Developmental pathways of language and social communication problems in 9-11 year olds: unpicking the heterogeneity

This paper addressed relations between language, social communication and behaviour, and their trajectories, in a sample of 9-11-year-olds (n=91) who had been referred to clinical services with concerns about language as pre-schoolers. Children were first assessed at 2½-4 years, and again 18 months later. Results revealed increasing differentiation of profiles across time. By 9-11 years, 11% of the sample had social communication deficits, 27% language impairment, 20% both, and 42% neither. The size of group differences on key language and social communication measures was striking (2-3 standard deviations). Social communication deficits included autistic mannerisms and were associated with social, emotional and behavioural difficulties (SEBDs); in contrast, language impairment was associated with hyperactivity only. Children with both language and social communication problems had the most severe difficulties on all measures. These distinct school-age profiles emerged gradually. Investigation of developmental trajectories revealed that the three impaired groups did not differ significantly on language or SEBD measures when the children were first seen. Only low performance on the Early Sociocognitive Battery, a new measure of social responsiveness, joint attention and symbolic understanding, differentiated the children with and without social communication problems at 9-11 years. These findings suggest that some children who first present with language delay or difficulties have undetected Autism Spectrum Disorders which may or may not be accompanied by language impairment in the longer term. This new evidence of developmental trajectories starting in the preschool years throws further light on the nature of social communication and language problems in school-age children, relations between language impairment and SEBDs, and on the nature of early language development.

Enhancing communication in jargon aphasia: a small group study of writing therapy

People with jargon aphasia have severely disordered and incomprehensible speech that may be resistant to therapeutic intervention. In this study, we treated written output and examined whether it assisted communication for these clients. In stage one of the study, anagram sorting, delayed copying and lexical decision tasks were used to investigate the residual knowledge of written words in a group of ten people with jargon aphasia. Evidence of the presence of orthographic knowledge was taken as an indication that writing might be a useful focus for therapy. This hypothesis was explored in stage two with six clients. A personally useful vocabulary was selected for each, and copying, word completion and written picture-naming tasks were used in therapy to improve written production of these words. The clients made progress in written naming. However, they showed little change on a 'message' assessment that tested their ability to use the written words to convey messages. Stage three targeted communicative writing. Here, three of the clients received 'message therapy', which encouraged them to relate treated words to functional messages and to communicate them to a partner. The clients improved on the message assessment and observation of their communication and reports from relatives suggested that they made functional use of writing in a range of communication settings.

When ottoman is easier than chair: an inverse frequency effect in jargon aphasia

This paper presents evidence of an inverse frequency effect in jargon aphasia. The subject (JP) showed a pre-disposition for low frequency word production on a range of tasks, including picture naming, sentence completion and naming in categories. Her real word errors were also striking, in that these tended to be lower in frequency than the target. Reading data suggested that the inverse frequency effect was present only when production was semantically mediated. It was therefore hypothesised that the effect was at least partly due to the semantic characteristics of low frequency items. Some support for this was obtained from a comprehension task showing that JP's understanding of low frequency terms, which she often produced as errors, was superior to her understanding of high frequency terms. Possible explanations for these findings are considered.

Phonological naming therapy in jargon aphasia: positive but paradoxical effects

This article is a single-case investigation of phonological naming therapy. The individual involved had fluent jargon speech, with neologisms, verbal paraphasias, and paragrammatisms. The jargon was underpinned by a severe anomia. Content words were rarely accessed either in spontaneous speech or naming. Single word investigations highlighted some preserved skills. Auditory comprehension, at least for concrete words, was relatively intact and although nonwords could not be repeated, words could, and at a level which was far superior to naming. The patient also had some ability to respond to phonological cues. These results suggested that phonological representations were preserved and that there were some intact semantic abilities. It seemed that the naming disorder was primarily due to an inability to access phonology from semantics. Therapy took a phonological approach. The patient was encouraged to reflect upon the syllabic structure and first phoneme of pictured targets. Subsequently, she was required to use this partial phonological knowledge as a self-cue. It was hypothesized that this therapy might equip the subject with a self-cuing naming strategy. Posttherapy investigations of naming demonstrated dramatic improvements, which generalized to untreated items. However, there was little evidence that these were due to a self cuing strategy. Performance on phonological judgment and discrimination assessments, which required conscious phonological reflection, was unchanged, and there were no signs that the patient was self-cuing during naming. Reasons for these paradoxical results are discussed.

Written communication in undifferentiated jargon aphasia: a therapy study

A subject, R.M.M., with a 2-year history of jargon aphasia is described. At the beginning of this study she had minimal meaningful spoken output and showed little awareness of her speech despite having relatively well-preserved auditory comprehension. Her spoken output had proved resistant to earlier periods of therapy. In contrast, R.M.M.'s written output showed some ability to access orthographic information and monitoring of this modality was shown by an acute awareness of her errors. A 3-stage therapy programme is described. This was designed to improve R.M.M.'s writing of single words and to encourage use of writing as an alternative means of communication. The initial stage of therapy aimed to increase R.M.M.'s access to written word forms by use of picture stimuli. She showed significant improvement in writing treated items in response to pictures both immediately after therapy and at re-assessment 6 weeks later. Despite the acquisition of these skills, R.M.M. failed to use them in communicative contexts. A second stage of therapy replicated the results of the first and sought to facilitate R.M.M.'s functional use of her written vocabulary by asking her to write words to spoken questions. She again showed improved written naming of the treated items and could now produce written names appropriately in a questionnaire-type assessment. Generalization of this ability extended to items that had not been trained in this way. Functional use of writing in everyday communication remained absent, however. The final stage of therapy made explicit the potential links between items which R.M.M. could now write and functional messages which they might convey. She again showed significant changes in the acquisition of new vocabulary and, encouragingly, progress was also seen in her use of the strategy in functional communication. R.M.M.'s speech is almost entirely incomprehensible. It has remained unchanged for 2 years and has not responded to therapy. Relatively well-preserved auditory comprehension and good monitoring of written output allowed therapy to effectively target a small written vocabulary. Despite significant progress in the acquisition of new items, transfer of this skill to functional communication was initially absent. Further therapy which specifically targeted the impairment causing this failure was needed before functional use was seen. The potential for treating written output in cases of jargon aphasia which have been resistant to therapy for spoken language is discussed.

Verb retrieval and sentence production in aphasia

This paper presents a subject with a selective verb retrieval deficit. Nouns were produced more successfully than verbs in spontaneous speech, picture naming and when naming to definition. The word class effect was not observed in comprehension tasks, reading aloud or writing. This indicated that it was due to a specific problem in accessing verbs' phonological representations from semantics. The second part of the paper explores the implications of the verb deficit for sentence production. Analyses of narrative speech revealed a typically agrammatic profile, with minimal verb argument structure and few function words and inflections. Two investigations suggested that the sentence deficit was at least partly contingent upon the verb deficit. In the first, the subject was asked to produce a sentence with the aid of a provided noun or verb. The noun cues were not effective in eliciting sentences, whereas verb cues were. The second investigation explored the effects of therapy aiming to improve verb retrieval. This therapy resulted in better verb retrieval and improved sentence production with those verbs. These findings suggest that an inability to access verbs' phonological representations can severely impair sentence formulation. Implications for models of sentence production are considered.

Why does monitoring fail in jargon aphasia? comprehension, judgment, and therapy evidence

Many people with jargon aphasia seem unaware of their speech disorder. The first section of this paper reports data from four subjects which indicate that self-monitoring can fail even when subjects' input skills are apparently adequate to detect their errors. Explanations for this dissociation have attributed monitoring failure to a deficit in auditory feedback, or to a resource limitation which prevents concurrent speaking and monitoring. Section 2 reports a series of naming and judging experiments with one of the subjects which rule out these explanations. These show that the subject can detect his neologisms when he is repeating, but not when he is naming. These results suggest that his monitoring difficulties arise when he is accessing phonology from semantics. Section 3 presents a study which supports this inference, since it shows that semantically focused intervention yields improvements in self-monitoring. It is concluded (1) that monitoring failure can arise from deficits within the production process which preclude comparison of actual with intended output, and (2) that this deficit is best explained within a connectionist model in which monitoring is performed by feedback mechanisms in the word production process.

When is it best to hear a verb? The effects of the timing and focus of verb models on children's learning of verbs

This paper explores the effects of certain aspects of verb input on verb acquisition. It has been observed that the timing of a verb model affects children's learning of the verb (Tomasello & Kruger, 1992). It has also been observed that the focus of the event to which the verb refers affects the argument structure children assign to the verb (Pinker, 1989). This experiment investigated the interaction between the timing of verb models and the focus of the events to which they refer. Thirty children aged from 2;3 to 3;6 heard two novel verbs, one movement focused and the other result focused. Half heard the verbs before the event (impending condition) and half after it (completed condition). An interaction of verb timing and verb focus was found. The movement verb was learned better in the impending condition and the result verb in the completed condition. The contribution of this finding to our understanding of the processes involved in verb acquisition is considered.

I, you, me, and autism: an experimental study

The nature of autistic individuals' abnormalities in the use of personal pronouns has been a topic of considerable speculation but little systematic investigation. We tested groups of CA- and verbal MA-matched autistic and nonautistic mentally retarded children and young adults on a series of tasks that involved the comprehension and use of the personal pronouns "I," "you," and "me." All subjects were able to comprehend these pronouns within the test situations, and there were few instances of pronoun reversal. However, autistic subjects were significantly less likely to employ the pronoun "me" in a visual perspective-taking task (when instead they tended to say: 'I can see the . . .'), and lower ability subjects were more likely to use their own proper names rather than personal pronouns in certain photograph-naming tasks. There were also circumstances in which autistic subjects were less likely than controls to employ the pronoun "you" to refer to the experimenter. A high proportion of these autistic subjects were reported to have current difficulties with personal pronouns in their everyday life, and we discuss some alternative interpretations of the results.

If I were you and you were me: the analysis of pronouns in a pronoun-reversing child

An investigation into the pronoun distribution of a pronoun-reversing child reveals inconsistencies both within production and between production and comprehension. This distribution is compatible with some analyses of normal pronoun development and pronoun reversal which have attributed non-adult person distinctions to the child. However, the data are also compatible with a quite distinct hypothesis which postulates that the child's pronouns are plurifunctional: the unreversed pronouns encode full adult distinctions, and are independent of the reversed pronouns, which function to shift perspective. The evaluation of these hypotheses and the questions they raise for normal and pathological pronoun development are discussed.

Context-specificity and generalization in the acquisition of pronominal distinctions

The pronoun system provides a fruitful area for investigating the conditions under which children make linguistic generalizations. Pronouns are defined by a complex of semantic, syntactic, and morphological distinctions whose interaction is only partially consistent. In the course of acquiring them, children often make systematic errors which reflect novel generalizations from the adult input. A distributional analysis was applied to the errors made by 48 children in marking distinctions of person, possession, and case in their spontaneous use of pronouns. The analysis indicated that children do not make maximal generalizations which extend a particular feature to all related contexts. Rather, they acquire specific complexes of features, and are quite conservative in extrapolating from one feature complex to another.