Anomalous cerebral language organization: acquired crossed aphasia in a dextral child

Following a dramatic change of its reported incidence, it was only recently recognized that acquired crossed aphasia in dextral children represents a highly exceptional phenomenon. We describe in a three epoch time-frame model the aphasic and neurocognitive manifestations of an additional case and focus briefly on its anatomoclinical configurations. In our patient, a right parietal cortico-subcortical hemorrhagic lesion caused an initially severe aphasia. After remission of the global aphasic symptoms in the acute phase, an adynamic output disorder with relatively severe auditory-verbal comprehension disturbances developed. In addition to the adynamia of self-generated speech, formal language investigations performed 3 weeks postonset, revealed agrammatism, hypertonic dysarthria, and dysprosodia. A substantial improvement of the aphasic disorder was objectified 83 days postonset. Neuropsychological investigations disclosed both dominant and nondominant hemisphere dysfunctions. Reassessment of neurocognitive functions after a 10-year period evidenced discrete residual anomia, confined to visual confrontational naming and a discrete visuo-perceptual syndrome. Given the posterior localization of the lesion, the syndrome shift from global to predominantly adynamic aphasia represents a finding beyond the plausible anatomoclinical expectations holding in general for the uncrossed, classic types of childhood and adult aphasia. As the first representative of crossed aphasia in dextral children with an anomalous lesion-aphasia profile, our case provides evidence to enrich the discussion on lateralization and intrahemispherical organization of language functions in both childhood and adult aphasia.     

Analysis of the elements of attention: A neuropsychological approach

A model for conceptualizing the components or elements of attention is presented. The model substitutes for the diffuse and global concept of attention a group of four processes and links them to a putative system of cerebral structures. Data in support of the model are presented; they are derived from neuropsychological test scores obtained from two samples, the first consisting of 203 adult neuropsychiatric patients and normal control subjects, and the second, an epidemiologically-based sample of 435 elementary school children. Principal components analyses of test scores from these two populations yielded similar results: a set of independent elements of attention that are assayed by different tests. This work presents a heuristic for clinical research in which the measurement of attention is essential.     

Parent and child experiences of neuropsychological assessment as a function of child feedback by individualized fable

This study evaluated whether receiving developmentally appropriate feedback in the form of individualized fables would affect how children and their parents reported experiencing a neuropsychological assessment. Participants were 32 children who underwent a neuropsychological assessment, along with one of their parents. The evaluation process, including the provision of parent feedback, was standard for the setting, a private practice of neuropsychology. The only addition was the provision of child feedback through a fable, given to the experimental group prior to the collection of research measures and to the comparison group after the collection of research data. Multivariate and univariate statistics were used to test differences between the two groups. Results indicated that children in the experimental group reported a greater sense of learning about themselves, a more positive relationship with their assessor, a greater sense of collaboration with the assessment process, and a sense that their parents learned more about them because of the assessment than did children in the comparison group. Parents in the experimental group reported a more positive relationship between their child and the assessor, a greater sense of collaboration with the assessment process, and higher satisfaction with clinic services compared to the comparison group. Limitations and implications for future research and assessment practice with children are discussed.     

Toward a synthetic approach to the Rorschach: the case of a psychotic child.

Much Rorschach research on case material focuses on the utility of a single scoring system, set of variables, or scale in isolation from other systems, scales, or perspectives. This approach fails to acknowledge the complexity of the Rorschach and to reflect the manner in which sophisticated clinicians select and synthesize various perspectives during the clinical inference and decision-making process. A case of a psychotic child is presented to illustrate the utility of a synthetic approach to the Rorschach. The strengths and weaknesses of various Rorschach perspectives in addressing specific diagnostic issues is explored through the case material.     

Interpreting imaginative play in child psychotherapy: Towards a phenomenological hermeneutic approach

Abstract

Despite renewed interest and technical advances in play therapy with children, its theoretical basis remains weak. A phenomenological hermeneutic approach to play therapy offers a philosophically grounded theoretical understanding of the meaning of children's expressions through imaginative play in a therapeutic context. Drawing upon Gadamer's ontological concept of play and Ricoeur's theory of interpretation, a child's imaginative play is seen as a text that calls for interpretation. The understanding and interpretation of imaginative play in play therapy is illustrated by means of a case vignette of a young physically abused child.     

Spirituality and child protection in early childhood education: a strengths approach

In recent international and Australian early childhood curriculum guidelines and child-protection policies, the need for teachers of young children to foster spirituality has been highlighted. However, what this might mean in practice has not been widely explored. This article addresses the more controversial issue of spiritual abuse and the right of children to protection in terms of spiritual development. We present a critique of current definitions taken from research and policy documents. Qualitative data provide the research background. Vignettes are presented to give examples of what spiritual harm might look like in practice. Finally, a strengths-based approach is introduced and strategies are suggested in order to explore the potential of the Strengths Approach (a social justice approach originating from social service practice) to aid early years’ teachers to create spiritually protective learning environments. This approach recognises and values children’s holistic development and wellbeing and supports them to appreciate, engage with and question the world around them with a resilient spirit.     

Visuomotor channels: Their integration in goal-directed prehension

The visuomotor transformations for producing a grasping movement imply simultaneous control of different visual mechanisms. The size, orientation and 3D characteristics of the object have to be encoded for the selection of the appropriate opposition space, within which the opposition forces will be applied on the object surface. These mechanisms also have to combine with those of the transport of the hand to the object location. Finally, biomechanical constraints impose categorical visuomotor decisions for positioning the opposition space according to object changes in size, orientation and spatial location. This paper examines possible interactions between the specialized structures for visuomotor transformation and the internal model that adapts prehension to its goals.PsycINFO classification: 2300; 2323; 2380; 2500; 2540; 3297     

Visuomotor binding in older adults

Action integration is the process through which actions performed on a stimulus and perceptual aspects of the stimulus become bound as a unitary object. This process appears to be controlled by the dopaminergic system in the prefrontal cortex, an area that is known to decrease in volume and dopamine functioning in older adults. Although the decline should lead to reduced action integration in older adults, we found equivalent integration in both young and older adults. This indicates that older adults may be able to compensate for their dopaminergic deficiencies by activating additional neural networks that are not used by young adults.     

The emergence of psychopathy: implications for the neuropsychological approach to developmental disorders

In this paper, I am going to examine the disorder of psychopathy and consider how genetic anomalies could give rise to the relatively specific neuro-cognitive impairments seen in individuals with this disorder. I will argue that genetic anomalies in psychopathy reduce the salience of punishment information (perhaps as a function of noradrenergic disturbance). I will argue that the ability of the amygdala to form the stimulus-punishment associations necessary for successful socialization is disrupted and that because of this, individuals with psychopathy do not learn to avoid actions that will harm others. It is noted that this model follows the neuropsychological approach to the study of developmental disorders, an approach that has been recently criticized. I will argue that these criticisms are less applicable to psychopathy. Indeed, animal work on the development of the neural systems necessary for emotion, does not support a constructivist approach with respect to affect. Importantly, such work indicates that while environmental effects can alter the responsiveness of the basic neural architecture mediating emotion, environmental effects do not construct this architecture. However, caveats to the neuropsychological approach with reference to this disorder are noted.     

A review and critique of the process approach in neuropsychological assessment

This paper surveys the process approach literature with an emphasis on higher level cognitive functions like attention and concentration, learning and memory, and problem solving and executive functioning. In particular, it discusses organizational strategies and kinds of errors found on a variety of tests as well as behavioral, situational, and interpersonal issues as they relate to test procedures. It critiques the process approach and suggests future directions.     

Semantic organization in the young child: Evidence for the development of semantic feature systems

In two experiments, 5-, 7-, 9-, and 11-year-old children and college students were presented on each trial with a sentence followed by a probe word. Their task was to indicate whether the probe was in the sentence or not. Of primary interest were the false recognitions and the correct latencies that occurred when the probe word was a synonym or antonym of one of the words in the sentence (Experiment I) or when the probe was a subordinate, superordinate, part, or whole (Experiment II). The younger children were more affected by synonymy than antonymy, although the older children and adults were not. At all ages, the categorical relationships caused more recognition confusion than the partwhole relationships. Subjects were more affected when the probe was a superordinate than when it was a subordinate, and somewhat more affected when the probe was the whole than when it was the part. These results suggest that children as young as 5 years of age have well-organized conceptual systems based on shared meaning components.     

Age,context, and spatial memory: A neuropsychological approach

Abstract

The hypothesis that a reduction in age differences in spatial location memory in the presence of distinctive cues reflects a decreased dependence on a hippocampally based memory system was tested in three experiments. In Experiments 1 and 2 the presence of distinctive cues did not reduce age differences in spatial location memory nor did these cues eliminate the significant relation between spatial location memory and a measure of hippocampal function. Distinctive cues did, however, place additional demands on processing resources and spatial visualization abilities. In Experiment 3 the relevance of prior knowledge was manipulated. With irrelevant prior knowledge there was a strong unique association between the hippocampal measure and outcome measure. With relevant prior knowledge there was no such association. the implications of these findings for understanding the role of the hippocampus in age-related decline in memory for locations are discussed.     

Visuomotor adaptation in normal aging

Visuomotor adaptation to a gradual or sudden screen cursor rotation was investigated in healthy young and elderly subjects. Both age groups were equally divided into two subgroups; one subgroup was exposed to 11.25° step increments of visual feedback rotation, every 45 trials (up to a total of 90°), whereas a second subgroup was subjected to 90° rotation from the onset of exposure. Participants performed discrete, horizontal hand movements to virtual targets in four randomized directions. Targets appeared on a computer screen in front of them, and a board prevented vision of the hand at all times. Differential effects of aging on visuomotor adaptation were found, depending on the time course of the visual distortion. In both age groups, early exposure to the sudden visual feedback distortion resulted in typical spiral-like trajectories, which became straighter by late exposure. However, the final adaptation level was reduced in the aged group, although the aftereffects were similar. When subjects were exposed to the gradual distortion, no statistically significant differences in measures of adaptation with advancing age were found. In this case, both age groups appeared to adapt equally. However, after removal of the distortion, elderly subjects showed reduced aftereffects as compared with the young group. These findings suggest differential effects of aging on adaptation to gradual versus sudden visual feedback distortions, and may help to explain the conflicting results obtained in previous visuomotor adaptation studies.     

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.     

The Visuomotor Mental Rotation Task: Visuomotor Transformation Times Are Reduced for Small and Perceptually Familiar Angles

In the visuomotor mental rotation (VMR) task, participants point to a location that deviates from a visual cue by a predetermined angle. This task elicits longer reaction times (RT) relative to tasks wherein the visual cue is spatially compatible with the movement goal. The authors previously reported that visuomotor transformations are faster and more efficient when VMR responses elicit a degree of dimensional overlap (i.e., 0° and 5°) or when the transformation involves a perceptually familiar angle (i.e., 90° or 180°; K. A. Neely & M. Heath, 2010b). One caveat to this finding is that standard and VMR responses were completed in separate blocks of trials. Thus, between-task differences not only reflect the temporal demands of the visuomotor transformations, but also reflect the temporal cost of response inhibition. The goal of this study was to isolate the time cost of visuomotor transformations in the VMR task. The results demonstrated that visuomotor transformations are more efficient and effective when the response entails a degree of dimensional overlap between target and response (i.e., when the angular disparity between the responses is small) or when the transformation angle is perceptually familiar.     

Mild cognitive impairment: a neuropsychological perspective

Mild cognitive impairment (MCI) is a clinical diagnosis in which deficits in cognitive function are evident but not of sufficient severity to warrant a diagnosis of dementia. For the majority of patients, MCI represents a transitional state between normal aging and mild dementia, usually Alzheimer's disease. Multiple subtypes of MCI are now recognized. In addition to presentations featuring memory impairment, symptoms in other cognitive domains (eg, executive function, language, visuospatial) have been identified. Neuropsychological testing can be extremely useful in making the MCI diagnosis and tracking the evolution of cognitive symptoms over time. A comprehensive test battery includes measures of baseline intellectual ability, attention, executive function, memory, language, visuospatial skills, and mood. Informant-based measures of neuropsychiatric symptoms, behaviors, and competency in instrumental activity are also included. Careful assessment can identify subtle deficits that may otherwise elude detection, particularly in individuals of superior baseline intellectual ability. As we move closer to disease-modifying therapy for Alzheimer's disease, early identification becomes critical for identifying patients who have an opportunity to benefit from treatment.     

Cognitive decline and human (Homo sapiens) aging: an investigation using a comparative neuropsychological approach

Using a comparative neuropsychological approach, the authors compared performance of younger and healthy older adults ages 65 and over on tasks originally developed to measure cognition in animals. A battery of 6 tasks was used to evaluate object discrimination, egocentric spatial abilities, visual and spatial working memory, and response shifting. Older adults performed more poorly than younger adults on tasks that evaluate egocentric spatial abilities, response shifting, and to a lesser extent object recognition. The two groups did not differ for tasks that evaluate spatial working memory and object discrimination. The impairments the authors observed in tasks that evaluate response shifting and object recognition are consistent with those found in canines and primates as well as those found in Alzheimer's disease. The results are consistent with the notion that cognitive processes supported by the amygdala and the orbitofrontal cortex are among the first to decline with increasing age in both humans and animals.