Acquired aphasia in children and the ontogenesis of hemispheric functional specialization.

We have described a series of 26 cases of cortical lesions in children from $\text{3}\text{1}\text{2}$ to 15 years of age (17 left-sided, six right-sided, three bilateral), in which 19 had varying degrees of language disturbance. We have attempted to establish the nature and evolution of these aphasic disorders, and have compared our observations to those previously published. Our analysis appears to indicate a relative hemispheric equipotentiality which permits the transfer of language representation to the opposite hemisphere in the case of a unilateral lesions in childhood. This conclusion, however, has at least the appearance of being in conflict with other reported findings, viz., those deriving from psychometric testing of subjects with unilateral perinatal lesions; and those concerning studies of fetal and newborn brains which suggest a very early, if not innate, hemispheric specialization.The fact of this discrepancy has lead us to reconsider the concept of a critical period as defined by Lenneberg. In this respect, we have also discussed the possibility of a partial transfer of language representation, of an intrahemispheric reorganization by intact “uncommitted” areas (P. Goldman), and finally, the need for an adequate stimulus during a given period in order for a preformed area to become functional.     

Estimated Intelligence Moderates Cognitive Processing Therapy Outcome for Posttraumatic Stress Symptoms

Although patient intelligence may be an important determinant of the degree to which individuals may comprehend, comply with, and ultimately benefit from trauma-focused treatment, no prior studies have examined the impact of patient intelligence on benefit from psychotherapies for PTSD. We investigated the degree to which educational achievement, often used as a proxy for intelligence, and estimated full scale intelligence quotient (FSIQ) scores themselves moderated treatment outcomes for two effective psychotherapies for PTSD: Cognitive Processing Therapy (CPT) and Written Exposure Therapy (WET). Participants, 126 treatment-seeking adults with PTSD (52% male; mean age = 43.9, SD = 14.6), were equally randomized to CPT and WET; PTSD symptom severity was measured at baseline and 6-, 12-, 24-, 36-, and 60-weeks following the first treatment session. Multilevel models revealed that participants with higher FSIQ scores experienced significantly greater PTSD symptom reduction through the 24-week assessment in CPT but not WET; this effect did not persist through the 60-week assessment. Educational achievement did not moderate symptom change through either 24- or 60-weeks. Individuals with higher FSIQ who are treated with CPT may experience greater symptom improvement in the early stages of recovery.