Spoken syntax in children with acquired unilateral hemisphere lesions

The spoken syntax of eight left hemisphere lesioned and eight right hemisphere lesioned children were compared to matched controls. The children's lesions were acquired between 0.08 and 6.17 years of age (mean = 1.33 years), and at the time of testing they were between 1.67 and 8.15 years of age (mean = 4.19). Based on analyses of spontaneous language samples, left hemisphere lesioned subjects performed more poorly than did their controls on most measures of simple and complex sentence structure. In contrast right lesioned subjects performed similarly to their controls on these measures, except for a tendency to make more errors in simple sentence structures. These findings provide further evidence that the left and right hemispheres are not comparable in supporting syntactic abilities.     

Narrative skill in children with early unilateral brain injury: a possible limit to functional plasticity

Children with pre‐ or perinatal brain injury (PL) exhibit marked plasticity for language learning. Previous work has focused mostly on the emergence of earlier‐developing skills, such as vocabulary and syntax. Here we ask whether this plasticity for earlier‐developing aspects of language extends to more complex, later‐developing language functions by examining the narrative production of children with PL. Using an elicitation technique that involves asking children to create stories de novo in response to a story stem, we collected narratives from 11 children with PL and 20 typically developing (TD) children. Narratives were analysed for length, diversity of the vocabulary used, use of complex syntax, complexity of the macro‐level narrative structure and use of narrative evaluation. Children’s language performance on vocabulary and syntax tasks outside the narrative context was also measured. Findings show that children with PL produced shorter stories, used less diverse vocabulary, produced structurally less complex stories at the macro‐level, and made fewer inferences regarding the cognitive states of the story characters. These differences in the narrative task emerged even though children with PL did not differ from TD children on vocabulary and syntax tasks outside the narrative context. Thus, findings suggest that there may be limitations to the plasticity for language functions displayed by children with PL, and that these limitations may be most apparent in complex, decontextualized language tasks such as narrative production.     

"Frog, where are you?" Narratives in children with specific language impairment, early focal brain injury, and Williams syndrome

In this cross-population study, we use narratives as a context to investigate language development in children from 4 to 12 years of age from three experimental groups: children with early unilateral focal brain damage (FL; N=52); children with specific language impairment (SLI; N=44); children with Williams syndrome (WMS; N=36), and typically developing controls. We compare the developmental trajectories of these groups in the following domains: morphological errors, use of complex syntax, complexity of narrative structure, and types and frequency of evaluative devices. For the children with early unilateral brain damage, there is initial delay. However, by age 10, they are generally within the normal range of performance for all narrative measures. Interestingly, there are few, if any, side specific differences. Children with SLI, who have no frank neurological damage and show no cognitive impairment demonstrate significantly more delay on all morphosyntactic measures than the FL group. Quantitatively, on morphosyntactic measures, the SLI group clusters with those children with WMS who are moderately retarded. Together these data help us to understand the extent and nature of brain plasticity for language development and those aspects of language and discourse that are dissociable.     

Early language development after peri-natal stroke

Early unilateral brain damage has different implications for language development than does similar damage in adults, given the plasticity of the developing brain. The goal of this study was to examine early markers of language and gesture at 12 and 24 months in children who had peri-natal right hemisphere (RH) or left hemisphere (LH) stroke (n = 71), compared with typically developing controls (n = 126). Parents completed the MacArthur-Bates Communicative Development Inventory (CDI): Words & Gestures (12 month data point), or the CDI: Words & Sentences (24 month data point). Statistical analyses were performed on percentile scores using analysis of variance techniques. At 12 months, there were no differences among groups for Words Understood, Phrases Understood or Words Produced. At 24 months, both lesion groups scored significantly lower than controls on Word Production, Irregular Words, and Mean Length of Sentences, but lesion groups did not differ from each other. In a longitudinal subset of participants, expressive vocabulary failed to progress as expected from 12 to 24 months in the stroke group, with no differences based on lesion side. Gesture and word production were dissociated in the left hemisphere subjects. Findings suggest that early language development after peri-natal stroke takes a different course from that of typical language development, perhaps reflecting brain reorganization secondary to plasticity in the developing brain.     

Spoken language correlates of reading impairments acquired in childhood

This study reports the reading difficulties of five children following unilateral left hemisphere stroke sustained either before or during the early stages of literacy acquisition. Although each of the children experienced a period of disturbed language processing in the initial stages postonset, at the time of testing none of the children were considered to be clinically aphasic. Yet, on a standardized test of oral reading each of the children achieved a reading age that lagged behind chronological age and marked reading impairments were disclosed in four of the five children. A set of standardized and nonstandardized tests, aimed at measuring aspects of cognitive and spoken language processing that are considered to be important for normal reading acquisition, was administered. Where nonstandardized tests were used, performance of each of the stroke children was compared to that of groups of normally developing control children, closely matched for chronological age. A range of residual deficits in cognitive and spoken language processing was disclosed among the five brain-damaged children that appeared to be associated with their reading impairments. Two children had expectedly poor reading due to a selective impairment in verbal IQ; a specific phonological reading disorder was revealed in two children, each of which had a residual impairment to phonological awareness; and delayed reading acquisition was observed in one child with a general language deficit. It is suggested that when a child suffers damage to the left hemisphere in the early stages of reading acquisition, difficulties with learning to read are likely to ensue and may arise as a consequence of an underlying cognitive or linguistic deficit.     

Social and affective impairments are important recovery after acquired stroke in childhood

Despite a congenital stroke, overall intelligence at school age is generally within the normal range. Language acquisition problems are more prominent when children are younger (<5 years of age) than when they are older. They are present after both right and left lesions, but appear to have different features. They are less apparent than in the child with a developmental language disorder. Acquired aphasia in childhood results in subtle and often persisting deficits. Children with congenital strokes are at risk for behavioral and psychiatric problems. Those with congenital right hemisphere strokes appear to be more difficult infants, but there is no clear side of lesion effect in older children. Children with congenital right hemisphere strokes have more prominent spatial difficulties than their left lesion counterparts. Evaluating both the process and the product highlights this. Increasing the difficulty of the task often brings out deficits in the right lesion group even when they seemingly recovered.     

Language Outcome After Perinatal Stroke: Does Side Matter?

The goal of this study was to examine structured language skills in children with perinatal strokes. Participants were 28 school-age children with early focal brain lesions (17 with left hemisphere [LH] damage, 11 with right hemisphere [RH] damage), and 57 controls. A standardized test of language (Clinical Evaluation of Language Fundamentals–Revised) was administered. Receptive, Expressive, and Total Language scores, as well as subtest scores, were analyzed. Control participants scored within the normal range, whereas the LH and RH groups scored significantly more poorly than did controls. There were no differences between the LH and RH groups on any of the language scores, and all scores were below the 14th percentile. Within the lesion group as a whole, scores were not related to lesion laterality, site, or severity. Results also were not accounted for by socioeconomic status or IQ. However, children who experienced seizures demonstrated significantly poorer performance than did children who did not experience seizures. Damage to either the LH or RH early in development adversely affects later language abilities, particularly on tasks with structured and complex linguistic demands. Although lesion side has little effect, the presence or absence of seizures is a major contributor to language outcome.     

Language outcome after perinatal stroke: does side matter?

The goal of this study was to examine structured language skills in children with perinatal strokes. Participants were 28 school-age children with early focal brain lesions (17 with left hemisphere [LH] damage, 11 with right hemisphere [RH] damage), and 57 controls. A standardized test of language (Clinical Evaluation of Language Fundamentals-Revised) was administered. Receptive, Expressive, and Total Language scores, as well as subtest scores, were analyzed. Control participants scored within the normal range, whereas the LH and RH groups scored significantly more poorly than did controls. There were no differences between the LH and RH groups on any of the language scores, and all scores were below the 14th percentile. Within the lesion group as a whole, scores were not related to lesion laterality, site, or severity. Results also were not accounted for by socioeconomic status or IQ. However, children who experienced seizures demonstrated significantly poorer performance than did children who did not experience seizures. Damage to either the LH or RH early in development adversely affects later language abilities, particularly on tasks with structured and complex linguistic demands. Although lesion side has little effect, the presence or absence of seizures is a major contributor to language outcome.     

The relationship between spoken language and speech and nonspeech processing in children with autism: a magnetic event‐related field study

It has been proposed that language impairments in children with Autism Spectrum Disorders (ASD) stem from atypical neural processing of speech and/or nonspeech sounds. However, the strength of this proposal is compromised by the unreliable outcomes of previous studies of speech and nonspeech processing in ASD. The aim of this study was to determine whether there was an association between poor spoken language and atypical event‐related field (ERF) responses to speech and nonspeech sounds in children with ASD (n = 14) and controls (n = 18). Data from this developmental population (ages 6–14) were analysed using a novel combination of methods to maximize the reliability of our findings while taking into consideration the heterogeneity of the ASD population. The results showed that poor spoken language scores were associated with atypical left hemisphere brain responses (200 to 400 ms) to both speech and nonspeech in the ASD group. These data support the idea that some children with ASD may have an immature auditory cortex that affects their ability to process both speech and nonspeech sounds. Their poor speech processing may impair their ability to process the speech of other people, and hence reduce their ability to learn the phonology, syntax, and semantics of their native language.     

Spoken Language Outcomes after Hemispherectomy: Factoring in Etiology

We analyzed postsurgery linguistic outcomes of 43 hemispherectomy patients operated on at UCLA. We rated spoken language (Spoken Language Rank, SLR) on a scale from 0 (no language) to 6 (mature grammar) and examined the effects of side of resection/damage, age at surgery/seizure onset, seizure control postsurgery, and etiology on language development. Etiology was defined as developmental (cortical dysplasia and prenatal stroke) and acquired pathology (Rasmussen's encephalitis and postnatal stroke). We found that clinical variables were predictive of language outcomes only when they were considered within distinct etiology groups. Specifically, children with developmental etiologies had lower SLRs than those with acquired pathologies (p =.0006); age factors correlated positively with higher SLRs only for children with acquired etiologies (p =.0006); right-sided resections led to higher SLRs only for the acquired group (p =.0008); and postsurgery seizure control correlated positively with SLR only for those with developmental etiologies (p =.0047). We argue that the variables considered are not independent predictors of spoken language outcome posthemispherectomy but should be viewed instead as characteristics of etiology.     

Patterns of language and discourse comprehension skills in school‐aged children with autism spectrum disorders

Åsberg, J. (2010). Patterns of language and discourse comprehension skills in school‐aged children with autism spectrum disorders. Scandinavian Journal of Psychology 51, 534–539. The present study examined patterns of language and discourse comprehension skills in Swedish school‐aged children with autism spectrum disorders (ASD) (n = 16) as compared to a slightly younger group of typically developing children (n = 16) matched for non‐verbal cognitive ability. Results suggested significantly lower abilities in narrative discourse comprehension for the ASD group, but not in oral receptive vocabulary or reception of grammar. This difficulty with discourse‐level comprehension appeared to be of a general nature, as no evidence was found for the hypothesis that participants with ASD would find comprehension of inferential discourse information disproportionally more difficult than stated information, or for the hypothesis that discourse processing in ASD would be characterized by an elevated processing of explicitly stated narrative details. The study has clinical and educational implications, as the findings suggest that children with ASD would benefit from being offered specific support for discourse‐level comprehension.     

Rapid Gains in Speed of Verbal Processing by Infants in the 2nd Year

Infants improve substantially in language ability during their 2nd year. Research on the early development of speech production shows that vocabulary begins to expand rapidly around the age of 18 months. During this period, infants also make impressive gains in understanding spoken language. We examined the time course of word recognition in infants from ages 15 to 24 months, tracking their eye movements as they looked at pictures in response to familiar spoken words. The speed and efficiency of verbal processing increased dramatically over the 2nd year. Although 15-month-old infants did not orient to the correct picture until after the target word was spoken, 24-month-olds were significantly faster, shifting their gaze to the correct picture before the end of the spoken word. By 2 years of age, children are progressing toward the highly efficient performance of adults, making decisions about words based on incomplete acoustic information.     

Word Detection in Sung and Spoken Sentences in Children With Typical Language Development or With Specific Language Impairment

Background: Previous studies have reported that children score better in language tasks using sung rather than spoken stimuli. We examined word detection ease in sung and spoken sentences that were equated for phoneme duration and pitch variations in children aged 7 to 12 years with typical language development (TLD) as well as in children with specific language impairment (SLI ), and hypothesized that the facilitation effect would vary with language abilities. Method: In Experiment 1, 69 children with TLD (7–10 years old) detected words in sentences that were spoken, sung on pitches extracted from speech, and sung on original scores. In Experiment 2, we added a natural speech rate condition and tested 68 children with TLD (7–12 years old). In Experiment 3, 16 children with SLI and 16 age-matched children with TLD were tested in all four conditions. Results: In both TLD groups, older children scored better than the younger ones. The matched TLD group scored higher than the SLI group who scored at the level of the younger children with TLD . None of the experiments showed a facilitation effect of sung over spoken stimuli. Conclusions: Word detection abilities improved with age in both TLD and SLI groups. Our findings are compatible with the hypothesis of delayed language abilities in children with SLI , and are discussed in light of the role of durational prosodic cues in words detection.     

Spatial analysis after perinatal stroke: patterns of neglect and exploration in extra-personal space

This study was conducted to determine whether school-aged children who had experienced a perinatal stroke demonstrate evidence of persistent spatial neglect, and if such neglect was specific to the visual domain or was more generalized. Two studies were carried out. In the first, 38 children with either left hemisphere (LH) or right hemisphere (RH) damage and 50 age-matched controls were given visual cancellation tasks varying in two factors: target stimuli and stimulus array. In the second study, tactile neglect was evaluated in 41 children with LH or RH damage and 72 age-matched controls using a blindfolded manual exploration task. On the visual cancellation task, LH subjects omitted more target stimuli on the right, but also on the left, compared with controls. Children with RH lesions also produced a larger number of omissions on both the left and right sides than controls, but with poorer performance on the left. On the manual exploration task, LH children required significantly longer times to locate the target on both sides of the board than did controls. RH children had significantly prolonged search times on the left side, but not on the right, compared with controls. In both tasks, LH subjects employed unsystematic search strategies more often than both control and RH children. The search strategy of RH children also tended to be erratic when compared to controls, but only in the random arrays of the visual cancellation tasks; structure of the target stimuli improved their organization. These results demonstrate that children with early LH brain damage display bilateral difficulties in visual and tactile modalities; a pattern that is in contrast to that seen in adults with LH damage. This may result from disorganized search strategies or other subtle spatial or attentional deficits. Results of performance of RH children suggests the presence of contralateral neglect in both the visual and tactile modalities; a finding that is similar to the neglect in adult stroke patients with RH lesions. The fact that deficits in spatial attention and organizational strategies are present after very early focal damage to either the LH or the RH broadens our understanding of the differences in functional lateralization between the immature and mature brain. These results also add to evidence for limitations to plasticity in the developing brain. Our findings may have therapeutic and rehabilitative implications for the management of children with early focal brain lesions.     

Online measures of basic language skills in children with early focal brain lesions

Twenty children with early focal lesions were compared with 150 age-matched control subjects on 11 online measures of the basic skills underlying language processing, a digit span task, and 6 standardized measures. Although most of the children with brain injury scored within the normal range on the majority of the tasks, they also had a disproportionately high number of outlier scores on the reaction time tests. This evidence for a moderate impairment of the basic skills underlying language processing contrasts with other evidence suggesting that these children acquire normal control of the functional use of language. Furthermore, these children scored within the normal range on a measure of general cognitive ability, suggesting that there is no particular sparing of linguistic functions at the expense of general cognitive functions. Using the MPD procedure (Valdés-Pérez & Pericliev, 1997), we found that the controls and the five clinical groups could be best distinguished with two measures of online processing (word repetition and visual number naming) and one standardized test subcomponent (the CELF Oral Directions subtest). The 12 children with left hemisphere lesions scored significantly lower than the 8 other children on the CELF-RS measure. Within the group of children with cerebral infarct, the nature of the processing disability could be linked fairly well to site of lesion. Otherwise, there was little relation between site or size of lesion and the pattern of deficit. These results support a model in which damage to the complex functional circuits subserving language leads to only minor deficits in process efficiency, because of the plasticity of developmental processes.     

Productive use of the English past tense in children with focal brain injury and specific language impairment

In this study, 22 children with early left hemisphere (LHD) or right hemisphere (RHD) focal brain lesions (FL, n=14 LHD, n=8 RHD) were administered an English past tense elicitation test (M=6.5 years). Proportion correct and frequency of over-regularization and zero-marking errors were compared to age-matched samples of children with specific language impairment (SLI, n=27) and with typical language development (TD, n=27). Similar rates of correct production and error patterns were observed for the children with TD and FL; whereas, children with SLI produced more zero-marking errors than either their FL or TD peers. Performance was predicted by vocabulary level (PPVT-R) for children in all groups, and errors did not differ as a function of lesion side (LHD vs. RHD). Findings are discussed in terms of the nature of brain-language relations and how those relationships develop over the course of language learning.     

Narrative Discourse in Children with Early Focal Brain Injury

Children with early brain damage, unlike adult stroke victims, often go on to develop nearly normal language. However, the route and extent of their linguistic development are still unclear, as is the relationship between lesion site and patterns of delay and recovery. Here we address these questions by examining narratives from children with early brain damage. Thirty children (ages 3;7–10;10) with pre- or perinatal unilateral focal brain damage and their matched controls participated in a storytelling task. Analyses focused on linguistic proficiency and narrative competence. Overall, children with brain damage scored significantly lower than their age-matched controls on both linguistic (morphological and syntactic) indices and those targeting broader narrative qualities. Rather than indicating that children with brain damage fully catch up, these data suggest that deficits in linguistic abilities reassert themselves as children face new linguistic challenges. Interestingly, after age 5, site of lesion does not appear to be a significant factor and the delays we have witnessed do not map onto the lesion profiles observed in adults with analogous brain injuries.     

Perceptual simulation in developing language comprehension

We tested an embodied account of language proposing that comprehenders create perceptual simulations of the events they hear and read about. In Experiment 1, children (ages 7–13 years) performed a picture verification task. Each picture was preceded by a prerecorded spoken sentence describing an entity whose shape or orientation matched or mismatched the depicted object. Responses were faster for matching pictures, suggesting that participants had formed perceptual-like situation models of the sentences. The advantage for matching pictures did not increase with age. Experiment 2 extended these findings to the domain of written language. Participants (ages 7–10 years) of high and low word reading ability verified pictures after reading sentences aloud. The results suggest that even when reading is effortful, children construct a perceptual simulation of the described events. We propose that perceptual simulation plays a more central role in developing language comprehension than was previously thought.     

Language Development in Children with Simple-Partial Left-Hemisphere Epilepsy

The nature of cerebral involvement in the acquisition of language was addressed in this longitudinal study of children with an early diagnosis of epilepsy with simple-partial seizures (SPE) and with epileptogenic foci localized in the left frontal (LF) lobe. Yearly evaluations of six SPE-LF children on tests of linguistic comprehension (pointing, understanding of narrative, and understanding of prepositions) and production (repetition, lexical diversity, and grammatical production) were carried out between the ages of 3 and 8 years and compared to those of large samples of control children on the same tasks and at each age level. Linguistic production of all children were transcribed, coded, and analyzed using the Child Language Data Exchange System (MacWhinney & Snow, 1991). Individual evolution trajectories revealed that SPE-LF children showed a clear dissociation in linguistic performance between comprehension and production. Linguistic comprehension gradually improved to reach normal performance levels by age 7 while linguistic production, even at later stages, remained quite poor. This dissociation in the development of linguistic performance in SPE-LF children suggests a complex interplay between brain maturation dynamics and dysfunction modulating the succession of stages in language development. The observed persistent deficits in specific aspects of linguistic performance argue for an early involvement of the anterior areas of the left cerebral hemisphere in the production of language.     

Visual working memory in young children

Five experiments investigated immediate memory for drawings of familiar objects in children of different ages. The aims were to demonstrate younger children’s greater dependence on visual working memory and to explore the nature of this memory system. Experiment 1 showed that visual similarity of drawings impaired recall in young (5-year-old) children but not in older (10-year-old) children. Experiment 2 showed that younger and older children were affected in contrasting ways when the temporal order of recall was manipulated. Experiment 3 explored a recency effect found in backward recall and investigated its sensitivity to the presentation modality of materials used to produce retroactive interference (RI). For younger children, recency was reduced by visual but not by auditory-verbal RI; for older children, recency was more sensitive to auditoryverbal RI. Experiment 4 confirmed the effect of visual RI on visual recency in young children and showed that the same RI had little effect on their recall of spoken words. These results confirm younger children’s dependence on visual working memory. A final experiment showed that the effects of visual similarity and visual RI are additive, suggesting that they reflect different modes of accessing stored visuospatial information. Implications of these findings for developmental issues and for the nature of visual working memory are discussed.