety of neuropsychological and motor speech changes. The implications of these findings for the clinical management of HD and PD are discussed.

Spoken language of individuals with mild fluent aphasia under focused and divided-attention conditions.

The spoken language of individuals with mild aphasia and age-matched control subjects was studied under conditions of isolation, focused attention, and divided attention. A picture-description task was completed alone and in competition with a tone-discrimination task. Regardless of condition, individuals with aphasia performed more poorly on most morphosyntactic, lexical, and pragmatic measures of spoken language than control subjects. Increasing condition complexity resulted in little quantitative or qualitative change in the spoken language of the control group. In contrast, the individuals with aphasia showed dual-task interference; as they shifted from isolation to divided-attention conditions, they produced fewer syntactically complete and complex utterances, fewer words, and poorer word-finding accuracy. In pragmatic terms, their communication was considered less successful and less efficient. These results suggest that decrements of attentional capacity or its allocation may negatively affect the quantity and quality of the spoken language of individuals with mild aphasia.

Microbiota of health, gingivitis, and initial periodontitis.

This study compared the subgingival microbiota in periodontal health, gingivitis and initial periodontitis using predominant culture and a DNA probe, checkerboard hybridization method. 56 healthy adult subjects with minimal periodontal attachment loss were clinically monitored at 3-month intervals for 12 months. More sites demonstrated small increments of attachment loss than attachment gain over the monitoring period. Sites, from 17 subjects, showing > or = 1.5 mm periodontal attachment loss during monitoring were sampled as active lesions for microbial analysis. Twelve subjects demonstrated interproximal lesions, and 5 subjects had attachment loss at buccal sites (recession). Cultural studies identified Bacteroides forsythus, Campylobacter rectus, and Selenomonas noxia as the predominant species associated with active interproximal lesions (9 subjects), whereas Actinomyces naeslundii, and Streptococcus oralis, were the dominant species colonizing buccal active sites. A. naeslundii, Campylobacter gracilis, and B. forsythus (at lower levels than active sites) were the dominant species cultured from gingivitis (10 subjects). Health-associated species (10 subjects) included Streptococcus oralis, A. naeslundii, and Actinomyces gerencseriae. DNA probe data identified higher mean levels of B. forsythus and C. rectus with active (7 subjects) compared to inactive periodontitis sites. Porphyromonas gingivalis and Actinobacillus actinomycetemcomitans were detected infrequently. Cluster analysis of the cultural microbiota grouped 8/9 active interproximal lesions in one subcluster characterized by a mostly gram-negative microbiota, including B. forsythus and C. rectus. The data suggest that B. forsythus C. rectus and S. noxia were major species characterizing sites converting from periodontal health to disease. The differences in location and microbiota of interproximal and buccal active sites suggested that different mechanisms may be involved in increased attachment loss.

Auditory processing in individuals with mild aphasia: a study of resource allocation.

This study examined the effects of lesion location (frontal vs. posterior) and nature of distraction (nonverbal vs. verbal secondary, competing task) on mildly aphasic individuals' performances of listening tasks that required semantic judgments and lexical decisions under isolation, focused attention, and divided attention conditions. Despite comparable accuracy among all groups during isolation conditions, the aphasic groups responded less accurately and more slowly than the normal control group during focused and divided attention conditions. Generally, the two aphasic groups performed similarly, quantitatively and qualitatively. Demographic characteristics such as time post stroke did not correlate with performance decrements. Independent of group, all individuals showed greater disruption of auditory processing skills when the secondary task was verbal rather than nonverbal. Within a limited-capacity model of attention, the results suggest that aphasic individuals display impairments of attention and resource allocation and that these impairments negatively interact with their auditory processing abilities.

An estimation of the annual incidence of poisoning using automated telephone polling.

An automated telephone poll was conducted in Bernalillo County NM during February, 1988. The equipment made 33,458 telephone calls and 2,703 households responded to the eight items included in the poll. The results included a minimum of 810 poisoning incidents in these households in the previous year, giving an annual incidence of poisoning in this population of 108 per 1,000. This rate is considerably higher than previous estimates. Other results included a trend toward delaying poisoning therapy until symptoms developed or taking the poisoned patient directly to an emergency department. If these results are confirmed by conventional polling, poisoning is a major public health problem. Furthermore, confirmation would establish automated telephone polling as a valuable tool for rapidly and inexpensively surveying large populations.