A prime-masked ERP investigation on phonology in visual word processing among bilingual speakers of alphasyllabic and alphabetic orthographies.

In this study, we experimentally manipulated the phonology of the cross-script prime-target dyads in an ERP-coupled masked priming paradigm to explore the role phonology plays in visual word processing. The written characters of certain bilingual dyads seldom show any visual/orthographic similarity, yet have the same phonological representation. While the Bilingual Interactive Activation (BIA) model relies on the orthographic similarity between the languages in a bilingual dyad, its revised version (BIA + model) additionally banks on the phonological (and semantic) similarity between the words in such dyads. Thus, there exists the need to investigate the role of phonological (and semantic) similarity between the words of a bilingual dyad, especially in the absence of orthographic similarity. Borrowed words from one language to another provide a suitable avenue to explore this question. Cross-orthographic (or cross-script) bilingual participants of this study performed the semantic judgment of visually presented words in a masked priming paradigm in each of their languages while we simultaneously collected the event-related potentials (ERPs). The primes were either translations (different phonology & orthography: P-O-; phonologically incongruent) or transliterations (same phonology & different orthography: P + O-; phonologically congruent) of the target. Overall, the results showed no difference between the two prime conditions. We discuss our findings in light of the BIA and BIA + models of bilingual visual word processing and discuss the relevance of the former model in orthographically distinct bilingual language dyads.

Lexical-semantic processing of action verbs and non-action nouns in Persian speakers: Behavioral evidence from the semantic similarity judgment task.

The processing of sensory-motor aspect of word's meaning, and its difference between nouns and verbs, is the main topic of neurolinguistic research. The present study aimed to examine the lexical-semantic processing of Persian non-action nouns and action verbs. The possible effects of semantic correlates on noun/verb dissociation were evaluated without morphological confound. A total of 62 neurologically intact Persian speakers responded to a computerized semantic similarity judgment task, including 34 triplets of non-action nouns and 34 triplets of action verbs by pressing a key. Response Time (RT) and percentage error were considered as indirect measures of lexical-semantic encoding efficiency. We also assessed the latency of hand movement execution with no linguistic demand. The results showed that action verbs elicited more errors and had slower RT compared with object nouns. Mixed ANOVA revealed that the observed noun/verb distinction was not affected by demographic factors. These results provided evidence that the lexical-semantic encoding of Persian action verbs, compared to non-action nouns, requires more support from cognitive sources during the processing of the motor - related semantic feature. The possible accounts for the different processing of action verbs in terms of semantic view are suggested.

Development and validation of a novel corpus of 269 verb pictures in Kannada based on an argument structure taxonomy.

Pictorial stimuli are crucial in psycholinguistic research and clinical practice. The development of culturally and linguistically appropriate, standardized picture corpora is a tedious and meticulous process. Yet, such readily accessible picture sets are useful for researchers and clinicians alike. The current study introduces a novel set of 269 verb pictures for an Indian language - Kannada. The included verbs were selected from a published database of 100,000 words along with their frequency scores in this language, and were subsequently categorized based on an argument structure taxonomy. Each picture is developed based on an exemplar sentence that depicts a scenario rather than a mere action. Norms are provided for verb name and argument agreement, image agreement, concept familiarity, and visual complexity, along with the orthographic frequency. Correlations between these measures are also described. The complete set of pictures are freely downloadable from https://osf.io/uk2af/?view_only=ecffbd92f48546a484c869b3f0b8ec94 for academic, research, and clinical usage in the future.

A systematic review on the role of language-related factors in the manifestation of stuttering in bilinguals.

PURPOSE: Bilingual(s) who stutter (BWS) provide an opportunity to explore the link between stuttering and language. Unlike in monolinguals, stuttering in bilinguals could be influenced by both speaker-related language (e.gs. dominance & proficiency) and linguistic typology-related factors (e.g., structure of languages). However, the available literature is largely inconclusive on these factors. In this context, we systematically reviewed the literature to compile evidence on the influence of such factors on BWS. METHOD: We followed the conventional systematic review process that included five databases. Further, the quality of the included articles was assessed using Newcastle-Ottawa Scale (NOS) for quality rating. RESULT: Thirteen articles passed the selection criteria. Review of these articles revealed that language proficiency and dominance are the important factors that affect stuttering frequency in BWS. Though the linguistic typology is portrayed as a factor on the differential manifestation of dysfluencies in both languages of the BWS, the literature does not provide substantiating data for this. Further, the lack of uniformity in assessing and reporting language dominance and proficiency are the major drawbacks in the existing literature on stuttering in BWS. CONCLUSION: This review identifies proficiency and dominance as the major factors that influence the stuttering frequency in BWS. Currently, the evidence for the influence of typological differences between languages of the BWS on stuttering largely remains whimsical. Future research shall employ the recommended tasks and metrics while assessing the dysfluencies in BWS so that findings across centres become comparable, which in turn, could yield valid inferences.

Literacy Profile of Children with Language Impairment: Evidence from an Alphasyllabary.

BACKGROUND: Most of the evidence explaining the language-literacy link is derived from children learning to read and write alphabetic orthography. AIM: This study investigated the literacy deficits in children learning to read Kannada, a Dravidian language that employs an alphasyllabary. METHODS: A group of 15 children with language impairment (CwLI) was compared with two groups of control (age- and language-matched) participants on a range of literacy measures. RESULTS: The results showed that, compared to the age-matched group, the CwLI group performed significantly poorer on reading (words and nonwords) and written spelling tasks. However, the performance on akshara (the written symbol in the alphasyllabary) recognition task was comparable between groups. Similarly, comparison of the CwLI group with the language-matched control group revealed poorer performance in the former group on most literacy measures but not the akshara recognition task. Akshara recognition emerged as the most significant predictor of literacy performance in children learning to read and write the Kannada alphasyllabary. Detailed analyses of the written spelling errors unveiled several unique error types in the language-impaired group. CONCLUSION: The findings of our study revealed both orthography-independent and orthography-dependent deficits in the literacy skills of CwLI mastering the Kannada alphasyllabary.

Aphasia in Neurology Practice: A Survey about Perceptions and Practices.

BACKGROUND: Aphasia is one of those clinical conditions, where the role of affiliated professionals, mainly speech language pathologists (SLPs) is substantial in diagnostic assessments, therapy, and rehabilitation. There is no study to focus on neurologists, with respect to their perceptions and practices about aphasia, the disease, as well as the profession of SLP. OBJECTIVE: To reach out to the neurologist community in India and learn about their perceptions and practices about the nature of the ailment and role of speech language therapy (SLT). Our premise was that observations and inferences from a questionnaire-based survey will be subsequently helpful in planning educational activities targeted to neurologists with more focus on specific gaps in perceptions and practices. MATERIAL AND METHODS: Three neurologists and two SLPs collaboratively developed the questionnaire. The aim was to probe the issues which were likely to have a bearing upon optimum service delivery to persons with aphasia by a dyad of neurologist and SLP. The survey was set in "Google Forms" and sent by "WhatsApp" and email to approximately 500 practicing neurologists in India. We employed a nonprobability sampling design for ease of administration with a combination of "chunk sampling" and "snowball sampling." Telephonic reminders were made to almost all. RESULTS AND DISCUSSION: We received 100 responses. The mean age of respondents was 50.64 (SD +/- 12.60) with a range of 28-78 years. The mean number of years of experience as a neurophysician was 19.88 (SD. +/- 12.72) with range of 1-47 years. Females were only 8%. Apparently, the proportion of neurologists working in large corporate and large public sector institutions from tier one and tier two cities was higher, who are more likely to have SLP and related rehabilitation facilities in their institutions and hence harbor more conducive attitudes to SLT in aphasia. The ground reality from tier three cities and small private and public sector hospital and solo practitioners may be somewhat worse than this. Many responses were in conformity with facts and in tune with desirable attitudes as per guidelines like aphasia being a detrimental factor in stroke recovery, doing assessment of handedness, paying attention to neuroimaging correlations and associated cognitive functions, not resorting to unnecessary pharmacotherapy, being aware about efficacy of SLT, and fairly good chances of recovery. However, many more answers highlighted a need for emphasis in Continuing Medical Education like not being aware about community burden of aphasia in comparison to a few better known neurological diseases, not paying attention to psychosocial aspects apart from biological ones in assessment and rehabilitation, not using a standardized and validated battery, not confidant about role of SLT in chronic stable aphasia and need for longer and intensive therapy, and being unconcerned for the value of advocacy for aphasia, like the role of Self-Help Groups. CONCLUSION: The thrust areas, pertaining to gaps in perception and practices identified through this study, can be viewed as "an in-time input." We hope that changes in some of the perceptions and practices can be attained through an emphasis on education and training at multiple levels right from the undergraduate to the practicing physicians. A few more themes and domains will need advocacy actions targeted to different stakeholders.

Literacy-Based Normative Data for Elderly Adults on Linguistic Profile Test in Kannada and Malayalam.

OBJECTIVES: Literacy is an important variable that can influence the performance of persons with aphasia on language tasks. This study aimed to generate the literacy-based normative data in two Indian languages (Kannada and Malayalam) for a linguistic tool originally designed for adults with acquired language impairment following brain damage-the Linguistic Profile Test (LPT). METHODS: The Kannada and Malayalam versions of LPT were administered on 134 and 127 normal speakers of these languages, respectively. The participants were divided into three literacy groups (nonliterates, semiliterates, and literates). The scores on each section of the test as well as the overall scores were determined, as per the instructions provided in the test material. RESULTS: The influence of literacy was apparent in semantic and syntax sections of the LPT. Participants from nonliterate group performed notably poorly on these two tasks compared to other two groups. Literacy, however, did not show an effect on the "phonology" section of LPT. CONCLUSION: The literacy-based norms of LPT developed here could improve the sensitivity of clinical evaluation by reducing the "false positives," especially while evaluating the language skills of nonliterate persons with brain damage.

Clinical Use of the Kannada and English Rate of Reading Tests.

The rate of reading test in which randomly ordered common words are read aloud has found use in optometric and educational practice as a means of assessing visual aspects of reading largely independently of comprehension. English and Kannada versions of the rate of reading test were administered to 761 children aged between 9 and 15 years. These children were recruited from four private and five state schools in Udupi Taluk that had English and Kannada, respectively, as the principal medium of instruction. The results showed that the reading rate increased with age, as expected, but depended on the language of the test and the medium of instruction. The study emphasizes the importance of using normative data based on age and the language of instruction used in school. It also suggests age-specific criteria to measure the efficacy of any visual intervention aimed at improving reading speed. The test can be used to assess (1) educational under-performance in reading and (2) the effects of optometric and educational intervention, and separate norms appropriate for each use are presented.

Expert Group Meeting on Aphasia: A Report.

A multidisciplinary team of experts took stock of the current state of affairs about many aspects of aphasia in India, including community burden, diagnostic assessment, therapy, rehabilitation, research, education, and advocacy. The broad spectrum of aphasiology was matched by the types of participants ranging from neurologists, speech-language pathologists, clinical psychologists, linguists, to experts in neuroimaging and computer sciences. Threadbare discussion in 16 sessions over 3 days leads to the identification of pressing problems and possible solutions. Many action plans have been envisaged and recommendations made. A few examples with high priority are community-based and hospital-based study incidence and prevalence of aphasia, development of test batteries for the assessment of many components of speech and communication in Indian languages which are validated on rigorous psychometric, and linguistic criteria, national registry for aphasia, educational modules about aphasia for different target groups, resources for advocacy and its training, a bank of research questions and outlines of research protocols for young professionals to pursue. The expert group will continue to oversee execution of some of the actionable plans in short and long term.

Reliability and validity of a Kannada rate of reading test.

Purpose: Kannada, one of the Dravidian languages, is the official language of Karnataka state of India. There is a need for a test using Kannada words that can assess visual aspects of reading independently of syntactic and semantic knowledge. Methods: A test of reading rate in Kannada was developed following the design principles of the Wilkins Rate of Reading Test (RRT). Fifteen high-frequency bisyllabic Kannada words were selected. Children were recruited from state and private schools that used Kannada or English as the medium of instruction. A total of 799 children from Grade 2 to 9 participated in the study. Reading rate was measured using the English RRT and the Kannada version twice in immediate succession during the first session. In 85 children, measurements using the Kannada RRT were repeated after an interval of 15 days. Results: Pearson product moment correlation between the two immediately successive tests was 0.95 for the Kannada RRT and 0.91 for the English RRT. The correlation for the tests separated by an interval of 15 days was 0.83. When Kannada was the medium of instruction, there was little difference between test scores for Kannada and English. When English was the medium of instruction, test scores were greater in English. Scores increased as expected with age (P < 0.0001), similarly for Kannada and English tests. Conclusion: The newly developed Kannada RRT is both reliable and valid and can be used as a tool for measuring the visual aspects of reading.

Short Version of the Bilingual Aphasia Test in Malayalam.

BACKGROUND: Brain damage can impair the use of all languages in bilingual persons. For effective management of aphasia (i.e., impaired language) in such persons, assessment of all languages is essential. The most widely used test for this purpose - the Bilingual Aphasia Test (BAT) - is cumbersome and requires a considerable amount of time for administration. To overcome this limitation, a short version of the BAT has been recommended. OBJECTIVE: The objective of this study was to derive a short version of BAT for Malayalam-English bilingual persons with aphasia and to establish the test-retest reliability as well as the content and construct validities of this version. METHODS: Following the recommendations of the test developers, we used seven subtests from the draft of an adapted full version of Malayalam BAT. These subtests in Malayalam and their counterparts in English were administered on a group of 22 Malayalam-English bilingual participants with aphasia. The scores obtained from these two languages were used to establish content and construct validities of the short version of the BAT in Malayalam. Further, we readministered the short version of BAT in a group of ten participants with aphasia to examine the test-retest reliability within 14 days from the date of first administration. RESULTS: The short version of BAT in Malayalam revealed high test-retest reliability as well as content and construct validities. The administration time ranged between 30 and 45 min. CONCLUSIONS: Thus, the short version of the BAT in Malayalam can be considered a valid and reliable language test that can be quickly administered in Malayalam-English bilingual persons with aphasia.

Acceptability, reliability, and validity of the Stroke and Aphasia Quality of Life Scale-39 (SAQOL-39) across languages: a systematic review.

OBJECTIVES: This systematic review aimed to explore the acceptability, reliability, and validity of the Stroke and Aphasia Quality of Life-39 (SAQOL-39) scale across languages. DATA SOURCES: We employed a systematic search of the online databases including MEDLINE (Pubmed), Science direct, Web of science, Psychinfo, Scopus, ProQuest, Google Scholar, and Cochrane library published between 2003 and 2016. REVIEW METHODS: We used PRISMA guidelines for conducting and reporting this review. Subsequently, screening of the titles and abstracts, extraction of data as well as the appraisal of the quality of relevant studies were carried out. RESULTS: The initial search returned 8185 studies. Subsequent screening and study selection processes narrowed them to 20, needing detailed review. Forward-backward translation scheme was the preferred method for translation of the SAQOL-39 from English to other languages. Mainly, the socio-cultural and linguistic adaptations were performed in the translated versions. Most versions of the SAQOL-39 showed high test-retest reliability and internal consistency. However, several psychometric properties including the validity and responsiveness were seldom reported in these versions. CONCLUSION: The SAQOL-39 scale showed high acceptability, and reliability across the languages reviewed in this study. Future translations may additionally focus on reporting the validity and responsiveness of the instrument.

Adaptation and validation of stroke-aphasia quality of life (SAQOL-39) scale to Malayalam.

BACKGROUND: Aphasia, an acquired inability to understand and/or speak language, is a common repercussion of stroke that denigrates the quality of life (QOL) in the affected persons. Several languages in India experience the dearth of instruments to measure the QOL of persons with aphasia. Malayalam, the language spoken by more than 33 million people in Kerala, the southern state of India, is not an exception to this. OBJECTIVE: This study aimed to adapt and validate the widely-used stroke-aphasia quality of life (SAQOL-39) scale to Malayalam. MATERIALS AND METHODS: We required seven Malayalam-speaking Speech Language Pathologists (SLPs), hailing from different regions of Kerala, to examine the socio-cultural suitability of the original items in SAQOL-39 and indicate modifications, wherever necessary. Subsequently, the linguistic adaptation was performed through a forward-backward translation scheme. The socio-culturally and linguistically adapted Malayalam version was then administered on a group of 48 Malayalam-speaking persons with aphasia to examine the test-retest reliability, acceptability, as well as the internal consistency of the instrument. RESULTS: The Malayalam SAQOL-39 scale showed high test-retest reliability (intraclass correlation coefficient, ICC = 0.91) as well as acceptability with minimal missing data (0.52%). Further, it yielded high internal consistency (Chronbach's ∝ = 0.98) as well as item-to-total and inter-domain correlations. CONCLUSIONS: The Malayalam version of SAQOL-39 is the first socio-culturally and linguistically adapted tool to measure the QOL of persons with stroke-aphasia speaking this language. It may serve as a potential tool to measure the QOL of this population in both clinical practice and future research endeavors.

Adaptation and validation of stroke-aphasia quality of life (SAQOL-39) scale to Hindi.

BACKGROUND: Stroke is a major detriment to the quality of life (QOL) in its victims. Several functional limitations following stroke contribute to the denigrated QOL in this population. Aphasia, a disturbance in the comprehension, processing, and/or expression of language, is a common consequence of stroke. Yet, in most Indian languages, including the national language (Hindi), there are no published tools to measure the QOL of persons with stroke-aphasia. OBJECTIVE: The current study was carried out to adapt and validate a well-known tool to measure the QOL (i.e., Stroke-Aphasia Quality of Life-39; SAQOL-39) to Hindi. MATERIALS AND METHODS: We presented the original (English) version of the SAQOL-39 to a group of six Hindi-speaking Speech Language Pathologists hailing from the central and northern regions of India to examine the sociocultural suitability of items and indicate modifications, if any. The linguistic adaptation was performed through a forward-backward translation scheme. The socioculturally and linguistically adapted (to Hindi) version was then administered on a group of 84 Hindi-speaking persons with aphasia to examine the acceptability, test-retest reliability as well as the internal consistency of the instrument. RESULTS: The SAQOL-39 in Hindi exhibited high test-retest reliability (ICC = 0.9) as well as acceptability with minimal missing data. This instrument exhibited high internal consistency (Chronbach's ∝ = 0.98) as well as the both item-to-total and inter-domain correlations. CONCLUSIONS: The socioculturally and linguistically adapted Hindi version of SAQOL-39 is a robust tool to measure the QOL of persons with stroke-aphasia. It may serve as an essential tool to measure the QOL in this population for both clinical and research purposes.

Stroke and aphasia quality of life scale in Kannada-evaluation of reliability, validity and internal consistency.

BACKGROUND: Quality of life (QoL) dwells in a person's overall well-being. Recently, QoL measures have become critical and relevant in stroke survivors. Instruments measuring QoL of individuals with aphasia are apparently rare in the Indian context. The present study aimed to develop a Kannada instrument to measure the QoL of people with aphasia. Study objectives were to validate Stroke and aphasia quality of life-39 (SAQOL-39) into Kannada, to measure test-retest reliability and internal consistency. MATERIALS AND METHODS: The original English instrument was modified considering socio-cultural differences among native English and Kannada speakers. Cross-linguistic adaptation of SAQOL-39 into Kannada was carried out through forward-backward translation scheme. The scale was administered on 32 people from Karnataka (a state in India) having aphasia. For a direct understanding of the subject's QoL, scores were categorized into QoL severity levels. Item reliability of the Kannada version was examined by measuring Cronbach's alpha. Test-retest reliability was examined by calculating the intraclass correlation coefficient (ICC). RESULTS: Kannada SAQOL-39 showed good acceptability with minimum missing data and excellent test-retest reliability (ICC = 0.8). Value of Cronbach's α observed for four items modified in the original version was 0.9 each and the mean α of all Kannada items was 0.9, demonstrating high internal consistency. CONCLUSIONS: The present study offers a valid, reliable tool to measure QoL in Kannada-speaking individuals with aphasia. This tool is useful in a cross-center, cross-national comparison of QoL data from people with aphasia. This instrument also permits direct translation into other Indian languages as the items are culturally validated to the Indian population. This study promotes future research using the Kannada SAQOL-39.

Variability in aphasia following subcortical hemorrhagic lesion.

BACKGROUND: Vascular lesion of the subcortical structures leads to aphasia. Cortical hypoperfusion has been proposed to be the etiological mechanism in aphasia following subcortical vascular lesion. Subcortical aphasia shows considerable variability in its clinical profile. Such variability has been attributed to the variable sites of cortical hypoperfusion following ischemic lesion of the subcortical structures. PURPOSE: This study investigated the variability in clinical aphasic profile following subcortical hemorrhagic lesion. METHODS: We retrospectively investigated the clinical aphasic profiles of twelve patients who reported to our hospital during a period of one year with subcortical hemorrhagic lesions. All patients underwent routine neurological examination, neuroimaging (CT/MRI) investigations and linguistic assessment. RESULTS: Eight patients exhibited lesion to the basal ganglia and four showed thalamic lesion. All of them showed considerable variability in their aphasic profile. CONCLUSION: Subcortical hemorrhagic lesion leads to variability in aphasia. Variability in aphasia may be considered as an important consequence in subcortical vascular lesion. Observations from this study were suggestive of better preservation of, and when affected, faster recovery of comprehension skills.

Global aphasia without hemiparesis: A case series.

BACKGROUND: Global aphasia without hemiparesis (GAWH) is a rare stroke syndrome characterized by the unusual dissociation of motor and language functions. Issues regarding its etio-pathogenesis, lesion sites, and recovery patterns are extensively being debated in contemporary neuroscience literature. MATERIALS AND METHODS: Four patients admitted in our hospital between 2005 and 2009 with GAWH caused by ischemic stroke were studied retrospectively with emphasis on number and site of lesions, etiology, and recovery patterns. RESULTS: The clinical findings from our subjects showed that GAWH could result from either single/multiple lesions including subcortical lesions. The recovery was rapid, although not complete. One case evolved into Wernicke's aphasia as seen in earlier studies. Two subjects revealed evolution to transcortical sensory aphasia and one to Broca's aphasia which is distinct from previous proposals. Two cases showed lack of clinico-anatomic correlation during recovery. CONCLUSIONS: GAWH could result from both embolic and large vessel strokes and single or multiple lesions. The recovery pattern may be variable and may show lack of clinico-anatomical correlation indicating anomalous cerebral functional reorganization, questioning the conventional teaching of language representation in the brain.

Apraxic agraphia: An insight into the writing disturbances of posterior aphasias.

BACKGROUND: Reading and writing disturbances are common accompaniments of aphasia following brain damage. However, impaired writing in the absence of apparent primary linguistic disturbances is infrequently reported in the literature. MATERIALS AND METHODS: A 67-year-old right-handed subject underwent neurological, neuroradiological, and linguistic investigations following development of a minimal right upper limb weakness. RESULT: The patient had polycythemia and the neurological investigation revealed right upper limb paresis. The neuroradiological investigation revealed hypodense areas involving the gray-white matter of the left postero-parietal and frontal lobe, left caudate and lentiform nuclei, and the anterior limb of the internal capsule, suggesting an infarct. The linguistic investigation revealed a mild anomic aphasia with apraxic agraphia. This mild anomic aphasia resulted primarily from the relatively poor scores on the verbal fluency tests. DISCUSSION: The marked writing impairment, even with the left hand, points to disturbances in written output - apraxic agraphia - in the presence of near-normal spoken output. This finding should raise suspicion about hidden apraxic agraphia in subjects with posterior aphasias.