Exploring Cognitive-Pragmatic Heterogeneity Following Acquired Brain Injury: A Cluster Analysis of Hint Comprehension.

PURPOSE: Difficulties understanding nonliteral language (especially hints) are frequently reported following acquired brain injury (ABI). Several cognitive mechanisms, such as context processing, executive functions, and theory of mind (ToM), may underlie these disorders. However, their role remains controversial, mainly because of the characteristic heterogeneity of this population. Therefore, our study aimed to identify cognitive-pragmatic profiles in individuals with ABI. METHOD: A new task of hint comprehension, manipulating executive demand, markers of hints, and ToM and neuropsychological tests were administered to 33 participants with frontal ABI and 33 control participants. Cluster analysis, a method sensitive to profile heterogeneity, was applied and coupled with error analysis. RESULTS: We highlighted two cognitive-pragmatic profiles. One subgroup of participants with ABI exhibited contextual insensitivity, leading them to infer the utterance meaning based on linguistic decoding alone-literal meaning. This difficulty in understanding hints was associated with deficits in working memory, inhibition, and ToM. The second subgroup of participants with ABI showed difficulty with literal statements, associated with impaired inhibition and ToM. In addition, the two subgroups differed only on the ToM task. This result suggests that various types of ToM deficit (misunderstanding vs. incorrect attribution of mental states) could contribute to the variability of the pragmatic profiles observed (difficulties in interpreting hints vs. literal statements). CONCLUSION: The experimental design adopted in this study provides valuable insight into the explanatory hypotheses of nonliteral language comprehension disorders and has important clinical implications. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.24069516.

Acquisition of grammatical aspect by Mandarin-speaking preschool children with autism spectrum disorder.

BACKGROUND: Mandarin-speaking children with autism spectrum disorder (ASD) have difficulties producing aspect markers. The difficulties were explained in terms of pragmatic deficits since these children demonstrated strength in the comprehension of aspect markers using the Intermodal Preferential Looking (IPL) task. AIMS: To verify whether this dissociation between production and comprehension could be replicated using another technique to the IPL, and if all children with ASD show difficulties in the production of aspect markers. METHODS & PROCEDURES: A total of 34 children with ASD without cognitive delay, half with language impairment (ALI; mean age = 61.25 months old) and half with normal language (ALN, mean age = 61.52 months old), as well as 17 age-matched typically developing (TD) children (mean age = 61.38 months old) participated in a sentence-picture-matching task and a priming picture-description task to investigate their comprehension and production of Mandarin aspect markers zai-, -le and -zhe. OUTCOMES & RESULTS: In the comprehension task, children in the ALN group performed similarly to their TD peers, but those in the ALI group were less accurate on zai- and -le than TD children; children in all groups received higher accuracy when zai- was combined with Activity rather than Accomplishment verbs, and those in the ALI group was also more accurate when -le occurred with Achievement verbs, in contrast to Activity verbs. In the production task, children in the ALI group produced fewer targets and more irrelevant sentences with zai- than their TD peers, and they tended to produce bare verbs for -le and -zhe than TD children; children in all groups tended to combine zai- with Activity verbs, and those in the ALN group also tended to combine -le with Achievement verbs. CONCLUSIONS & IMPLICATIONS: The comprehension and production of Mandarin aspect markers by children with ASD are linked to general language abilities, and interactions between lexical and grammatical aspect. Patterns of performance are similar to those of TD peers only for the subgroup with spared global language, while pragmatic deficits are pervasive throughout the spectrum. Therefore, training on formal language, with a specific emphasis on aspectual rather than pragmatic abilities, may be more effective at enhancing the production of aspect markers. WHAT THIS PAPER ADDS: What is already known on this subject Mandarin-speaking children with ASD have difficulties producing aspect markers but demonstrate strengths in aspectual comprehension via the IPL task. Therefore, it has been proposed that their 'specific' difficulties in aspectual production should be ascribed to their pragmatic deficits. However, pragmatic deficits are highly pervasive in children with ASD while only a subgroup of children with ASD who are impaired in language development (children with ALI) show difficulties in producing tense/aspect morphology. Pursuing this reasoning, pragmatic deficits might not be the critical factor impacting the performance of children with ASD in aspectual production. What this study adds Children with ASD were divided into one group with ALI and the other with normal language (ALN). Results of a sentence-picture-matching and a priming picture-description task illustrated that both groups preserved the comprehension of Mandarin aspect markers zai-, -le and -zhe. However, children with ALI performed worse than age-matched TD children, while children with ALN demonstrated similar performance to TD children in aspectual production. These findings, coupled with the fact that pragmatic challenges affect individuals throughout the spectrum, suggest that general language abilities rather than pragmatics better explain the performance of children with ASD on aspectual production. What are the potential or actual clinical implications of this work? Since general language abilities rather than pragmatic deficits of children with ASD determine their performance on the production of aspect markers, direct training on the use of aspect markers or more global language therapy could benefit children with ASD in the production of aspect markers.

Linguagem e comunicação na perspectiva do sujeito com esquizofrenia / Language and communication from the perspective of people with schizophrenia / Lenguaje y comunicación desde la perspectiva del sujeto con esquizofrenia

Introdução: a esquizofrenia apresenta um conjunto de sintomas cognitivos, psicóticos, afetivos e emocionais que influenciam a linguagem e o processo comunicativo. Objetivo: refletir sobre o impacto das manifestações linguístico-discursivas da esquizofrenia na comunicação, a partir da perspectiva de sujeitos com esse transtorno mental, além de descrever as principais manifestações linguísticas presentes no discurso desses indivíduos. Método: estudo transversal, descritivo e qualitativo, com modelo de amostragem não probabilística por conveniência, realizado em um Centro de Atendimento Psicossocial. Realizou-se análise de prontuários e entrevista semiestruturada com usuários do serviço de saúde diagnosticados com esquizofrenia. Os resultados foram submetidos à análise estatística descritiva, sendo que as entrevistas foram exploradas de forma qualitativa por meio da "Análise Temática do Conteúdo", após transcrição das falas na íntegra. Resultados: metade dos participantes relatou satisfação e conforto comunicativo, enquanto a outra metade informou dificuldade de comunicação associada a sentimentos de frustração, má disposição, nervosismo e receio de falar em público. Tais sentimentos parecem estar relacionados à postura de desvalorização e estigma do interlocutor perante o discurso de pessoas com esquizofrenia. Observaram-se as seguintes manifestações linguístico-discursivas: descarrilamento e alogia. Não é possível afirmar que uma das manifestações linguístico-discursivas observadas nos participantes, a alogia, esteja associada, exclusivamente, à sintomatologia do transtorno mental, visto que a condição de segregação e estigma social pode ser um fator determinante na redução da produção do discurso. Conclusão: os sintomas de linguagem característicos da esquizofrenia impactam as relações de comunicação dos sujeitos diagnosticados com esse transtorno mental.

Introduction: schizophrenia has a set of cognitive, psychotic, affective and emotional symptoms that influence language and the communicative process. Objective: to reflect on the impact of linguistic-discursive manifestations of schizophrenia on communication, from the perspective of individuals with this mental disorder, in addition to describing the main manifestations present in the speech of these individuals. Method: cross-sectional, descriptive and qualitative study, with a non-probabilistic sampling model for convenience, carried out in a Psychosocial Service Center. Analyses of medical records and semi-structured interviews with users of the health service, diagnosed with schizophrenia, were performed. The results were subjected to descriptive statistical analysis, and the interviews were explored in a qualitative way through the "Thematic Content Analysis", after transcribing the speeches. Results: half of the participants reported satisfaction and communicative comfort, while the other half reported communication difficulties, associated with feelings of frustration, nervousness and fear of speaking in public. Such feelings seem to be related to the attitude of devaluation and stigma of the interlocutor regarding the speech of people with schizophrenia. The following discursive linguistic manifestations were observed: derailment and allogy. It is not possible to state that one of the linguistic-discursive manifestations observed in the participants, the allogy, is associated exclusively with the symptoms of mental disorder, since the condition of segregation and social stigma can be a determining factor in reducing the production of speech. Conclusion: the language symptoms characteristic of schizophrenia impact the communication relationships of subjects diagnosed with this mental disorder.

Introducción: la esquizofrenia tiene un conjunto de síntomas cognitivos, psicóticos, afectivos y emocionales que influyen en el lenguaje y el proceso comunicativo. Objetivo: Reflexionar sobre el impacto de las manifestaciones lingüístico-discursivas de la esquizofrenia en la comunicación, desde la perspectiva de sujetos con este trastorno mental, además de describir las principales manifestaciones presentes en el discurso de estos individuos. Método: estudio transversal, descriptivo y cualitativo, con un modelo de muestreo no probabilístico por conveniencia, realizado en un Centro de Servicios Psicosociales. Se realizaron análisis de historias clínicas y entrevistas semiestructuradas a usuarios del servicio de salud, diagnosticados de esquizofrenia. Los resultados fueron sometidos a análisis estadístico descriptivo, y las entrevistas fueron exploradas de manera cualitativa a través del "Análisis de contenido temático", luego de transcribir los discursos en forma íntegra. Resultados: la mitad de los participantes reportó satisfacción y comodidad comunicativa, mientras que la otra mitad reportó dificultades de comunicación, asociadas con sentimientos de frustración, nerviosismo y miedo a hablar en público.Tales sentimientos parecen estar relacionados con la actitud de desvalorización y estigma del interlocutor con respecto al discurso de las personas con esquizofrenia. Se observaron las siguientes manifestaciones lingüísticas discursivas: descarrilamiento y alogía. No es posible afirmar que una de las manifestaciones lingüístico-discursivas observadas en los participantes, la alología, esté asociada exclusivamente a los síntomas del trastorno mental, ya que la condición de segregación y estigma social puede ser un factor determinante en la reducción de la producción del habla. Conclusión: los síntomas del lenguaje característicos de la esquizofrenia impactan las relaciones de comunicación de los sujetos diagnosticados con este trastorno mental.

The Relation Between Academic Word Use and Reading Comprehension for Students From Diverse Backgrounds.

Purpose The aims of the current project were twofold: (a) to describe the use of academic words in written language samples by fifth-grade students and (b) to examine the predictive relation between academic word use in academic writing and reading comprehension. Method Investigators utilized written expository responses of 1,128 students in fifth grade who differed in English proficiency and language ability. The sample included 214 students who were English learners (ELs) and 144 students with identified language learning disabilities (LLD). Group differences in the use of academic words from the Coxhead word list were examined. Results ELs and students with LLD used academic words less frequently than their peers and demonstrated less variety in their academic word use. There was a significant relation between students' use of academic words and reading comprehension. Academic word use accounted for 16% of the variance in reading comprehension, which was not significantly different for ELs or students with LLD. The relation was moderated by economic advantage, with the strength of the relation being lower for students who were eligible for free/reduced lunch. Conclusions Findings support the need for additional research on ways to improve academic vocabulary skills to minimize achievement gaps. The relation between academic word use and reading comprehension warrants further consideration.

Generalized Effects of Naturalistic Social Communication Intervention for Minimally Verbal Children with Autism.

JASP-EMT, the combined Enhanced Milieu Teaching (EMT) and Joint Attention, Structured Play, and Emotion Regulation (JASPER) interventions, has been found to be effective for promoting social communication in young children with autism (Kasari et al. in J Am Acad Child Adolesc Psychiatry 53(6):635-646, https://doi.org/10.1016/j.jaac.2014.01.019 , 2014). The current study examined the effects of this naturalistic intervention on social language use in three children with autism who were in the early stages of language acquisition. Generalization to communication partners who did not utilize the intervention strategies was systematically examined using a multiple-baseline design. The results from this study indicate that this blended intervention is effective in increasing target social language for young children with autism, however, generalization to communication partners does not readily occur. Implications for practice and future research are discussed.

A Pilot Study Comparing Tele-therapy and In-Person Therapy: Perspectives from Parent-Mediated Intervention for Children with Autism Spectrum Disorders.

Conclusions about the efficacy of tele-therapy for parent-mediated intervention for children with Autism Spectrum Disorders (ASD) are limited, due to the shortage of direct comparisons between tele-therapy and traditional face-to-face therapy. In this study, we implemented a parent training program, which targeted on language facilitating intervention strategies. Fifteen parents of children with ASD participated in person, and 15 participated via online video conferencing. We measured parents' intervention fidelity and children's initiations, responses, lexical diversity and morphosyntactic complexity. Results indicated significant improvements in parents' fidelity and children's lexical diversity and morphosyntactic complexity. No significant differences were detected between the two therapy delivery groups on any outcome measures. Finally, children's progress on morphosyntactic complexity was significantly correlated with parents' improvement on fidelity.

Descriptive study of young disabled children aged 2-6, enrolled in mainstream schools, and benefiting from special needs assistants in the Bouches-du-Rhône in 2014.

BACKGROUND: Since the law of February 11, 2005, in France, the number of children with disabilities enrolled in ordinary schools has increased steadily. As a result, the amount of personal support provided by a special needs assistant (personal support) is also increasing. The aim of the study was to describe the diseases and impairments of disabled children aged 2-6, enrolled in mainstream schools and benefiting from personal support for schooling by special needs assistants in the Bouches-du-Rhône (France) in 2014. METHODS: A cross-sectional descriptive study was performed. Children included were benefiting from either an individual or shared personal support. Physicians from the territorial organization in charge of disability coded diseases and deficiencies using the International Classification of Diseases, 10th revision, and nomenclature inspired by the International Classification of Functioning, Disability and Health. RESULTS: Medical data were coded for 990 children out of 1260 of the total population. These young disabled children were most frequently children with pervasive developmental disorders (23.3%), lack of expected normal physiological development (19.9%), or mixed specific developmental disorders (13.5%), and most often had behavioral, personality, and relational skills disorders (61.8%), psychomotor function impairments (51.9%), or written or oral language learning impairment (43.2%). Finally, the two main types of impairments most represented among these children were psychological impairments (86.7%) and language and speech impairments (79.8%). The children were most often supported by an individual personal support (for one child only) than by a shared personal support (60% vs. 40%). They were mainly boys (almost 75%). CONCLUSION: This study provides working guidelines for the management of health policies relating to disability at the territorial or even national level.

Profile of language abilities in a sample of adults with developmental disorders.

This study investigated the profile of language abilities in a sample of high-achieving English speaking adults with developmental disorders. Ninety-seven adult participants were recruited: 49 with a dyslexia diagnosis (dyslexic group), 16 with a diagnosis of a different developmental disorder including dyspraxia, autism and SpLD (non-dyslexic developmental disorder group) and 32 with no diagnosis (non-disordered group). Dyslexic and non-dyslexic developmental disorder groups demonstrated similar impairments across measures of word reading, working memory, processing speed and oral language. Dyslexic participants showed the usual pattern of impaired phonological skills but spared non-verbal intelligence and vocabulary. There were also some suggestions of impaired structural oral language skills in this group. A data-driven clustering analysis found that diagnosis was not a reliable predictor of similarity between cases, with diagnostic categories split between data-driven clusters. Overall, the findings indicate that high-achieving adults with developmental disorders do demonstrate impairments that are likely to affect success in higher education, but that support needs should be assessed on a case-by-case basis, rather than according to diagnostic label.

Early Word Reading of Preschoolers with ASD, Both With and Without Hyperlexia, Compared to Typically Developing Preschoolers.

A portion of children with Autism Spectrum Disorder (ASD) exhibit a strength in early word reading referred to as hyperlexia (HPL), yet it remains unclear what mechanisms underlie this strength. Typically developing children (TD) acquire phonological awareness, alphabet knowledge and language skills as precursors to word reading. We compared these skills across English-speaking preschoolers with ASD, both with and without hyperlexia, and TD preschoolers. Findings indicated that the group with both ASD and HPL (ASD + HPL) exhibited advanced word reading and letter naming skills as compared to the other two groups, but did not demonstrate commensurate phonological awareness, letter-sound correspondence, or language skills. Findings support an alternative, non-phonological approach to early word reading in preschoolers with ASD and hyperlexia.

Oral language in children with benign childhood epilepsy with centrotemporal spikes.

PURPOSE: Benign childhood epilepsy with centrotemporal spikes is one of the most common childhood disorders. Despite the benignity usually attributed to this epileptic syndrome, several studies have demonstrated that these children have cognitive disabilities. Among these disturbances, language disorders have been the less studied in depth. We aimed to obtain accurate information about the language skills of children with this epileptic syndrome and to explore the correlation between demographic and clinical factors associated with epilepsy and the language skills. METHODS: We assessed 30 children with this epileptic syndrome, followed in three hospitals in Lisbon, and 60 controls, aged between 6 and 12 years, attending the same schools and matched by age, gender, and parents' socioprofessional level. All the included children did not present cognitive impairment (reasoning ability, verbal memory), sensory, or motor limitations. The evaluation tests covered all language areas. RESULTS: Overall, children with this epileptic syndrome had lower skills in the majority of the language areas, when compared with their peers. These children showed greater difficulties in semantics and syntax domains. The atypical evolution of the seizures and a longer duration of epilepsy were the clinical variables that most influence the language skills of our samples. CONCLUSION: The early assessment of these capacities and the possible need for therapeutic intervention should be emphasized, in order to minimize the impact on their academic performance and quality of life.

Patterns and predictors of language representation and the influence of epilepsy surgery on language reorganization in children and young adults with focal lesional epilepsy.

Mapping brain functions is crucial for neurosurgical planning in patients with drug-resistant seizures. However, presurgical language mapping using either functional or structural networks can be challenging, especially in children. In fact, most of the evidence on this topic derives from cross-sectional or retrospective studies in adults submitted to anterior temporal lobectomy. In this prospective study, we used fMRI and DTI to explore patterns of language representation, their predictors and impact on cognitive performances in 29 children and young adults (mean age at surgery: 14.6 ± 4.5 years) with focal lesional epilepsy. In 20 of them, we also assessed the influence of epilepsy surgery on language lateralization. All patients were consecutively enrolled at a single epilepsy surgery center between 2009 and 2015 and assessed with preoperative structural and functional 3T brain MRI during three language tasks: Word Generation (WG), Rhyme Generation (RG) and a comprehension task. We also acquired DTI data on arcuate fasciculus in 24 patients. We first assessed patterns of language representation (relationship of activations with the epileptogenic lesion and Laterality Index (LI)) and then hypothesized a causal model to test whether selected clinical variables would influence the patterns of language representation and the ensuing impact of the latter on cognitive performances. Twenty out of 29 patients also underwent postoperative language fMRI. We analyzed possible changes of fMRI and DTI LIs and their clinical predictors. Preoperatively, we found atypical language lateralization in four patients during WG task, in one patient during RG task and in seven patients during the comprehension task. Diffuse interictal EEG abnormalities predicted a more atypical language representation on fMRI (p = 0.012), which in turn correlated with lower attention (p = 0.036) and IQ/GDQ scores (p = 0.014). Postoperative language reorganization implied shifting towards atypical language representation. Abnormal postoperative EEG (p = 0.003) and surgical failures (p = 0.015) were associated with more atypical language lateralization, in turn correlating with worsened fluency. Neither preoperative asymmetry nor postoperative DTI LI changes in the arcuate fasciculus were observed. Focal lesional epilepsy associated with diffuse EEG abnormalities may favor atypical language lateralization and worse cognitive performances, which are potentially reversible after successful surgery.

Network Analysis of Language Disorganization in Patients with Schizophrenia.

Language disorganization, an objective component of formal thought process abnormality, has been regarded as a core symptom of schizophrenia from an evolutionary psychopathology perspective. However, to the best of our knowledge, the network structure of language disorganization has rarely been examined in patients with schizophrenia. Thus, our preliminary study aimed to evaluate the network structure using the Clinical Language Disorder Rating Scale (CLANG) in 167 inpatients with schizophrenia. All 17 of the CLANG items were considered to be ordered categorical variables ranging from 0 to 3. Our results indicated that disclosure failure, excess syntactic constraints, abnormal prosody, and aprosodic speech rank among the top five central domains within the network structure. We deemed that disclosure failure and prosody problems are the most important symptoms of language disorder in schizophrenia. Thus, reduced top-down processing of linguistic information may be a core neurobiological underpinning of language disorganization in schizophrenia. Further studies controlling for the potential effects of confounding factors (i.e., duration of illness) on network analyses of language disorder and formal thought disorder are warranted in patients with schizophrenia.

Forum: Morphological Awareness as a Key Factor in Language-Literacy Success for Academic Achievement.

Purpose This article introduces the Language, Speech, and Hearing Services in Schools Forum: Morphological Awareness as a Key Factor in Language-Literacy Success for Academic Achievement. The goal of this forum is to relate the influence morphological awareness (MA) has on overall language and literacy development with morphology acting as the "binding agent" between orthography, phonology, and semantics (Perfetti, 2007) in assessment and intervention for school-aged children. Method This introduction provides a foundation for MA development and explores the influence MA has over the course of school-aged language and literacy development. Through summaries of the 11 articles in this forum, school-based speech-language pathologists will be able to convey the importance of MA to promote successful educational outcomes for kindergarten to adolescent students. The forum explores researcher-developed assessments used to help identify MA skill level in first- through eighth-grade students at risk for literacy failure to support instructional needs. The forum also provides school-based speech-language pathologists with details to design and implement MA interventions to support academic success for school-aged students with varying speech-language needs (e.g., dual language emersion, vocabulary development, reading comprehension) using various service delivery models (e.g., small group, classroom-based, intensive summer camps). Conclusion MA is effective in facilitating language and literacy development and as such can be an ideally focused on using multilinguistic approaches for assessment and intervention. The articles in this issue highlight the importance in assessment measures and intervention approaches that focus on students' MA to improve overall academic success in children of all ages and abilities.

Collecting Words: A Clinical Example of a Morphology-Focused Orthographic Intervention.

Purpose Morphological interventions promote gains in morphological knowledge and in other oral and written language skills (e.g., phonological awareness, vocabulary, reading, and spelling), yet we have a limited understanding of critical intervention features. In this clinical focus article, we describe a relatively novel approach to teaching morphology that considers its role as the key organizing principle of English orthography. We also present a clinical example of such an intervention delivered during a summer camp at a university speech and hearing clinic. Method Graduate speech-language pathology students provided a 6-week morphology-focused orthographic intervention to children in first through fourth grade (n = 10) who demonstrated word-level reading and spelling difficulties. The intervention focused children's attention on morphological families, teaching how morphology is interrelated with phonology and etymology in English orthography. Results Comparing pre- and posttest scores, children demonstrated improvement in reading and/or spelling abilities, with the largest gains observed in spelling affixes within polymorphemic words. Children and their caregivers reacted positively to the intervention. Therefore, data from the camp offer preliminary support for teaching morphology within the context of written words, and the intervention appears to be a feasible approach for simultaneously increasing morphological knowledge, reading, and spelling. Conclusion Children with word-level reading and spelling difficulties may benefit from a morphology-focused orthographic intervention, such as the one described here. Research on the approach is warranted, and clinicians are encouraged to explore its possible effectiveness in their practice. Supplemental Material https://doi.org/10.23641/asha.12290687.

A Systematic Review of Academic Discourse Interventions for School-Aged Children With Language-Related Learning Disabilities.

Purpose This systematic review synthesized a set of peer-reviewed studies published between 1985 and 2019 and addressed the effectiveness of existing narrative and expository discourse interventions for late elementary- and middle school-aged students with language-related learning disabilities. Method A methodical search of the literature for interventions targeting expository or narrative discourse structure for students aged 9-14 years with group experimental designs identified 33 studies, seven of which met specific criteria to be included in this review. Results An 8-point critical appraisal scale was applied to analyze the quality of the study design, and effect sizes were calculated for six of the seven studies; equivocal to small effects of far-transfer outcomes (i.e., generalizability to other settings) and equivocal to moderate near-transfer outcomes (i.e., within the treatment setting) were identified. The most effective intervention studies provided explicit instruction of expository texts with visual supports and student-generated learning materials (e.g., notes or graphic organizers) with moderate dosage (i.e., 180-300 min across 6-8 weeks) in a one-on-one or paired group setting. Greater intervention effects were also seen in children with reading and/or language disorders, compared to children with overall academic performance difficulties. Conclusions A number of expository discourse interventions showed promise for student use of learned skills within the treatment setting (i.e., near-transfer outcomes) but had limited generalization of skills (i.e., far-transfer outcomes). Supplemental Material https://doi.org/10.23641/asha.12449258.

High-level language outcomes three and twelve months after awake surgery in low grade glioma and cavernoma patients.

OBJECTIVE: Knowledge about the long-term outcome of high-level language ability in awake surgery patients with low-grade gliomas or cavernomas in language eloquent regions is limited, particularly regarding subtle changes in high-level language abilities. PATIENTS AND METHODS: The study group consisted of 27 patients with LGG or cavernoma which involved language eloquent regions in the left hemisphere. A comprehensive assessment battery was used to target subtle changes in overall high-level language ability as well as in language sub skills. Assessments were made preoperatively and at 3 and 12 months postoperatively. RESULTS: The results showed that overall high-level language ability had not decreased significantly at group level at 3 or 12 months postoperatively. The proportion of patients with a decline of 5 percent or more at follow up 3 and 12 months were 13% and 9% respectively. There was a marked decline in semantic fluency (animals and verbs) at 3 and 12 months postoperatively. Phonemic fluency, while not significantly reduced at three months, improved markedly in the interval between 3 and 12 months. At 12 months, the only significant decline relative to preoperative scores were seen in semantic fluency for animals and verbs. Verbal cognitive speed did not decline significantly postoperatively but approximately 40% of the patients had a decline of 5% or more at 12 months. CONCLUSIONS: Overall high-level language ability was not significantly affected postoperatively at 3 and 12 months in LGG and cavernoma awake surgery patients. Semantic word fluency had deteriorated postoperatively at 3 and 12 months follow-up. Taken together our results indicate a decline in processing speed of verbal material postoperatively in the patient group.

Computer-Assisted Speech Analysis in Mild Cognitive Impairment and Alzheimer's Disease: A Pilot Study from Shanghai, China.

BACKGROUND: Language dysfunction is a frequently reported symptom in Alzheimer's disease (AD). However, computer-assisted analysis of spontaneous speech in AD and mild cognitive impairment (MCI) is rarely used to date. OBJECTIVE: To characterize the language impairment in AD and amnestic MCI (aMCI) with computer-based automatic analysis via the "Automatic Speech Recognition (ASR) software for cognitive impairment V1.3". METHODS: A total of 64 subjects, including 20 AD patients, 20 aMCI patients, and 24 healthy controls were recruited. All subjects underwent neuropsychological tests, and spontaneous speech samples were recorded through the description of the "Cookie-Theft Picture" and then analyzed by the computerized software. Subsequently, we compared the speech parameters between the subjects and the controls. RESULTS: We identified seven spontaneous speech parameters (percentage of silence duration, average duration of phrasal segments, average duration of silence segments, number of speech segments, number of long pauses, ratio of hesitation/speech counts and ratio of short pause/speech counts) demonstrating significant differences between the three groups (p < 0.05). All seven speech parameters significantly correlated with cognitive performance, with average duration of silence segments demonstrating the best correlation to cognitive performance on stepwise multiple linear regression analysis. CONCLUSION: Computer-assisted automated analysis of speech/silence segments demonstrated the potential to reflect the intrinsic linguistic impairment associated with MCI and AD. It has a promising prospect in the early detection of AD and assessment of disease severity.

Frontotemporal dementias: main syndromes and underlying brain changes.

PURPOSE OF REVIEW: Frontotemporal dementia (FTD) is a rare dementia, that accounts for about 15% of all dementia cases. Despite consensus diagnostic criteria, FTD remains difficult to diagnose in life because of its complex and variable clinical phenomenology and heterogeneous disorders. This review provides an update on the current knowledge of the main FTD syndromes -- the behavioural variant, semantic variant, and nonfluent/agrammatic variant-- their brain abnormalities and genetic profiles. RECENT FINDINGS: The complexity of the clinical features in FTD has become increasingly apparent, particularly in the domain of behaviour. Such behaviour changes are now also being recognized in the language variants of FTD. Initial interest on emotion processing and social cognition is now complemented by studies on other behavioural disturbance, that spans gambling, antisocial behaviours, repetitive behaviours, and apathy. At a biological level, novel pathological subcategories continue to be identified. From a genetic viewpoint, abnormalities in three genes explain nearly three quarters of familial cases of FTD. SUMMARY: In the absence of effective drug treatments, novel approaches are needed to target some of the most disabling features of FTD, such as language loss or behaviour disturbance. Recent interventions appear promising but will require confirmation.

Transient Aphasia Following Resection of a Thalamic Cavernous Malformation.

BACKGROUND: The thalamus has a demonstrated role in language, particularly through its connectivity to frontal language cortices. CASE DESCRIPTION: A 59-year-old man with transient mixed aphasia following resection of a left-sided thalamic cavernous malformation is reported. No operative complications were encountered, and there was no surgical contact with cortical language areas. The patient recovered full language function within a week postoperatively. CONCLUSIONS: The role of thalamic nuclei in language processes and other reports of transient thalamic aphasia are reviewed.

Perspectives of preschool children in England with speech and language needs in the development of evidence-based activities.

BACKGROUND: The existing evidence is limited in terms of perspectives of preschool children with speech and language needs and their views on activities used to support their needs. This paper discusses a stream of work from the interdisciplinary research programme known as "Child Talk," based in England, UK. The overall purpose of this work stream was to gain the perspectives of preschool children aged 2 to 5 years and 11 months, with speech and language needs, to use in the development of an evidence-based framework of activities. METHODS: Twenty-four preschool children with a variety of needs from diverse backgrounds took part. An observational methodology was used to capture children's experiences. Children were filmed during a series of sessions, with innovative head-mounted cameras worn by the children and supported by researcher field notes. Framework analysis was used to analyse the data based on the body movement, vocalization, and visual attention of the children during these sessions. RESULTS AND CONCLUSIONS: Results included that children expressed enjoyment and engagement in the activities. The children expressed themselves and demonstrated their focus "multimodally" through combinations of body language, vocalization, and visual attention. These modalities were present across all contexts and children. It highlights the importance of encouraging participation in preschool children and consequently this innovative piece of work has national and international importance.