Psycholinguistic models of speech development and their application to clinical practice.

This article presents an introduction to psycholinguistic models of speech development. Two specific types of models are addressed: box-and-arrow models and connectionist or neural network models. We review some historical and some current models and discuss recent applications of such models to the management of speech impairment in children. We suggest that there are two ways in which a psycholinguistic approach can influence clinical practice: by directly supplementing a speech-language pathologist's repertoire of assessment and treatment approaches and by offering a new way to conceptualize speech impairment in children.

Cortical degeneration associated with phonologic and semantic language impairments in AD.

OBJECTIVE: To compare the pattern of cortical degeneration associated with different language deficits in cases of AD. METHODS: Cases for detailed neuropathologic analysis (Patients 1 and 2) were selected because of their detailed clinical and neuropsychological assessments of language dysfunction in AD. Patient 1 had severe phonologic impairment with relatively preserved semantic aspects of language. Patient 2 had severe semantic language impairment with relatively preserved phonologic skills. The tissue volume of cortical regions associated with speech and language function was measured using standardized three-dimensional techniques. Neuronal areal fraction was also measured from histologic tissue samples. The degree of volume atrophy and neuronal loss was calculated in comparison to control measures (n = 10 men and 11 women). Measurements more than 2 SD from controls were considered abnormal. RESULTS: Both AD cases had significant degeneration of the superior temporal gyrus and area 37. Cortical language regions affected only in Patient 1 included the anterior and posterior insula and part of Broca's area. In contrast, Patient 2 had a greater degree of degeneration in the temporal gyri and their white matter connections with the hippocampal/entorhinal complex. CONCLUSIONS: Variable patterns of neurodegeneration underlie the clinical differences observed in patients with AD. Disconnection within the temporal lobe appears associated with semantic language difficulties, whereas disconnection of the anterior and posterior language areas appears associated with phonologic and grammatical impairment.

Phonological and articulatory impairment in Alzheimer's disease: a case series.

We demonstrate that phonological and articulatory impairments may occur at presentation or early in the course of Alzheimer's disease, contrary to claims that these aspects of language production are relatively preserved until the final stages of this disease. Six patients with pathologically confirmed Alzheimer's disease (AD) and four patients with clinically diagnosed dementia of the Alzheimer's type (DAT) presented with one of five different clinical profiles: nonfluent progressive aphasia, mixed progressive aphasia, progressive aphasia diagnosed as DAT from neuropsychological assessment, initial amnestic syndrome with prominent phonological errors, and biparietal syndrome. Analysis of their conversational speech, single-word production, and performance of highly familiar series speech tasks such as counting revealed false start errors, phonological paraphasias, and/or articulatory difficulty. Neuropathological changes were located in left perisylvian regions consistent with speech and language impairment but atypical for Alzheimer's disease.

Evidence for impaired sentence comprehension in early Alzheimer's disease.

We investigated sentence comprehension in 46 patients with probable minimal (very mild), mild, or moderate dementia of the Alzheimer type (DAT), comparing their performance on the Test for the Reception of Grammar (TROG), with that of 20 age- and education-matched controls. Performance on the TROG was generally related to dementia severity, independent of lexicosemantic and working memory (digit span) impairments, but related to at least 1 measure of attention. Some patients in the minimal group showed sentence comprehension deficits while others in the moderate group did not, indicating that DAT may impair sentence comprehension at the very earliest stages of disease, but that its effects are heterogeneous. Patients were most impaired on sentences with 2 propositions and noncanonical word order, suggesting difficulties with both interpretative and postinterpretative stages of sentence processing. Further investigation is needed into the relationship between attentional processes, interpretative and postinterpretative stages of syntactic processing in DAT.

Single word production in nonfluent progressive aphasia.

We present an experiment investigation of the spoken single word production of two patients with nonfluent progressive aphasia. In Experiment 1, a task effect (reading > repetition > naming) suggested that phonological information available from task stimuli facilitated the patients' speech production; a length effect reflected the increased difficulty of phonological processing required for long words compared with that required for shorter words. Experiment 2 compared repetition, reading, copying, and writing to dictation tasks and demonstrated that a correspondence between input and output modality also facilitated performance. Experiment 3 showed that the patients' access to appropriate phonology in reading was positively related to the degree of correlation between orthographic and phonological forms. These results are discussed with reference to an account of pathologically weakened connections between nodes in an interactive spreading activation model of speech production of the type described by Dell (1986).

P300 latency after ethanol ingestion in sons of alcoholics and in controls.

The magnitude and persistence of ethanol-induced increases in the latency of the P3 event-related potential from auditory stimuli were evaluated in 21 sons of alcoholic fathers (FHP) and 21 control sons of nonalcoholics (FHN) matched on demography and drinking history. The men were assessed at baseline, 70 min after imbibing a beverage, and 240 min after drinking, with observations carried out for each individual in 3 dosage conditions (placebo, 0.75 ml/kg of ethanol, and 1.1 ml/kg of ethanol). There were no family group differences for baseline (prechallenge) P3 latencies, nor any significant group differences after placebo or low-dose ethanol challenges. However, in the high alcohol dose challenge condition, P3 latencies for FHP subjects returned toward baseline measures more quickly than for FHN men. These results are consistent with previous reports of behavioral and biochemical measures in which FHP subjects demonstrated less intense reactions or returned toward baseline conditions more rapidly after ethanol ingestion relative to the FHN controls.