The impact of culture and education on non-verbal neuropsychological measurements: a critical review

Clinical neuropsychology has frequently considered visuospatial and non-verbal tests to be culturally and educationally fair or at least fairer than verbal tests. This paper reviews the cross-cultural differences in performance on visuoperceptual and visuoconstructional ability tasks and analyzes the impact of education and culture on non-verbal neuropsychological measurements. This paper compares: (1) non-verbal test performance among groups with different educational levels, and the same cultural background (inter-education intra-culture comparison); (2) the test performance among groups with the same educational level and different cultural backgrounds (intra-education inter-culture comparisons). Several studies have demonstrated a strong association between educational level and performance on common non-verbal neuropsychological tests. When neuropsychological test performance in different cultural groups is compared, significant differences are evident. Performance on non-verbal tests such as copying figures, drawing maps or listening to tones can be significantly influenced by the individual's culture. Arguments against the use of some current neuropsychological non-verbal instruments, procedures, and norms in the assessment of diverse educational and cultural groups are discussed and possible solutions to this problem are presented.     

Sustained attention in language production: An individual differences investigation

Whereas it has long been assumed that most linguistic processes underlying language production happen automatically, accumulating evidence suggests that these processes do require some form of attention. Here we investigated the contribution of sustained attention: the ability to maintain alertness over time. In Experiment 1, participants’ sustained attention ability was measured using auditory and visual continuous performance tasks. Subsequently, employing a dual-task procedure, participants described pictures using simple noun phrases and performed an arrow-discrimination task while their vocal and manual response times (RTs) and the durations of their gazes to the pictures were measured. Earlier research has demonstrated that gaze duration reflects language planning processes up to and including phonological encoding. The speakers’ sustained attention ability correlated with the magnitude of the tail of the vocal RT distribution, reflecting the proportion of very slow responses, but not with individual differences in gaze duration. This suggests that sustained attention was most important after phonological encoding. Experiment 2 showed that the involvement of sustained attention was significantly stronger in a dual-task situation (picture naming and arrow discrimination) than in simple naming. Thus, individual differences in maintaining attention on the production processes become especially apparent when a simultaneous second task also requires attentional resources.     

Cognitive processes that underlie mathematical precociousness in young children

The working memory (WM) processes that underlie young children's (ages 6-8 years) mathematical precociousness were examined. A battery of tests that assessed components of WM (phonological loop, visual-spatial sketch pad, and central executive), naming speed, random generation, and fluency was administered to mathematically precocious and average-achieving children. The results showed that (a) precocious children performed better on executive processing, inhibition, and naming speed tasks than did average-achieving children, although the two groups were statistically comparable on measures of the phonological loop and visual-spatial sketch pad, and (b) the executive component of WM predicted mathematical accuracy independent of chronological age, reading, inhibition, and naming speed. The results support the notion that the executive system is an important predictor of children's mathematical precociousness and that this system can operate independent of individual differences in the phonological loop, inhibition, and reading in predicting mathematical accuracy.     

Neuropsychological differentiation of progressive aphasic disorders

The differentiation of subtypes of primary progressive aphasia (PPA) remains challenging. We aimed to identify optimum neuropsychological measures for characterizing PPA, to examine the relationship between behavioural change and subtypes of PPA and to determine whether characteristic profiles of language, working memory, and behavioural changes occur in PPA. Forty-seven patients with PPA and multi-domain Alzheimer's disease (AD) together with 19 age-matched controls underwent a large battery of working memory and language tests. We found that simple tasks of sentence ordering, narrative production, and buccofacial praxis were particularly useful in differentiating non-fluent/agrammatic variant PPA (nfvPPA) from other PPA subtypes, whereas a test of single word comprehension was useful in detecting semantic dementia (SD). No individual tests were discriminating for logopenic variant PPA (lvPPA) relative to nfvPPA. LvPPA and multidomain AD exhibited similar language profiles. A principal components analysis revealed that characteristic PPA profiles extended beyond the realms of language, in particular, the presence of apraxia in nfvPPA, behavioural changes in SD, and working memory deficits in lvPPA. These findings suggest that not all tests are equally discriminatory for PPA and highlight the importance of a test profile in differentiating PPA. These results also support the view that lvPPA is a focal form of AD and emphasize the difficulties classifying lvPPA.     

Eye–voice span during rapid automatized naming of digits and dice in Chinese normal and dyslexic children

We measured Chinese dyslexic and control children's eye movements during rapid automatized naming (RAN) with alphanumeric (digits) and symbolic (dice surfaces) stimuli. Both types of stimuli required identical oral responses, controlling for effects associated with speech production. Results showed that naming dice was much slower than naming digits for both groups, but group differences in eye‐movement measures and in the eye–voice span (i.e. the distance between the currently fixated item and the voiced item) were generally larger in digit‐RAN than in dice‐RAN. In addition, dyslexics were less efficient in parafoveal processing in these RAN tasks. Since the two RAN tasks required the same phonological output and on the assumption that naming dice is less practiced than naming digits in general, the results suggest that the translation of alphanumeric visual symbols into phonological codes is less efficient in dyslexic children. The dissociation of the print‐to‐sound conversion and phonological representation suggests that the degree of automaticity in translation from visual symbols to phonological codes in addition to phonological processing per se is also critical to understanding dyslexia.     

FMRI of two measures of phonological processing in visual word recognition: ecological validity matters

Previous functional magnetic resonance imaging (fMRI) studies have investigated the role of phonological processing by utilizing nonword rhyming decision tasks (e.g., Pugh et al., 1996). Although such tasks clearly engage phonological components of visual word recognition, it is clear that decision tasks are more cognitively involved than the simple overt naming tasks, which more closely map onto normal reading behavior. Our research aim for this study was to examine the advantages of overt naming tasks for fMRI studies of word recognition processes. Process models are presented to highlight the similarities and differences between two cognitive tasks that are used in the word recognition literature, pseudohomophone naming (e.g., pronounce BRANE) and rhyming decision (e.g., do LEAT and JEAT rhyme?). An fMRI study identified several differences in cortical activation associated with the differences observed in the process models. Specifically, the results show that the overt naming task involved the insular cortex and inferior frontal gyrus, whereas the rhyming decision task engaged the temporal-parietal regions. It is argued that future fMRI research examining the neuroanatomical components of basic visual word recognition utilize overt naming tasks.     

Working memory capacity and dual-task interference in picture naming

Researchers have found no agreement on whether dual-task interference in language performance, such as dual-task interference from tone discrimination on picture naming, reflects passive queuing or active scheduling of processes for each task. According to a passive-queuing account, while a central response-selection bottleneck is occupied by the tone discrimination task, picture naming is held in a passive queue until the bottleneck is freed. In contrast, according to an active-scheduling account, participants determine the order in which the tasks proceed, monitor progress on the tasks, suspend picture naming and hold it in working memory, and determine when to resume picture naming. Here, we report a study that assessed the relative merits of the queuing and scheduling accounts by examining whether the magnitude of dual-task interference in picture naming is associated with individual differences in the capacity of monitoring and updating of working memory representations, as assessed by the operation-span task. We observed that the updating/monitoring ability correlated with the speed of picture naming and with the magnitude of the interference from tone discrimination on picture naming. These results lend support to the active-scheduling account of dual-task interference in picture naming.     

阅读障碍与注意缺陷多动障碍儿童的语言加工和反应抑制

阅读障碍与注意缺陷多动障碍(ADHD)高度共病,以往研究结果显示两种障碍在语言加工、执行功能等领域的缺陷既相似又不同。本研究采用语音意识测验、快速命名测验、语素意识测验和停止信号任务,以及阅读广度测验,分别考察四组被试（阅读障碍组、ADHD组、双重障碍组、正常控制组）的基础语言加工、反应抑制和言语工作记忆能力,结果发现：阅读障碍组和双重障碍组在语言加工任务上的成绩均显著差于ADHD组和正常组;ADHD组和双重障碍组在停止信号任务上的成绩显著差于阅读障碍组和正常组;所有障碍组在阅读广度测验上的成绩显著差于正常组。表明阅读障碍的特异性缺陷体现在语言加工过程上,而注意缺陷多动障碍的特异性缺陷体现在反应抑制上。这对于今后单一障碍的研究及临床诊断和干预具有重要的参考价值。     

Phonological encoding in the silent speech of persons who stutter

The purpose of the present study was to investigate the role of phonological encoding in the silent speech of persons who stutter (PWS) and persons who do not stutter (PNS). Participants were 10 PWS (M=30.4 years, S.D.=7.8), matched in age, gender, and handedness with 11 PNS (M=30.1 years, S.D.=7.8). Each participant performed five tasks: a familiarization task, an overt picture naming task, a task of self-monitoring target phonemes during concurrent silent picture naming, a task of monitoring target pure tones in aurally presented tonal sequences, and a simple motor task requiring finger button clicks in response to an auditory tone. Results indicated that PWS were significantly slower in phoneme monitoring compared to PNS. No significant between-group differences were present for response speed during the auditory monitoring, picture naming or simple motor tasks, nor did the two groups differ for percent errors in any of the experimental tasks. The findings were interpreted to suggest a specific deficiency at the level of phonological monitoring, rather than a general monitoring, reaction time or auditory monitoring deficit in PWS. Educational objectives: As a result of this activity, the participant should: (1) identify and assess the literature on phonological encoding skills in PWS, (2) enumerate and evaluate some major psycholinguistic theories of stuttering, and (3) describe the mechanism by which defective phonological encoding can disrupt fluent speech production.     

Cross language learning disabilities and verbal versus spatial memory

The research reported in this talk involves comparisons of verbal and spatial memory tasks across groups of children (and adults) with different types of learning difficulties. The research focuses on children with literacy acquisition problems and investigates whether such problems are related to specific areas of deficit. In the first piece of research, children with dyslexia (literacy learning problems) and dyspraxia (motor deficits) were contrasted on measures of memory (for example, tasks that required the retention of sequences of verbal material or spatial movements) and additional measures of literacy (reading and spelling), phonological (awareness of sounds within words) and motor (fine and gross motor tasks) functioning. The data were consistent with a dissociation between tasks/groups such that dyslexics showed weak phonological processing but intact visuo-spatial processing, whereas children with dyspraxia showed weaknesses on task involving visuo-spatial information, but average levels of performance on tasks that required phonological processing. Similar results were identified amongst adult groups, consistent with a deviant level of functioning rather than a developmental delay. A second line of research contrasted children with or without literacy problems across language backgrounds (English, Arabic, Chinese and bilingual children). Consistent with the dyslexia data, children with poor English literacy skills showed weaknesses in verbal/phonological memory tasks but not in visuo-spatial memory. However, for Chinese-language children, visuo-spatial memory differed between good and poor literacy learners, but there was little evidence for verbal memory differences. In contrast, the Arabic and bilingual children showed differences in both verbal and visuo-spatial areas, although the evidence was consistent with enhanced visual/spatial skills amongst the good literacy groups, rather than poor literacy children showing weaknesses in those tasks. These data suggest that the influence of memory skills on learning may vary with the language of instruction. A final line of enquiry considers whether teaching strategies to children with learning difficulties may overcome some of the identified memory deficits and lead to better levels of learning. English language children with learning difficulties were taught visual and verbal strategies to support retention of materials in short-term memory tasks. In the majority of cases, learning was improved when it focused on visuo-spatial strategies but not when verbal strategies were used. These data support the relationship between learning difficulties and different aspects of short-term memory that may lead to poor levels of learning. It also presents evidence that memory (particularly those related to visuo-spatial) processes are influenced by the context within which learning is taking place, both in terms of the language of instruction and the strategies used to support learning. For some children with educational difficulties based around language-related deficits, visuo-spatial strategies may support acquisition.     

Posture recognition in Alzheimer's disease

BACKGROUND: Apraxia is neurologically induced deficit in the ability perform purposeful skilled movements. One of the most common forms is ideomotor apraxia (IMA) where spatial and temporal production errors are most prevalent. IMA can be associated Alzheimer's disease (AD), even early in its course, but is often not identified possibly because the evaluation of IMA by inexperienced judges using performance tests is unreliable. The purpose of this study, therefore, is to learn if the Postural Knowledge Test (PKT), a praxis discrimination test that assesses knowledge of transitive (PKT-T subtest) and intransitive (PKT-I subtest) postures and does not require extensive training, is as sensitive and specific as the praxis performance tests. METHODS: We studied 15 subjects with probable AD as well as 18 age-matched controls by having them perform transitive and intransitive gestures to command and imitation, as well as having them discriminate between correct and incorrect transitive and intransitive postures. RESULTS: Overall on all tests, the control subjects performed better than those with AD. In addition all subjects had more trouble with transitive than intransitive gestures. Using a stepwise discriminative analysis, 81.8% of the subjects could be classified according to Group (94.4% of Controls, 66.7% of AD subjects). In this analysis, the PKT-T (transitive posture subtest) was the only measure that contributed to the discrimination of subjects. CONCLUSION: We found that having subjects select the correct transitive hand postures in this "booklet test" was more sensitive than grading their praxis performances even when using judges with extensive training. This suggests that this discrimination test might be an excellent means for diagnosing and screening patients for AD. The reason why recognition of transitive postures is relatively more difficult for our AD subjects is not known. Two possibilities are that the representations for intransitive movements are stronger than those for transitive movements, and hence, more resistant to degradation, or that intransitive acts are stored in parts of the brain not affected by AD.     

Neuropsychological assessment in illiterates: visuospatial and memory abilities

A basic neuropsychological battery of visuospatial and memory abilities was administered to extreme educational groups (illiterates and professionals). Subjects were matched according to sex and age. The following visuospatial tasks were included: figure copy (cube, house, and Rey-Osterrieth complex figure), telling time, recognition of superimposed figures, recognition of a map, and drawing of the plan of the room. The following memory tasks were used: basic information, digit retention (forward and backward), memory curve, delayed verbal recall, sentence repetition, logical memory, delayed logical memory, immediate recall of the Rey-Osterrieth complex figure, immediate reproduction of a cube, visuospatial memory, and sequential memory. In visuospatial tasks all differences between the two groups were statistically significant. Five of the seven visuospatial tasks (all but telling time and recognition of superimposed figures) showed differences between age groups with a better performance found in the younger groups and four of the tasks (cube, house, Rey-Osterrith complex figure copying, and telling time) were significant between sexes with a better performance in men. In memory tasks, with the exception of the immediate memory of sentences, all tasks showed statistically significant differences between educational groups. Eight of the 13 memory tasks (digits forward and backward, delayed memory of words, immediate and delayed logical memory, Rey-Osterrieth immediate memory, cube immediate memory, and sequential memory) showed significant differences for age while 4 of the tasks (digits backward, memory curve, Rey-Osterrieth immediate memory, and cube immediate memory) were significant for sex. Results are analyzed with regard to current theories in cognitive psychology and anthropology. Emphasis is placed on the finding that cognitive skills usually examined by neuropsychological tests represent learned and highly trained abilities.     

Sex differences in cerebral laterality of language and visuospatial processing

Sex differences on language and visuospatial tasks are of great interest, with differences in hemispheric laterality hypothesized to exist between males and females. Some functional imaging studies examining sex differences have shown that males are more left lateralized on language tasks and females are more right lateralized on visuospatial tasks; however, findings are inconsistent. Here we used functional magnetic resonance imaging to study thirty participants, matched on task performance, during phonological and visuospatial tasks. For each task, region-of-interest analyses were used to test differences in cerebral laterality. Results indicate that lateralization differences exist, with males more left lateralized during the phonological task and showing greater bilateral activity during the visuospatial task, whereas females showed greater bilateral activity during the phonological task and were more right lateralized during the visuospatial task. Our data provide clear evidence for differences in laterality between males and females when processing language versus visuospatial information.     

Picture Naming Deficits in Developmental Dyslexia: The Phonological Representations Hypothesis

The picture and word naming performance of developmental dyslexics was compared to the picture and word naming performance of non-dyslexic (“garden variety”) poor readers, reading age, and chronological age-matched controls. The stimulus list used for both tasks was systematically manipulated for word length and word frequency. In order to examine picture naming errors in more depth, an object name recognition test assessed each subject's vocabulary knowledge of those names which they were unable to spontaneously label in the picture naming task. Findings indicated that the dyslexic and the garden variety poor readers exhibited a picture naming deficit relative to both chronological and reading age-matched controls. Findings also indicated that both groups of impaired readers obtained superior scores in the word naming task than in the picture naming task, while both groups of controls showed no difference in performance across tasks. The dyslexics' picture naming errors, but not those of the garden variety poor readers, were particularly marked on polysyllabic and/or low frequency words, indicating a possible phonological basis to the picture naming deficit of the dyslexic children. These children also recognized significantly more unnamed target words than all comparison groups, suggesting a particular difficulty inretrievingthe phonological codes of known picture names rather than a vocabulary deficit. Results are discussed in terms of dyslexics' difficulty in encoding full segmental phonological representations of names in long-term memory and/or in processing these representations in order to generate required names on demand.     

Primate learning tasks reveal strong impairments in patients with presenile or senile dementia of the Alzheimer type

Eight subjects with the likely diagnosis of presenile or senile dementia of the Alzheimer type were tested on two frequently used primate learning tasks: a concurrent object discrimination task and a delayed non-match-to-sample task. In addition, various tests for cognitive, mnemonic, perceptual, and language functions were applied. The results suggest a severe decline of the Alzheimer subjects in all measures when compared with 10 control subjects matched for age, gender, and education. The two animal learning tasks revealed strong impairments, thus demonstrating a high sensitivity for the detection and assessment of human amnesic disorders. Implications of these findings for human neuropsychological, and especially comparative neuropsychological, research are discussed.     

Auditory temporal information processing in preschool children at family risk for dyslexia: relations with phonological abilities and developing literacy skills

In this project, the hypothesis of an auditory temporal processing deficit in dyslexia was tested by examining auditory processing in relation to phonological skills in two contrasting groups of five-year-old preschool children, a familial high risk and a familial low risk group. Participants were individually matched for gender, age, non-verbal IQ, school environment, and parental educational level. Psychophysical thresholds were estimated for gap-detection, frequency modulation detection, and tone-in-noise detection using a three-interval forced-choice adaptive staircase paradigm embedded within a computer game. Phonological skills were measured by tasks assessing phonological awareness, rapid serial naming, and verbal short-term memory. Significant group differences were found for phonological awareness and letter knowledge. In contrast, none of the auditory tasks differentiated significantly between both groups. However, both frequency modulation and tone-in-noise detection were significantly related to phonological awareness. This relation with phonological skills was not present for gap-detection.     

汉语口吃者在不出声言语中的语音编码

口吃者与非口吃者在不出声言语中语音编码的差异是口吃者语音加工异常的有力证据。通过三个实验,分别考察了口吃者与非口吃者监控汉语拼音中声母、韵母及声调的差异。结果表明,口吃者对声母的监控与非口吃者相比没有显著的差异,但在监控韵母及声调时,口吃者的反应显著慢于非口吃者。研究结果支持了关于口吃的“内在修正假说”,对研究汉语的语音编码有启发,对于口吃的诊断和治疗也有重要的启示     

汉语儿童英语口语词汇与阅读学习的关系

以120名四、五年级小学儿童为被试,探讨汉语儿童英语口语词汇与阅读学习的关系,并检验了英语语音意识在其中的中介作用。结果表明:(1)汉语儿童的英语口语词汇与阅读学习之间存在密切关系。控制一般认知能力和母语口语词汇的影响后,英语口语词汇对阅读学习仍具有显著的预测作用。其中,英语口语词汇产生对于英语单词认读的预测作用更重要,英语口语词汇理解则对英语单词理解的预测作用更重要。(2)英语口语词汇产生既可以直接作用于英语单词认读、理解和假词拼读,也部分通过英语语音意识的中介间接作用于英语阅读;英语口语词汇理解对英语单词理解也具有直接作用,并部分地通过英语语音意识的中介发挥间接作用     

Phoneme monitoring in silent naming and perception in adults who stutter

The present study investigated phonological encoding skills in persons who stutter (PWS). Participants were 10 PWS (M = 31.8 years, S.D. = 5.9) matched for age, gender, and handedness with 12 persons who do not stutter (PNS) (M = 24.3 years, S.D. = 4.3). The groups were compared in a phoneme monitoring task performed during silent picture naming. The phonological complexity of the target items in the task was varied such that participants monitored either compound words or noun phrases. Performance in this task was compared to phoneme monitoring performed on aurally presented target words to investigate whether any differences observed in silent naming were also evident in perception. Analysis of the response time data, in milliseconds, indicated that PWS were significantly slower as compared to PNS in phoneme monitoring during silent naming; group differences were not obtained in the perception task. The groups were also comparable in the response time to phoneme monitoring within compound words and noun phrases in both silent naming and perception. The findings suggested that PWS were slower in the encoding of segmental, phonological units during silent naming. Furthermore, absence of such differences in perception ruled out a general monitoring deficit in PWS. Findings are interpreted within the context of the psycholinguistic theories of stuttering that postulate phonological encoding and/or monitoring as a causal variable in stuttering.

Educational objectives: As a result of this activity, the participant should: (1) describe relevant literature on phonological encoding skills in children and adults who stutter, (2) identify paradigms that can be used to investigate phonological processing in PWS, and (3) discuss the role of phonological encoding in speech production.