Effect of socioeconomic status on aphasia severity and recovery

Low levels of educational attainment and low socioeconomic status have been significantly linked to poor health and increased incidence of disease, including Alzheimer's disease and diseases of the cardiovascular, pulmonary, renal, and gastrointestinal systems. Our goal in the present study was to determine the degree to which educational level and socioeconomic status influence initial severity of aphasia and subsequent recovery. We evaluated the records of 39 persons with aphasia twice: at about 4 months and 103 months postonset. We found early severity of aphasia to be significantly greater for subjects in the lower educational and occupational groups. However, rate of recovery (the slope of the recovery curve) was the same regardless of educational or occupational status.     

Automatic and volitional semantic processing in aphasia.

The present study investigated the status of semantic information in aphasia by comparing the performances of aphasic and nonaphasic subjects on two tasks: an automatic semantic facilitation task and a volitional task of relatedness judgment. Both the aphasic and nonaphasic groups evidenced a semantic facilitation effect, in an on-line task of semantic processing. However, those aphasics with severe comprehension and naming disturbances (termed low comprehension aphasics) demonstrated considerable difficulty in judging the relatedness between a pictured object and members of that object's semantic field, the severity of the impairment being greater for those pictures that the low comprehension aphasics were unable to name. The pattern of results can best be explained by supposing the structural integrity of the store of semantic information in aphasia, and in particular in low comprehension aphasia: information that is retrieved and manipulated in judgment-mediated tasks with considerable difficulty.     

Relation of socioeconomic status to logical and sociomoral judgment of middle-aged men

Empirical links between socioeconomic status and logical and sociomoral judgment were studied. Logical judgment was measured with adaptations of the pendulum and correlations tasks devised by Inhelder and Piaget (1958); sociomoral judgment was scored with the standard Kohlberg interview. Measures of socioeconomic status (SES) were status of family of origin and subject's educational attainment and occupational prestige. In a sample of 83 middle-aged men, the 3 measures of SES accounted for 25% and 12% of the variance in logical and sociomoral judgment, respectively. Adult occupational prestige accounted for 6% of the variance in logical judgment beyond that explained by family status and education, suggesting that adult cognitive functioning may be related to occupational placement, occupational experience, or both.     

Gestural impairment and gestural ability in aphasia: A review

Studies of gestural ability in aphasic subjects have found impairment of gestural expression and comprehension, with a close relationship between severity of aphasia and degree of gestural impairment. A few investigators have correlated gestural ability with specific language functions or subcategories of aphasia. Reading appears to correlate better with gestural recognition than does auditory comprehension. Despite the general findings of gestural impairment in aphasia, successes have been reported with gestural training including artificial language techniques, pantomime, Amerind, and American Sign Language. Future studies of gestural therapy in aphasia should examine specific language deficits in order to identify those aphasic individuals who can benefit from gestural training.     

The association between low socioeconomic status and depressive symptoms depends on temperament and personality traits

Socioeconomic status and personality traits are known to be associated with depression risk. We examined whether temperament and personality traits modified the association between socioeconomic status and depressive symptoms. The participants were 2678 individuals from the Cardiovascular Risk in Young Finns study, aged 18-49 during the three study waves in 1997, 2001, and 2007 included in the present study. Temperament was assessed with the Temperament and Character Inventory, personality with the Five Factor Model, and depressive symptoms with a modified version of Beck’s Depression Inventory. Education, occupational status, and income level were used as indicators of socioeconomic status. Results of multilevel linear regression analysis indicated that low occupational status and income were associated with high depressive symptoms particularly in individuals with high neuroticism or harm avoidance, and with low extraversion or reward dependence. High persistence also strengthened the negative association between income and depressive symptoms, but this interaction effect was not observed with conscientiousness. The mental health risks of low socioeconomic status may therefore be most potent among individuals who are sensitive to negative and threatening stimuli.     

Early literacy among Arabic-speaking kindergartners: The role of socioeconomic status,home literacy environment and maternal mediation of writing

We explored the sociocultural context of early literacy development among Arabic-speaking kindergartners in Israel, focusing on the nature of mother–child joint writing. Eighty-nine kindergartners and their mothers participated. Mothers were videotaped in their homes while helping their children write words. Early literacy was evaluated by alphabetic knowledge, concepts about print, phonological awareness, and vocabulary. Kindergartners’ early literacy was related to socioeconomic status (SES), home literacy environment (HLE) and maternal mediation level. Hierarchical regressions indicate that HLE predicted alphabetic knowledge, phonological awareness, and vocabulary beyond SES. Maternal mediation of writing predicted all children's early literacy measures except vocabulary, after controlling for SES and HLE. We discuss maternally mediated joint writing interactions as a possible context for early literacy enhancement among young Arabic-speaking children in Israel.     

Cognitive function in older adults according to current socioeconomic status

Cognitive function may be influenced by education, socioeconomic status, sex, and health status. Furthermore, aging interacts with these factors to influence cognition and dementia risk in late life. Factors that may increase or decrease successful cognitive aging are of critical importance, particularly if they are modifiable. The purpose of this study was to determine if economic status in late life is associated with cognition independent of socioeconomic status in early life. Cross-sectional demographic, socioeconomic, and cognitive function data were obtained in 2592 older adults (average age 71.6 years) from the Center for Disease Control’s National Health and Nutrition Examination Survey (NHANES) and analyzed with linear regression modeling. Cognitive function, as measured with a test of processing speed, was significantly associated with poverty index scores after adjusting for educational attainment as an estimate of childhood socioeconomic status, ethnic background, age, health status, and sex (P < 0.001). Our findings suggest that current economic status is independently associated with cognitive function in adults over age 60 years.     

Therapy efficacy in chronic aphasia

There is good evidence that aphasia therapy is effective if sufficiently prolonged or intensive and that chronic aphasic individuals can also benefit from therapy, but data on chronic aphasia are scanty. The aim of this retrospective study was to investigate whether chronic aphasia benefits from a very intensive therapeutic regimen. We revised the files (January 2000 to December 2008) of the chronic subjects whom we suggested have periodic sessions in our Unit (generally once a week) and 2-3 hours daily of homework with the help of a family member, supervised and controlled by the speech-therapist. Treatment would go on as long as amelioration is evident. Results for 23 chronic aphasic subjects are reported. All subjects had undergone previous therapy and 10 had been dismissed because no further recovery was expected. Recovery was significant in oral and written nouns and actions naming, oral and written sentence production and Token Test scores. Only 4 subjects did not improve. Severity of the disorder did not predict success or failure. We conclude that recovery was due to the intense work done. Further, we believe such a regimen could be successful in a number of patients for whom a less intensive regimen would not be effective.     

Prosody, linguistic demands, and auditory comprehension in aphasia.

Prosody plays a clear role in the auditory comprehension of narratives by aphasic listeners. Previous research, however, has pointed to questions regarding variables which increase task complexity (e.g., memory, reading level) and the influence of the severity of aphasia. This study examined the role of the severity of aphasia and linguistic complexity in narrative comprehension by aphasic listeners. Findings indicate that while all subject groups improved their auditory comprehension when emphasis was present, people with severe aphasia improved significantly more, but only in a low linguistic complexity condition. However, subjects had additional opportunity for improved performance in both low and high linguistic complexity conditions. These results pose additional questions about perceived task difficulty (and performance) and resource allocation strategies.     

A developmental model for the occupational socioeconomic status of American men

Prior research suggested that psychological, sociological and economic variables, measuring both differential and developmental dimensions, must be considered for an exhaustive analysis of adult vocational status. From the resulting estimated predictive model, occupational socioeconomic status was examined through 16 selected family, ecological, educational, ethnoreligious, and political predictor variables. The data were obtained from a national sample of 1355 American men. Factor analysis supported the hypothesized existence of an educational-socioeconomic factor and a political identification factor, plus a less discrete religiousity factor. Path analysis confirmed that a respondent's education, adult social class, and father's occupational socioeconomic status were principle predictors of the respondent's occupational socioeconomic status.     

Dream recall frequency by socioeconomic status of Chinese students

Whereas the effect of sex and age on dream recall have been studied widely, socioeconomic status has rarely been investigated. However, two studies reported that higher socioeconomic status was related to greater frequency of dream recall. In the present sample of 612 Chinese students from three different schools, one elite (high socioeconomic status), one rural (low socioeconomic status) and one intermediate, analysis of variance indicated no significant association between frequency of dream recall and socioeconomic status. Researchers could investigate whether "dream socialization," e.g., encouragement of a child to remember his dreams, depends on socioeconomic background, whether these processes are mediated by culture.     

Predicting educational achievement from genomic measures and socioeconomic status

The two best predictors of children's educational achievement available from birth are parents’ socioeconomic status (SES) and, recently, children's inherited DNA differences that can be aggregated in genome‐wide polygenic scores (GPS). Here, we chart for the first time the developmental interplay between these two predictors of educational achievement at ages 7, 11, 14 and 16 in a sample of almost 5,000 UK school children. We show that the prediction of educational achievement from both GPS and SES increases steadily throughout the school years. Using latent growth curve models, we find that GPS and SES not only predict educational achievement in the first grade but they also account for systematic changes in achievement across the school years. At the end of compulsory education at age 16, GPS and SES, respectively, predict 14% and 23% of the variance of educational achievement. Analyses of the extremes of GPS and SES highlight their influence and interplay: In children who have high GPS and come from high SES families, 77% go to university, whereas 21% of children with low GPS and from low SES backgrounds attend university. We find that the associations of GPS and SES with educational achievement are primarily additive, suggesting that their joint influence is particularly dramatic for children at the extreme ends of the distribution.     

Community identity as a mediator of the relationship between socioeconomic status and altruistic behaviour in Chinese residents

Socioeconomic status is related to altruistic behaviour, but the link between them remains controversial. The present study explored the link between socioeconomic status and altruistic behaviour, as well as the psychological mechanism between them. We recruited 1,052 residents from 34 provinces in China to investigate the relationship between socioeconomic status and altruistic behaviour and the mediating mechanism. Results showed that objective socioeconomic status was positively related to altruistic behaviour. Subjective socioeconomic status was positively associated with community identity and altruistic behaviour. Community identity mediated the relationship between subjective socioeconomic status and altruistic behaviour. The findings suggest that enhancing individuals' community identity or subjective status perception can effectively increase their altruistic behaviour.     

Childhood intelligence and adult health: The mediating roles of education and socioeconomic status

The longitudinal relation between childhood intelligence and various health outcomes in adulthood is now well-established. One mediational model that accounts for this relation proposes that intelligence has cumulative indirect effects on adult health via subsequent educational attainment and adult socioeconomic status (SES). The aim of the present study was to examine whether and the extent to which educational attainment and SES mediate the impact of childhood intelligence on three dimensions of adult health in Luxembourg, a country with high-quality universal public health care. We used data from 745 participants in the Luxembourgish MAGRIP study. At the age of 12, participants completed a comprehensive intelligence test. At the age of 52, they reported their educational careers, SES, and functional, subjective, and physical health status. Using structural equation modeling, we investigated the direct and indirect effects (via educational attainment and adult SES) of childhood intelligence on adult health. We found that higher childhood intelligence predicted better functional, subjective, and physical health in adulthood. These effects were entirely mediated via educational attainment and SES. The mediational processes differed depending on the health dimension under investigation: Whereas SES was crucial in mediating the effect of intelligence on functional and subjective health, educational attainment was crucial in mediating the effect on physical health. These findings held up when considering adult intelligence and were similar for women and men. Our results suggest that even excellent public health care cannot fully offset the cumulative effects of childhood intelligence on adult health. Further studies are needed to investigate the relative importance of different mediators in the intelligence–health relation while including a broader set of objective health measures.     

Aphasia in left-handers. Comparison of aphasia profiles and language recovery in non-right-handed and matched right-handed patients.

The present retrospective analysis reports two studies. In Study 1, clinical aspects of aphasia are compared in right-handed (RH) and non-right-handed (NRH) patients; in Study 2, recovery from aphasia is compared in RH and NRH aphasic patients with a minimum of 5 months of daily language rehabilitation. From a continuous series of 1200 brain-damaged subjects, 24 NRH patients with a vascular lesion documented by computerized tomography were selected. In 19 cases the lesion was in the left hemisphere and in 5 cases in the right hemisphere. For 14 NRH patients, a RH subject with similar lesion, matched for age, education, length of illness, etiology (ischemic vs. hemorrhagic), and, when possible, sex was found. Presence and type of aphasia were compared in the two patients of the same pair and were found similar except for Pair 14; the RH subject had global aphasia and the NRH had conduction-like aphasia. Fifteen NRH patients were rehabilitated and reexamined at least 5 months after the first examination. Recovery of the 12 patients with a left-hemisphere lesion was compared with recovery of a group of RH subjects and no significant differences were found. Recovery of the three patients with right-hemisphere lesions is described. It is concluded that differences in type of aphasia and recovery between RHs and NRHs have been overemphasized in the past and must be reconsidered.     

The relationship of the acquisition of manual signs to severity of aphasia: A training study

To investigate the relationship between success in the acquisition of signs and the degree of severity of aphasic impairment 12 chronic severely aphasic subjects participated in a training program for the acquisition of a vocabulary of manual signs. The results demonstrate a clear and significant relationship between severity of aphasia and success in the acquisition and generalization of manual signs. The results also indicate that there may be a threshold of severity of aphasia below which acquisition is negligible. Discussion is presented relative to the theoretical, clinical, and methodological implications of these findings.     

Attempted suicide in youth: Its relationship to school achievement,educational goals,and socioeconomic status

Twenty-six suicide attempters, 9 to 18 years of age, were compared with 725 nonattempters on measures of school achievement, educational goals, socioeconomic status, and depression. As has been found in studies using clinical samples, suicide attempters in our communitybased sample had significantly lower school achievement than nonattempters. The relationship between attempted suicide and low school achievement seemed to be explained by the effects of depression. Lower-SES youth tended to be more likely to attempt suicide than higher-SES youths. However, SES appeared to have little effect on the relationship between attempted suicide and school achievement. Results also suggest that children of mothers with low educational goals for them may be more at risk for attempted suicide than youths whose mothers have higher educational goals for their children.This research was supported by the National Institute of Mental Health, Grant No. MH36971.     

Nonspeech and speech processing skills in patients with aphasia and apraxia of speech

Nonspeech and speech auditory processing skills as well as internal speech processing skills were assessed among four patients with acquired "pure" apraxia of speech, 10 with acquired aphasia, 10 with aphasia plus apraxia of speech, and 11 neurologically normal adults. Fourteen tasks were administered and performances on 68 variables were examined using both nonparametric and parametric analyses controlling for the effects of advancing age and associated hearing loss. In all cases, the "pure" apractic patients performed as normal subjects. Few differences were noted among the performances of the aphasic and aphasic-apractic subjects. Results led to three major conclusions: (1) apraxia of speech is a disorder distinct from aphasia; (2) aphasic individuals, despite locus of lesion, demonstrate disabilities for processing nonspeech and speech materials presented auditorily and for analytically evaluating speech evoked internally; and (3) aphasic individuals demonstrating similar severity levels of language impairment show similar performance patterns for these types of processing tasks, despite locus of lesion or coexistence of apraxia of speech.     

Auditory event-related potential probes and behavioral measures of aphasia

This study examined the relationship between an auditory event-related potential probe technique measure of differential hemispheric processing and traditional tests of aphasia in aphasic patients. Subjects were 10 aphasic and 10 normal adult males. The results of the electrophysiological measures indicated that the aphasic subjects responded differently from the normal group particularly when the task required processing of verbal information. During the verbal task the aphasic group showed higher amplitude right hemisphere responses as compared to left. The normal group showed little hemispheric task related asymmetries. The pattern of electrical asymmetry in the aphasic group seems to be an indicator of severity as measured by traditional aphasia examinations.     

Quantitative CT scan studies in aphasia. I. Infarct size and CT numbers

Infarct si?e (number of 1-mm² pixels in the lesion) on CT scans of 30 aphasia patients was obtained with a semiautomated computer program. The mean number of lesion pixels present per slice containing lesion was approximately 500 for mild aphasias (transcortical motor and conduction), 700 for Wernicke's, 1000 for Broca's, 1500 for mixed, and 2000 for globals. These differences were significant for $\text{11}\text{15}$ of the group pairwise comparisons. When lesion locus was controlled for in the anterior/posterior plane, 73–100% of the aphasia patients were correctly classified as to type of aphasia by a discriminant analysis utilizing only the number of lesion pixels present on two CT slices. Different slice combinations were used for different aphasia group comparisons. There was a significant correlation between severity of aphasia and lesion size. There was a significant correlation between lesion size and the CT numbers in the lesion. This type of analysis may be useful to predict the prognosis for recovery potential in aphasics who have CT scans performed at 2 months poststroke.