Clinical Characteristic in Primary Progressive Aphasia in Relation to Alzheimer's Disease Biomarkers.

BACKGROUND: Primary progressive aphasia (PPA) is associated with amyloid-ß (Aß) pathology. However, clinical feature of PPA based on Aß positivity remains unclear. OBJECTIVE: We aimed to assess the prevalence of Aß positivity in patients with PPA and compare the clinical characteristics of patients with Aß-positive (A+) and Aß-negative (A-) PPA. Further, we applied Aß and tau classification system (AT system) in patients with PPA for whom additional information of in vivo tau biomarker was available. METHODS: We recruited 110 patients with PPA (41 semantic [svPPA], 27 non-fluent [nfvPPA], 32 logopenic [lvPPA], and 10 unclassified [ucPPA]) who underwent Aß-PET imaging at multi centers. The extent of language impairment and cortical atrophy were compared between the A+ and A-PPA subgroups using general linear models. RESULTS: The prevalence of Aß positivity was highest in patients with lvPPA (81.3%), followed by ucPPA (60.0%), nfvPPA (18.5%), and svPPA (9.8%). The A+ PPA subgroup manifested cortical atrophy mainly in the left superior temporal/inferior parietal regions and had lower repetition scores compared to the A-PPA subgroup. Further, we observed that more than 90% (13/14) of the patients with A+ PPA had tau deposition. CONCLUSION: Our findings will help clinicians understand the patterns of language impairment and cortical atrophy in patients with PPA based on Aß deposition. Considering that most of the A+ PPA patents are tau positive, understanding the influence of Alzheimer's disease biomarkers on PPA might provide an opportunity for these patients to participate in clinical trials aimed for treating atypical Alzheimer's disease.

Relationships among tau burden, atrophy, age, and naming in the aphasic variant of Alzheimer's disease.

INTRODUCTION: Examination of pathologic, anatomic, and cognitive relationships has been limited in primary progressive aphasia (PPA) with underlying Alzheimer's disease (AD) neuropathology. METHODS: Spatial relationships between tau positron emission tomography (PET), cortical thickness, age, and naming on the Boston Naming Test (BNT) in PPA with biomarker evidence of AD (PPA-AD) were examined. RESULTS: Higher tau PET burden was associated with atrophy and younger age. There was a significant left-lateralized relationship between lower BNT and more atrophy, and between lower BNT and increased tau burden. Variance in naming was primarily shared between tau and atrophy (51%), but naming was uniquely explained more by atrophy (32%) than tau (16%). Higher left anterior temporal tau burden was associated with greater 1-year rate of decline in naming. DISCUSSION: PPA-AD has a similar relationship between abnormal biomarkers as first described in amnestic AD, with differing spatial extent, reflecting the left-lateralized nature of the language network.

Spanish Version of the Mini-Linguistic State Examination for the Diagnosis of Primary Progressive Aphasia.

BACKGROUND: Primary progressive aphasia (PPA) is a neurodegenerative syndrome with three main clinical variants: non-fluent, semantic, and logopenic. Clinical diagnosis and accurate classification are challenging and often time-consuming. The Mini-Linguistic State Examination (MLSE) has been recently developed as a short language test to specifically assess language in neurodegenerative disorders. OBJECTIVE: Our aim was to adapt and validate the Spanish version of MLSE for PPA diagnosis. METHODS: Cross-sectional study involving 70 patients with PPA and 42 healthy controls evaluated with the MLSE. Patients were independently diagnosed and classified according to comprehensive cognitive evaluation and advanced neuroimaging. RESULTS: Internal consistency was 0.758. The influence of age and education was very low. The area under the curve for discriminating PPA patients and healthy controls was 0.99. Effect sizes were moderate-large for the discrimination between PPA and healthy controls. Motor speech, phonology, and semantic subscores discriminated between the three clinical variants. A random forest classification model obtained an F1-score of 81%for the three PPA variants. CONCLUSION: Our study provides a brief and useful language test for PPA diagnosis, with excellent properties for both clinical routine assessment and research purposes.

Similarities and differences in psycho-educational assessments of adolescents with specific language impairments and specific learning disabilities: A challenging differential diagnosis.

Specific Language Impairment (SLI) and Specific Learning Disabilities (SLD) have been the subject of extensive research especially with respect to the connection between them. However, the manifestation of these disorders in adolescence has not been thoroughly investigated. The objective of the present study was to compare the intelligence scores and the reading, oral and written language skills of Greek adolescents with SLI and Greek adolescents with SLD, as assessed during their psycho-educational evaluation, in order to clear the path for diagnosis and intervention. 124 Greek adolescents diagnosed with Specific Learning Disabilities and 76 Greek adolescents diagnosed with Specific Language Impairment aged from 11 to 16 years took part in the study. All participants were assessed in reading, oral language and written language skills and took part in IQ testing. Independent samples t-test, chi-square test, odds ratios and their 95 percent confidence intervals were implemented to determine statistically significant differences. Analyses revealed differences in IQ scores and some differences in the skills assessed, thus indicating that SLI adolescents exhibited more difficulties across most of the basic academic skills, whereas SLD adolescents' difficulties confined to the affected written language skills. Specifically, the observed difference was statistically significant for the total and verbal IQ score, and WISC-III scores also disclosed a significant difference for the similarities and information defisub- tests. Regarding reading skills, SLI adolescents were 4.9 times more likely to exhibit line skipping, 5.8 times more likely to exhibit hesitations, 3.2 times more likely to exhibit repetitions of syllables/words/ phrases, and 8.5 times more likely to exhibit non-acknowledgement of punctuation. Regarding reading comprehension, adolescents with SLI were more likely to have difficulty in retrieving simple information questions, making inferences, and giving titles. Adolescents with SLI were also more likely to have difficulties in story reproduction, giving synonyms/opposites, oral sentence reproduction and auditory oral word reproduction. In the area of written language skills, SLI adolescents were more likely to have poor handwriting, poor content, poor structure, and poor use of punctuation. In adolescence, Specific Language Impairment can be a different manifestation of an ongoing language disorder, which finally appears as a different type of Specific Learning Disability, but with a more generalized nature of learning difficulties. This finding should be interpreted in terms of the importance of differential diagnosis, especially during the challenging period of adolescence.

Conducta adaptativa en niños con trastorno del espectro autista y su efecto sobre la calidad de vida familiar / Psychological adaptation in children with autism spectrum disorder and its effect on family quality of life

INTRODUCCIÓN: En la mayoría de los niños con trastorno del espectro autista (TEA) aparecen dificultades asociadas que, aunque no se incluyen en los criterios diagnósticos, podrían tener impacto sobre la calidad de vida familiar. La bibliografía ha mostrado algunas relaciones entre estas variables y la calidad de vida familiar, aunque los resultados no son concluyentes. OBJETIVO: Examinar el papel de la conducta adaptativa (incluyendo síntomas emocionales, problemas de conducta, hiperactividad/falta de atención, problemas de relaciones entre compañeros y comportamiento prosocial) en niños con TEA y con desarrollo típico, y su posible impacto sobre la calidad de vida familiar. SUJETOS Y MÉTODOS: Veinticuatro familias de niños con TEA (nivel 1 de apoyo) y 25 familias de niños con desarrollo típico con edades comprendidas entre 6 y 13 años. Se ha igualado el síndrome de Asperger (según el DSM-IV-TR) con el TEA con nivel 1 de apoyo (según el DSM-5). Se han evaluado la inteligencia, el vocabulario, la conducta adaptativa y la calidad de vida familiar. RESULTADOS: Se han encontrado diferencias significativas en las variables relacionadas con la conducta adaptativa y en algunos de los componentes de la calidad de vida familiar (interacción familiar, bienestar físico y emocional). En el modelo de regresión, presentar unos mejores niveles de conducta prosocial y el grupo aparecieron como los principales predictores de la satisfacción percibida en la calidad de vida familiar. CONCLUSIÓN: Es importante atender a las dificultades en la conducta prosocial en el TEA, dado su potencial efecto protector sobre la calidad de vida familiar

INTRODUCTION: In most children with autism spectrum disorder (ASD), other difficulties that do not fall within the diagnostic criteria arose, and could have an impact on family quality of life. Previous research has shown several relationships among these variables and family quality of life, however results are contradictories. AIM: To examine the role of psychological adaptation (including emotional symptoms, behavioral problems, hyperactivity, problems with peers, and prosocial behavior) in children with ASD and typical development, and its impact on family quality of life. SUBJECTS AND METHODS: Twenty-four families of children with ASD (level 1 of support) and 25 families of children with typical development between 6 and 13 years old. We have considered diagnosis of Asperger syndrome (following DSM-IV-TR) with ASD-level 1 of support (following DSM-5). We have evaluated intelligence, vocabulary, adaptive behavior, and family quality of life. RESULTS: We have found significant differences in those variables related to psychological adaptation, and in some components of the family quality of life (family interaction, physical and emotional wellbeing). In our regression model, prosocial behaviors and the group were the main predictors of satisfaction on family quality of life. CONCLUSION. It is important to pay attention to the prosocial behaviors in ASD due to its potential protective effect

Do Children Classified With Specific Language Impairment Have a Learning Disability in Writing? A Meta-Analysis.

In this meta-analysis, we examined whether children classified with specific language impairment (SLI) experience difficulties with writing. We included studies comparing children with SLI to (a) typically developing peers matched on age (k = 39 studies) and (b) typically developing younger peers with similar language capabilities (k = six studies). Children classified with SLI scored lower on writing measures than their typically developing peers matched on age (g = -0.97) when all writing scores in a study were included in the analysis. This same pattern occurred for specific measures of writing: quality (g = -0.92), output (g = -1.00), grammar (g = -0.68), vocabulary (g = -0.68), and spelling (g = -1.17). A moderator analysis revealed that differences in the writing scores of children classified with SLI and typically developing peers matched on age were not as large, but were still statistically significant, when assessment involved a contrived response format (vs. measured based on students' writing), researcher-created measures (vs. norm-referenced tests), or SLI included just children with a speech disorder (vs. children with a language disorder). Children classified with SLI further scored lower on writing than typically developing peers with similar language capabilities (g = -0.47). We concluded that children with SLI experience difficulties with writing.

The Prevalence of Dyslexia: A New Approach to Its Estimation.

How prevalent is dyslexia? A definitive answer to this question has been elusive because of the continuous distribution of reading performance and predictors of dyslexia and because of the heterogeneous nature of samples of poor readers. Samples of poor readers are a mixture of individuals whose reading is consistent with or expected based on their performance in other academic areas and in language, and individuals with dyslexia whose reading is not consistent with or expected based on their other performances. In the present article, we replicate and extend a new approach for determining the prevalence of dyslexia. Using model-based meta-analysis and simulation, three main results were found. First, the prevalence of dyslexia is better represented as a distribution that varies as a function of severity as opposed to any single-point estimate. Second, samples of poor readers will contain more expected poor readers than unexpected or dyslexic readers. Third, individuals with dyslexia can be found across the reading spectrum as opposed to only at the lower tail of reading performance. These results have implications for screening and identification, and for recruiting participants for scientific studies of dyslexia.

Assessment of English language performance scores and academic performance in an English-based curriculum for pharmacy students with English as a second language.

BACKGROUND: The primary objective was to determine if there is a relationship between English language performance and graduating grade point average (GPA) in pharmacy students with English as a second language (ESL). METHODS: Students graduating from a four-year pharmacy program in 2016-2018 were invited to participate in the study. We compared pharmacy students' pre-admission ESL scores to their cumulative GPA at graduation in each of the three graduating cohorts and also determined if these results held true for both genders. Correlation of GPA to individual mathematics, chemistry, and Chinese language scores were used as points of reference to compare the degree of correlation. RESULTS: There were 148 students screened for the study with 31 students not meeting the inclusion criteria and four students declining to participate. Statistical analyses show an overall weak correlation. There was a statistically significant stronger correlation between pre-admission ESL scores and cumulative graduating GPA (r = 0.273) as compared to the correlation of GPA with mathematics (r = 0.187), chemistry (r = 0.181), or Chinese language scores (r = 0.059). The results did not change when the study population was separated by gender as English score still had the strongest correlation as compared to the other subjects. CONCLUSION: This study provides evidence that English language scores correlate more strongly with academic performance than mathematics, chemistry, or Chinese language scores in ESL pharmacy students. Also, this English language correlation is stronger for females than males.

Expressive language sampling as a source of outcome measures for treatment studies in fragile X syndrome: feasibility, practice effects, test-retest reliability, and construct validity.

BACKGROUND: The evaluation of treatment efficacy for individuals with fragile X syndrome (FXS) or intellectual disability (ID) more generally has been hampered by the lack of adequate outcome measures. We evaluated expressive language sampling (ELS) as a procedure for generating outcome measures for treatment research in FXS. We addressed: (a) feasibility, (b) practice effects over two administrations, (c) test-retest reliability over the repeated administrations, and (d) construct validity. We addressed these issues for the full sample as well as for subgroups defined by age, IQ, and ASD status. METHODS: Participants were 106 individuals with FXS between ages 6 and 23 years who had IQs within the range of intellectual disability (IQ < 70). ELS procedures for collecting samples in conversation and narration were followed and analyzed separately. Five measures were derived from transcripts segmented into C-units (i.e., an independent clause and its modifiers): number of C-units per minute (talkativeness), number of different word roots (vocabulary), C-unit length in morphemes (syntax), percentage of C-units containing dysfluency (utterance planning), and percentage of C-units that were fully or partly unintelligible (articulatory quality). ELS procedures were administered twice at 4-week intervals for each participant. Standardized tests and informant reports were administered and provided measures for evaluating construct validity of ELS measures. RESULTS: We found low rates of noncompliance, suggesting the task can be completed meaningfully by most individuals with FXS, although noncompliance was higher for younger, lower IQ, and more autistic participants. Minimal practice effects and strong test-retest reliability over the 4-week interval were observed for the full sample and across the range of ages, IQs, and autism symptom severity. Evidence of convergent construct validity was observed for the measures of vocabulary, syntax, and unintelligibility for the full sample and across the range of IQ and autism symptom severity, but not for participants under age 12. Conversation and narration yielded largely similar results in all analyses. CONCLUSIONS: The findings suggest that the ELS procedures are feasible and yield measures with adequate psychometric properties for a majority of 6 to 23 years with FXS who have ID. The procedures work equally well regardless of level of ID or degree of ASD severity. The procedures, however, are more challenging and have somewhat less adequate psychometric properties for individuals with FXS under age 12.

The Factor Structure of Vocabulary: An Investigation of Breadth and Depth of Adults with Low Literacy Skills.

The purpose of this study was to examine the factor structure of vocabulary. We believe that not only is vocabulary multidimensional, but depth of vocabulary knowledge should also be assessed with multiple measures since it too, is composed of multiple aspects. Furthermore, to explore the predictive validity of the different aspects of vocabulary knowledge, we assessed the relationship between vocabulary breadth, vocabulary depth, and reading comprehension in adults with low literacy skills. The participants were 103 adults. They completed 12 tasks that have been used in past studies to measure vocabulary breadth, depth, and reading comprehension. We had several important findings. First, we confirmed that all of the assessments were highly reliable for adults with low literacy skills. Second, the results of the factor analysis indicated two distinct vocabulary factors. Finally, both breadth and depth contribute independently to explaining variance in reading comprehension. Implications for vocabulary measurement are suggested.

Predicting Dyslexia in Children With Developmental Language Disorder.

Purpose In this study, we examine how well kindergarten letter identification and phonological awareness predict 2nd grade word reading and dyslexia in children with developmental language disorder (DLD) and their age- and grade-matched peers with typical language (TL). Method We employ (a) logistic regression to determine how letter identification and phonological awareness predict dyslexia, that is, dichotomous categorization of good or poor word reading, in children with DLD and TL and (b) quantile regression to determine how letter identification and phonological awareness are associated with word reading abilities on a continuum in these groups of children. Results Logistic regression revealed that letter identification was the only significant, unique kindergarten predictor of dyslexia in 2nd grade children with DLD, when compared to phonological awareness. In children with TL, both kindergarten letter identification and phonological awareness significantly predicted dyslexia in 2nd grade. Quantile regression revealed that kindergarten letter identification was a stronger predictor of 2nd grade word reading for average and lower achieving word readers with DLD and their peers with TL compared to higher performing readers. Phonological awareness was weakly associated with word reading across the full continuum of word reading abilities in children with DLD. Conclusion Letter identification is a more accurate predictor of poor word reading and dyslexia than phonological awareness in kindergarten children with DLD, which has important implications for recent U.S. legislation around early identification of dyslexia in all children.

A Retrospective Study of Long-Term Improvement on the Boston Naming Test.

Purpose Lexical retrieval impairment is a universal characteristic of aphasia and a common treatment focus. Although naming improvement is well documented, there is limited information to shape expectations regarding long-term recovery. This was the motivation for a retrospective study of longitudinal data on the Boston Naming Test (BNT; Kaplan, Goodglass, & Weintraub, 1983, 2000). Method BNT scores were analyzed from a heterogeneous cohort of 42 individuals with anomia associated with a range of aphasia types. The data were collected over the course of 20 years from individuals who had participated in treatment and received at least 2 BNT administrations. A linear mixed model was implemented to evaluate effects of initial BNT score, time postonset, and demographic variables. For those over 55 years of age, BNT change was evaluated relative to data from the Mayo Clinic's Older Americans Normative Studies. Results There was a significant average improvement of +7.67 points on the BNT in individuals followed for an average of 2 years. Overall, the average rate of improvement was +5.84 points per year, in contrast to a decline of 0.23 points per year in a healthy adult cohort from the Mayo Clinic's Older Americans Normative Studies. Naming recovery was approximately linear, with significant main effects of initial BNT score (i.e., initial severity) and time postonset; the greatest changes were noted in those whose initial severity was moderate. Conclusions These findings indicate a positive prognosis for naming improvement over time regardless of demographic factors and provide estimates for clinical predictions for those who seek rehabilitation during the chronic phase.

An examination of cultural-linguistic influences on PPVT-4 performance in African American and Hispanic preschoolers from low-income communities.

In this study, we examined potential influences of cultural and linguistic background on PPVT-4 performance in a community sample of preschool-age children from low-SES households. We did this by evaluating PPVT-4 item-level performance across African American and Hispanic children from low-income families. We compared PPVT-4 item-level performance for 332 Hispanic and African American children (Mage = 48 months) using Wald chi-square tests of independence. There were clinically significant differences in accuracy on 14 PPVT-4 test items with most favouring the African American group. We then looked at the relationship between African American English use and PPVT-4 scores for a subset of 113 African American children (Mage = 49.9 months). A correlational analysis with PPVT-4 standard scores and a dialect density measure (DDM) in narratives revealed no association between these measures. We concluded that there were potential cultural-linguistic biases in PPVT-4 items that were not explained by income alone for the young Hispanic children.

Pediatric cochlear implant wear time and early language development.

Objectives: The purpose of this study is to analyze spoken language development in the first year of cochlear implant device use for pediatric recipients under five, and to determine the impact of device wear time on receptive and expressive spoken language outcomes using objective datalogging measures.Methods: Retrospective review of 37 children utilizing Cochlear™ processors capable of datalogging, who had completed speech and language testing before implantation and one year post. Hearing Hour Percentage (HHP) was created from datalogging results and two multiple regression analysis were performed including HHP and standard language scores.Results: HHP was found to be a predictor for receptive language outcomes one year after cochlear implant use. HHP was not found to be predictive of expressive language outcomes one year after cochlear implant use.Discussion: Datalogging is a vital objective measure that yields powerful data regarding a child's device use and early receptive spoken language development.Conclusion: In the first year of cochlear implant use, datalogging using the HHP significantly predicted receptive language scores. Increased HHP yielded higher receptive language standard scores. Continued research is needed to see if HHP is predictive of expressive language outcomes after a longer period of cochlear implant use.

Similarities and differences in the lexical-grammatical relation of young dual language learners with and without specific language impairment.

This study examines the lexical-grammatical relation within and across in preschool Latino dual language learners (DLLs) with and without specific language impairment (SLI) using language-specific vocabulary and conceptual lexical-semantic skills. The participants were sixty-one typically developing (TD) Spanish-English speaking DLLs and seventy-four DLLs with SLI from low-income households. Standardized and researcher developed assessment tools were used to measure vocabulary, semantics, and grammar in both Spanish and English. Cross-sectional data were analyzed using hierarchical linear regressions to determine the nature of the lexical-grammatical association within and across languages. The study found significant within-language relations between measures of vocabulary and grammar for both groups. Conceptual vocabulary was a significant predictor for English grammar in both groups. For the SLI group only, both English and Spanish vocabulary scores significantly predicted English grammar and bilingual semantics scores predicted Spanish grammar. These findings underscore the role of language-specific vocabulary on grammatical development and suggest the presence of bilingual bootstrapping in DLLs. However, the degree and nature of cross-linguistic associations vary by language ability and language proficiency. The role of age and nonverbal cognition and clinical implications are also discussed.

A retrospective video analysis of canonical babbling and volubility in infants later diagnosed with childhood apraxia of speech.

Canonical babbling and volubility are common indicators of infant vocal development. If either indicator falls below values found in typical infants, it may be an early signal of a developmental disorder. The aim of this retrospective investigation was to examine home videos for the frequency of canonical babbles, age of canonical babbling onset, and overall volubility of eight infants later diagnosed with childhood apraxia of speech and compare these data to that of six typically developing infants as well as four infants later diagnosed with a speech sound disorder. Results revealed the infants later identified with childhood apraxia of speech used fewer canonical babbles, had later onset of canonical babbling, and fewer syllables per minute (volubility) than the comparison groups. These results suggest that infants later diagnosed with childhood apraxia of speech may be less adept in vocal exploration and in the production of canonical babbles, perhaps due to fewer opportunities for mapping articulatory movement with auditory speech sound outcomes.

Examining the Effect of Semantic Relatedness on the Acquisition of English Collocations.

This study examines whether semantic relatedness facilitates or impedes the acquisition of English collocations by conducting two experiments respectively on Chinese undergraduates. Each experiment was composed of a reading session, a productive test, and a receptive test. Experiment 1 began with the reading session of 28 paired-up words and their collocations (in sentence context). Those words were counterbalanced between two randomly selected groups by cross-matching on semantic relatedness. Results of the productive test revealed that the participants scored significantly higher on test items that were semantically related than the randomly cross-paired counterparts. However, for the receptive test, the participants performed significantly better on semantically unrelated items. Experiment 2 was similar to Experiment 1 except that the word pairs selected were only semantically related and did not have any shared morphemes. Experiment 2 also revealed consistent results. The results of the two experiments consistently illustrate that semantic relatedness may exert a facilitatory effect on language output but an inhibitory effect on the process of language input.

Phonological acquisition and development in Putonghua-speaking children with Autism Spectrum Disorders.

Poor phonological development adversely affects language development and interpersonal communication abilities in children with Autism Spectrum Disorders (ASD). However, the characteristics of phonological development in children with ASD who speak Putonghua (the official standard spoken form of modern Mandarin Chinese) remain largely unknown. This study aims to investigate phonological acquisition and development among Putonghua-speaking children with ASD. Data were collected from participants recruited in Shanghai, China. Two experiments were conducted. In experiment I, phonological acquisition was compared between 16 children with ASD aged 3-6 years and 16 age-matched typically developing (TD) children. In experiment II, phonological acquisition was compared between 26 children with ASD over 6 years old and 26 receptive-language-age-matched TD children. Picture naming was applied to measure participants' phonology - the 21 initials, 36 finals and four tones of Putonghua. Paired-samples t-tests and Fisher's exact tests were applied. In experiment I, scores on initials, finals, tones and total phonology of children with ASD aged 3-6 years were significantly lower than those of age-matched TD children. The pronunciation accuracy rates for initials such as/x, th, l/, finals such as/jaʊ, joʊ, wo/ and Tone 3 (the low-rising tone) in the ASD group were significantly lower than in the TD group. In experiment II, there was no significant difference in overall phonological developmental level between children with ASD over 6 years old and receptive-language-age-matched TD children. Phonological development of Putonghua-speaking children with ASD was significantly lower than that of age-matched TD children but closer to that of receptive-language-age-matched TD children. Further, participants with ASD showed atypical development sequences in both initials and finals.

A sentence repetition task for early language assessment in Spanish

Sentence repetition tasks have been widely used in the last years as a diagnostic tool in developmental language disorders. However in Spanish there are few (if any) of these instruments, especially for younger children. In this context, we develop a new Sentence Repetition Task for assessing language (morphosyntactic) abilities of very young Spanish children. A list of 33 sentences of different length and complexity was created and included in the task. A total of 130 typical developing children from 2 to 4 years of age were engaged in a play situation and asked to repeat the sentences. Children's answers were scored for accuracy at sentence and word level and error analysis at the word level was undertaken. Besides a subsample of 92 children completed a non-word repetition task. First results show its adequacy to children from 2 to 4 years of age, its capacity to discriminate between different developmental levels, and its concurrent validity with the nonword repetition task

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In search for common patterns in aphasia: The case of Spanish wh-dependencies.

BACKGROUND: Research on comprehension of wh-dependencies in Broca's aphasia has resulted in discrepant findings, suggesting that structurally different languages may involve different comprehension patterns. AIMS: In the present study, we investigated whether Spanish speakers with Broca's aphasia rely on a language-specific cue that might facilitate comprehension of object wh-dependencies - the preposition a. Since the preposition a in Spanish indicates animate objects, reliance on this cue would facilitate comprehension of more demanding object wh-dependencies, cancelling out processing differences between structures with subject and object extractions. METHODS: We studied comprehension of subject vs. object quién ("who") and qué ("which") direct and embedded questions, and relative clauses introduced by que in seven speakers with aphasia (SWA): six with Broca's and one with mixed aphasia. Control data were obtained from ten neurologically intact elderly Spanish speakers. RESULTS: Mann-Whitney test revealed that compared to healthy controls, SWA had preserved comprehension of both subject and object who direct questions, object which direct questions, and object relative clauses. However, they exhibited considerably worse comprehension of subject which direct questions, all embedded questions regardless of the extraction site (subject, object) or type of wh-word (who, which), and subject relative clauses. Individual comprehension profiles obtained in a modified t-test and revised standardized difference test, while containing some variability, largely support lack of subject-object asymmetry and objects-better patterns. Furthermore, in direct questions, comprehension of who questions was better than the comprehension of which questions, while the opposite was found in embedded questions. CONCLUSIONS: The lack of significant subject-object asymmetry in most conditions, together with better comprehension of object than subject extractions in direct questions, indicates that Spanish SWA rely on the preposition a in the comprehension of object wh-dependencies. However, this strategy fails in more complex conditions (embedded questions), because the processing costs outweigh the facilitating effects of this cue, unless additional cues to the object are present (object relatives). The present findings have implications for the accounts of wh-dependencies in Broca's aphasia involving Discourse-linking, the Intervener hypothesis, and the Competition model.