Discourse after Closed Head Injury in Young Children

This study examined narrative discourse in 23 children, ages 6 to 8 years, who sustained a severe closed head injury (CHI) at least 1 year prior to assessment. Narratives were analyzed at multiple levels using language and information structure measures. Results revealed significant discourse impairments in the CHI group on all measures of information structure, whereas differences in the linguistic domain failed to reach significance. In addition, effects of age at injury and lateralization of lesion on discourse were considered. Although no significant differences were found according to age at injury, a consistent pattern of generally poorer discourse scores was found for the early injured group (<5 years). With regard to lesion focus, the group findings were unimpressive. However, preliminary examination of individual CHI cases with relatively large lateralized lesions suggested that the late injured children may show the language–brain patterns reported in brain-injured adults, whereas early injured children may not.     

Structural and functional imaging in children with partial epilepsy

Imaging plays an increasingly important role in the evaluation of children with complex partial seizures. Most partial epilepsy, especially of temporal lobe origin, begins during childhood. Structural imaging with high-resolution MRI can help identify the etiology of partial seizure disorders in many children. MRI studies also show the more widespread effect of seizures on brain structure. Progressive volume loss of the hippocampal formation in some patients with temporal lobe epilepsy provides evidence that continued seizures may be associated with progressive neuronal injury. FDG-PET studies show regional decreases in glucose consumption in the cortical zone from which seizures arise. Functional abnormalities often are more extensive than the seizure focus. Studies in children with recent-onset epilepsy show that metabolic abnormalities are considerably less common than in adults with partial epilepsy, supporting the notion that in some patients there may be progressive metabolic changes that occur with continued seizures. Functional MRI may be used to identify language areas in children with partial epilepsy. fMRI language tasks reliably identify the dominant hemisphere for language dominance when compared to the intracarotid amytal procedure. Tests of verbal fluency and semantic decision identify frontal lobe language areas, while reading text paradigms and auditory passage paradigms are better for identifying temporal language areas. A panel of paradigms is best used to identify language areas in children being considered for epilepsy surgery. fMRI is a valuable tool for elucidating the impact of chronic neurologic disease states on the functional organization of language networks during development.     

Emerging narrative discourse skills 18 months after traumatic brain injury in early childhood

This study examined the longer term effect of traumatic brain injury (TBI), approximately 18 months post-injury, on emerging narrative discourse skills of 85 children with orthopaedic injury (OI), 43 children with moderate TBI, and 19 children with severe TBI who were between 3 years and 6 years 11 months at injury. Children with TBI performed worse than children with OI on most discourse indices. Children with severe TBI were less proficient than children with moderate TBI at identifying unimportant story information. Age and pragmatic skills were predictors of discourse performance.     

A case study of selective impairment of the central executive component of working memory after a focal frontal lobe damage

RC is a 36-year-old man who sustained a closed head injury with bilateral frontal lobe hypometabolism in 1978. In 1994, after a lobectomy of a large part of the left frontal lobe, he presented no behavioral disruption and normal performances on most of intelligence, long-term memory, and executive tests. However, he showed deficits in tasks that implicate short-term storage (i.e., span tasks). These deficits in working memory were explored with regard to Baddeley's model using computerized tasks. On these tasks RC showed normal functioning of the articulatory loops and dysfunction of the central executive component in dual tasks. These results confirm those reported in another single case study by Van Der Linden, Coyette, and Seron (1992) and indicate that dual-task performance may assess one separable feature of executive functions.     

Age-Related Influences on Repetition Priming in the Verb Generation Task: Examining the Role of Response Competition

ABSTRACT

The identification-production framework suggests that aging is associated with a decline in production forms of repetition priming, particularly under test conditions that maximize response competition. The present study examined this prediction by testing young and healthy older adults in a single-encoding version of the verb generation task in which some items had one dominant verb response (low competition) or had no such dominant response (high competition). Further analyses examined whether priming and error rates were related to performance on neuropsychological tests purported to measure frontal lobe functioning. Priming was invariant across age groups and was not related to frontal lobe status in older adults, but frontal lobe status did predict task performance: low-frontal older adults made more errors than high-frontal older adults, particularly for high-competition items and items with high association strength. These results are not consistent with the identification-production framework, but are consistent with the conclusions that (a) aging is associated with invariance in the processes that support repetition priming in the verb generation task and (b) frontal lobe status in aging is related to verb generation performance.     

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.     

Language after temporal or frontal lobe surgery in children with epilepsy

The purpose of this study was to compare language function in children undergoing temporal or frontal lobe surgery to control intractable epilepsy. Language measures (expressive vocabulary, receptive vocabulary, comprehension, reading, spelling, phonemic fluency, and category fluency) were administered to 9 children with frontal lobe epilepsy (mean age: 10.8 +/- 2.7 years) and 10 children with temporal lobe epilepsy (11.5 +/- 2.6 years). The results indicate that no differences exist, in language function, before and after surgery between children with frontal and temporal lobe epilepsy (all p > or = .05). Children with left hemisphere lesions had significantly lower scores than those with right on category fluency and comprehension, but laterality effects were not seen on the other measures. In both groups, language function was not significantly affected by surgery.     

Verbal reaction time patterns in aphasic adults: consideration for apraxia of speech

Verbal reaction time patterns were compared in aphasic adults presenting anterior and posterior left hemisphere lesions. Reaction Times were measured from simultaneous recording of the subjects' verbal responses and electromyographic activity from three oral-facial sites. Total Reaction Time was fractionated into Premotor Time and Motor Time components to assess latencies associated with motor speech planning and execution. The results suggested that only anterior lesions result in deficits in motor speech planning and/or execution while posterior lesion patients perform no differently than normal. The evidence supports traditional concepts regarding apraxia of speech as being associated with frontal lobe lesions.     

Children's Narratives Following Traumatic Brain Injury: Linguistic Structure, Cohesion, and Thematic Recall

Narrative discourse and intellectual functioning were examined 3 years following traumatic brain injury (TBI) in children 1 to 8 years of age at the time of injury. The language-impaired TBI group (n= 9) had language deficits during the subacute stage of recovery; their performance was contrasted with that of a TBI comparison group equated on neurologic and demographic variables that did not show subacute language impairment (n= 8) and a sibling comparison group (n= 9). The language-impaired TBI group had lower Verbal and Full-Scale IQ scores and produced fewer words and utterances than the sibling group on a story retelling task; their stories were characterized by fewer complete referential and lexical ties and more referential errors, indicating difficulty conjoining meaning across sentences. The language-impaired TBI group recalled approximately one-third of the propositions needed to maintain the story theme and made more errors sequencing the propositions than either the TBI or the sibling comparison groups. Group differences were not obtained on the Performance IQ scores or on measures of rate or fluency of speech production, mazes, use of conjunctives, or naming errors. The discourse deficiencies of children with TBI and acute language impairment were most pronounced at the level of cognitive organization of the text reflecting text macrostructure and were least apparent at the level of lexical and sentential organization reflecting text microstructure. Results are discussed in terms of the vulnerability of developing language abilities to disruption by brain injury.     

Theory of Mind in Patients with Epilepsy: a Systematic Review and Meta-analysis

The ability to understand our own thoughts, intentions, beliefs and emotions and those of others (Theory of Mind; ToM) is a high-order social cognitive skill that is vital for social interaction and which has been found to be impaired in patients with epilepsy. Studies examining ToM in patients with epilepsy, however, have yielded inconsistent findings. The main aim of this study is to determine whether the magnitude of ToM deficits varies as a function of the site of epilepsy focus and/or the type of ToM task used. Electronic databases searches included Psychinfo, Medline/PubMed and EMBASE. Studies were included if they examined a group of patients with epilepsy and a group of healthy controls, reported original research, were published in the English language in peer reviewed journals, and used one of five empirically validated measures of ToM: False Belief, Reading the Mind in the Eyes Task (RMET), Faux-pas, Strange Stories, Cartoon ToM vignettes. Twelve studies were identified, ten included adults and two included children with epilepsy. Findings revealed marked ToM deficits in adults with focal seizures emanating from core brain regions underpinning ToM: temporal and frontal lobes (frontal lobe epilepsy, FLE; temporal lobe epilepsy, TLE), but not in adults with focal seizures outside the temporal and frontal lobes (extra-TLE/FLE). ToM deficits were also observed in children with generalised seizures (idiopathic generalised epilepsy, IGE). ToM deficits were documented across ToM tasks. In conclusion, ToM deficits represent a robust finding in adults with frontal and temporal epilepsy, but are also found in children with generalised seizures. Further research into ToM is needed, especially in children with epilepsy as early ToM may have cumulative, negative effects on development of social skills that continues into adulthood.     

Sequential Memory: A Developmental Perspective on Its Relation to Frontal Lobe Functioning

The multidimensional nature of the frontal lobes serves to organize and coordinate brain functionings playing a central and pervasive role in human cognition. The executive processes implicated in complex cognition such as novel problem solving, modifying behavior as appropriate in response to changes in the environment, inhibiting prepotent or previous responses, and the implementation of schemas that organize behavior over time are believed to be mediated by the frontal regions of the brain. Overall, the functioning of the frontal lobes assists individuals in goal directed and self-regulatory behavior. Additional theories of frontal lobe functioning have focused on its involvement in temporal, or time-related domains. The organizational and strategic nature of frontal lobe functioning affects memory processes by enhancing the organization of to-be-remembered information. Among the specific memory systems presumed to be based on anterior cerebral structures is the temporal organization of memory. An essential component of memory that involves temporal organization is sequential ordering entailing the ability to judge which stimuli were seen most recently and the temporal ordering of events in memory. Focal lesion studies have demonstrated the importance of the frontal lobes on retrieval tasks in which monitoring, verification, and placement of information in temporal and spatial contexts of critical importance. Similarly, frontal lobe damage has been associated with deficits in memory for the temporal ordering, or sequencing, of events. The acquisition of abilities thought to be mediated by the frontal lobes, including sequential memory, unfolds throughout childhood, serving to condition patterns of behavior for the rest of the brain. Development of the frontal regions of the brain is known to continue through late adolescence and into early adulthood, in contrast to the earlier maturation of other cortical regions. The developmental patterns of the frontal lobes are thought to involve a hierarchical, dynamic, and multistage process.     

The kindergarten-path effect: studying on-line sentence processing in young children

A great deal of psycholinguistic research has focused on the question of how adults interpret language in real time. This work has revealed a complex and interactive language processing system capable of rapidly coordinating linguistic properties of the message with information from the context or situation (e.g. Altmann & Steedman, 1988; Britt, 1994; Tanenhaus, Spivey-Knowlton, Eberhard & Sedivy, 1995; Trueswell & Tanenhaus, 1991). In the study of language acquisition, however, surprisingly little is known about how children process language in real time and whether they coordinate multiple sources of information during interpretation. The lack of child research is due in part to the fact that most existing techniques for studying language processing have relied upon the skill of reading, an ability that young children do not have or are only beginning to acquire. We present here results from a new method for studying children's moment-by-moment language processing abilities, in which a head-mounted eye-tracking system was used to monitor eye movements as participants responded to spoken instructions. The results revealed systematic differences in how children and adults process spoken language: Five Year Olds did not take into account relevant discourse/pragmatic principles when resolving temporary syntactic ambiguities, and showed little or no ability to revise initial parsing commitments. Adults showed sensitivity to these discourse constraints at the earliest possible stages of processing, and were capable of revising incorrect parsing commitments. Implications for current models of sentence processing are discussed.     

Word order and information status in child language

In expressing rich, multi-dimensional thought in language, speakers are influenced by a range of factors that influence the ordering of utterance constituents. A fundamental principle that guides constituent ordering in adults has to do with information status, the accessibility of referents in discourse. Typically, adults order previously mentioned referents ("old" or accessible information) first, before they introduce referents that have not yet been mentioned in the discourse ("new" or inaccessible information) at both sentential and phrasal levels. Here we ask whether a similar principle influences ordering patterns at the phrasal level in children who are in the early stages of combining words productively. Prior research shows that when conveying semantic relations, children reproduce language-specific ordering patterns in the input, suggesting that they do not have a bias for any particular order to describe "who did what to whom". But our findings show that when they label "old" versus "new" referents, 3- to 5-year-old children prefer an ordering pattern opposite to that of adults (Study 1). Children's ordering preference is not derived from input patterns, as "old-before-new" is also the preferred order in caregivers' speech directed to young children (Study 2). Our findings demonstrate that a key principle governing ordering preferences in adults does not originate in early childhood, but develops: from new-to-old to old-to-new.     

Frontal lobe epilepsy presenting as a psychotic disorder with delusions and hallucinations: a case study

Although psychotic symptoms are a recognized manifestation of epilepsy, these are more often associated with seizures of the temporal lobe type. While 10% of children with temporal lobe epilepsy develop a psychotic disorder by adulthood, the literature does not report any cases of psychotic disorders associated with frontal lobe seizures in children. This article presents a unique case of a girl whose frontal lobe seizures were associated with delusional psychotic symptoms. Once her seizure disorder was identified through electroencephalography (EEG) and appropriate anticonvulsant therapy was initiated, her associated psychotic symptoms resolved.     

Sequentiality of speech acts in conversational structure

One aspect of the phenomenon of coherence in conversational discourse was addressed in the present study: sequentiality of speech acts. Several models of discourse structure have postulated sequencing rules between speech acts in conversations, but these efforts have been hampered by the lack of an efficient empirical method that can characterize a large body of language data. The lag sequential technique is proposed here as a tool that can be used to abstract a grammar of speech act contingency from spoken discourse. Derived patterns of discourse between female adults and preschool children confirmed expectations that most discourse is based upon three fundamental speech act pairings: question-answer, statement-reply, and directive-acknowledgment. It was also found that interlocutor differences in status, knowledge, and conversational ability affected the structure of the discourse in predictable ways.     

Sense of Time and Executive Functioning in Children and Adults

A number of patient studies suggest that impairments in frontal lobe functions are associated with disorders in temporal information processing. One implication of these findings is that subjective experience of time should be related to executive functions regardless of etiology. In two experiments, we examined sense of time in relation to components of executive functioning in healthy children and adults. In Experiment 1, children between 8 to 12 years completed six experimental tasks that tapped three components of executive functioning: inhibition, updating, and mental shifting. Sense of time was examined in a duration judgment task in which participants reproduced stimulus durations between 4 to 32 s. In Experiment 2, adult participants completed the time reproduction task under varying concurrent task demands. Both experiments showed selective effects in that time reproduction errors were related to the inhibition and updating, but not to the shifting, components of executive functioning. However, the observed effects were modulated by task demands and age-related differences in cognitive competence. We conclude that individual differences in executive functioning are only weakly related to time reproduction performance in healthy children and adults.     

Loss of negative priming following sleep deprivation

It has been argued that one night of sleep loss in young healthy adults produces changes similar to that associated with normal, healthy ageing—in particular, that young sleep-deprived adults perform similarly to 60-year-old sleep-satiated adults on some tasks of frontal lobe function. This proposition was examined using a protocol viewed by many to be a direct probe of nonvolitional attention mechanisms associated with frontal lobe function. A negative priming (NP) procedure was used to compare performance between non-sleep-deprived (NSD) and sleep-deprived (SD, 34 hr) young, healthy adults. This protocol allowed for exploration of two theories of the NP effect based on inhibitory or memorial processes. Under conditions believed to facilitate inhibitory processes a normal NP effect was found for NSD(16 ms) and SD (9 ms) participants. Under conditions believed to rely on memorial processes there was no NPeffect following SD, compared with a normal NP effect for NSD participants (11 ms). Distractor interference was also greater following SD. These findings do not suggest a similar pattern of change following sleep loss in healthy young adults to that of normal, healthy, non-sleep-deprived aged groups.     

How Children with Head Injury Represent Real and Deceptive Emotion in Short Narratives

Narratives are not only about events, but also about the emotions those events elicit. Understanding a narrative involves not just the affective valence of implied emotional states, but the formation of an explicit mental representation of those states. In turn, this representation provides a mechanism that particularizes emotion and modulates its display, which then allows emotional expression to be modified according to particular contexts. This includes understanding that a character may feel an emotion but inhibit its display or even express a deceptive emotion. We studied how 59 school-aged children with head injury and 87 normally-developing age-matched controls understand real and deceptive emotions in brief narratives. Children with head injury showed less sensitivity than controls to how emotions are expressed in narratives. While they understood the real emotions in the text, and could recall what provoked the emotion and the reason for concealing it, they were less able than controls to identify deceptive emotions. Within the head injury group, factors such as an earlier age at head injury and frontal lobe contusions were associated with poor understanding of deceptive emotions. The results are discussed in terms of the distinction between emotions as felt and emotions as a cognitive framework for understanding other people's actions and mental states. We conclude that children with head injury understand emotional communication, the spontaneous externalization of real affect, but not emotive communication, the conscious, strategic modification of affective signals to influence others through deceptive facial expressions.     

Is lesion of Exner's area linked to progressive agraphia in amyotrophic lateral sclerosis with dementia? An autopsy case report

Agraphia, as a neuropsychological symptom of ALS, especially ALS with dementia (ALS-D), has recently attracted more attention. However, the brain lesion responsible has not been identified. Here we present an autopsy case of ALS-D of a patient with obvious agraphia, without aphasia, that also presented cerebrospinal degeneration with TDP-43-pathology compatible with ALS-D. Of the pre-motor frontal lobe cortices, degeneration and immuno-histochemical pathology were most obvious in the caudal area of the left middle frontal gyrus, or Exner's area. Assuring this area plays a pivotal role in the kanji and kana formation used in writing the Japanese language, this case of ALS-D showed both agraphia and Exner's area stressed pathological lesions. It may thus be the first case to indicate an intimate relationship between the neuropsychological symptoms and an associated lesion for ALS-D.     

Aging and the misinformation effect: a neuropsychological analysis

Older adults' susceptibility to misinformation in an eyewitness memory paradigm was examined in two experiments. Experiment 1 showed that older adults are more susceptible to interfering misinformation than are younger adults on two different tests (old-new recognition and source monitoring). Experiment 2 examined the extent to which processes associated with frontal lobe functioning underlie older adults' source-monitoring difficulties. Older adults with lower frontal-lobe-functioning scores on neuropsychological tests were particularly susceptible to false memories in the misinformation paradigm. The authors' results agree with data from other false memory paradigms that show greater false recollections in older adults, especially in those who scored poorly on frontal tests. The results support a source-monitoring account of aging and illusory recollection.