language in children with early unilateral brain injury：早期單側(cè)腦損傷兒童語言

OutlinePreformation/Emergentism--SeventheoriesDevelopmentoflanguageinpreschoolchildrenwithearlyunilateralbraininjuriesPerformanceatschoolageFormalmeasuresSentencecomprehensionstrategiesInformationprocessingtasksfMRItouncoverpatternsofreorganizationoflanguageClassictheory:LanguagemodulesinadultbrainFrontBackFrontBackLRLModules

from

birth?AtoolkitAGeneforthePastTense?Achilles’HeelofModularity:

achildwithmarkedhydrocephalusandnormallanguageAlternativetheory:

EmergentismLanguageareasnothighlycircumscribednorhighlyspecialized,thoughLHdominantRHbecomesactivatedforvariouscomponentsorlevelsofdifficultyAfterinjury,recoverymaybepossiblewithtrainingStructureinHoneycombsStructureinOcularColumnsWhathappensifearlydamage?ChildrenwithearlybraininjuryLRLRLRFrontBackMRIscansofPVHChildwithearlybraininjurySevenobservedpatterns1.Preferentiallanguagesparing2. Cognitivecrowding3.Hemisphericequipotentiality4.Contralateralrecruitment5.Localrecruitment6.Whitemattercommitment7.LaterigidityLackofdirectevidenceNodirectevidenceofcrowdingNodirectevidenceofuseofcontralateralhomologsUnclearevidenceonequipotentialityNodirectevidenceoflocalrecruitmentNodirectevidenceonactualorganizationOpenDevelopmentalQuestionsInitialdelay->catchup->finalparity? ORSparing->cognitivecrowding->declineinlateacquisitions(math,reading) Exactlyhowdoesbrainreorganize?Languagedevelopmentinchildrenwithearlybraininjuries

(Feldman,Holland,Kemp,Janosky,1992)TodescribethechangesovertimeinlanguageskillsofyoungchildrenlearninglanguageMultipleobservationsofparent-childcommunicationLexicon—NumberofwordsSyntax—MLUandIPSYNComparechildrenwithunilateralLHandRHdamagetochildrendevelopingtypicallyVocabularygrowthLHinjuryRHinjuryAveragesentencelength

LHinjuryRHinjuryGrammaticalcomplexityLHinjuryRHinjurySummaryandQuestionsChildrenwithearlybraininjuriesmayshowinitialdelaysandthennearnormalratesofdevelopmentSuggeststakeslongertoorganizethedamagedsystemIssuesWhatarethebestmeasurestoassessearlylanguageinthesechildren?Typesversustokens,competenceversusperformanceWouldlargersamplerevealgreaterdifference?Whathappensasthechildrenreachschoolage?Formaltestingatschoolage

(MacWhinney,Feldman,Sacco,Valdez-Perez,2000)Goal:todeterminehowchildrenwithearlybraininjuriesperformonformalmeasuresatages6to10yearsMeasuresNon-verbalintelligencetest(LeiterInternationalPerformanceScales)Receptivevocabulary(PPVT-R)LanguageFunctions(CELF-R)FormalTestingResultsFormalLanguageMeasuresSentencecomprehensionstudy

(Feldman,MacWhinney,Sacco,inpress)Goal:todeterminethecueschildrenusetodeterminetheagentoftheactioninsentence-comprehensionSyntaxisareaofallegedweaknessinmanystudiesofchildrenwithacquiredinjuriesPhilosophicalcommitmenttofunctionaltasksratherthanjudgmentsToisolatesentencecomprehensionstrategies,needtaskwithminimalotherprocessingdemands:simpleinput,nomemoryload,andnon-verbal(pointingresponse)TaskOn-line“whodoneit?”taskSentencesweresimpleVariedbywordorder:NVN,VNN,andNNVNounswereanimateorinanimateNointonationcuesWordsandpicturestimulipresentedsimultaneouslyoncomputerscreenChildindicatestheagentbypointingtotheappropriatepictureYieldsaccuracyandreactiontimeStimuliNVN-AA Thecatkissedthebear.NNV-AI Thelionthepencilwatched.VNN-IA Huggedtheblockthecamel.

Typicaldevelopmentresults3-4yearoldsdecideonthebasisofanimacy5-6yearoldschoosefirstnouninNVN7-8yearoldschoosefirstnouninNVNandsecondnouninVNN9-10yearoldschoosesecondnouninNNV,adultpattern

(VonBergenetal,1996)FirstnounchoiceMaineffectofwordorderp<.001Maineffectofgroupp=.058InteractionofwordorderXgroupp=.027ReactionTime

Maineffectofwordorderp<.001Maineffectofagep=.037ParameterestimatesSubjectsComparisonGroupSubjectGroupYounger(n=82)Older(n=59)Younger(n=7)Older(n=5)Animacy.5891.5782.5598.5374NVN.9242.9720.81311.000VNN.1955.0967.2460.1891NNV.4746.4428.6428.6684ChildrenwithRHdamageN=32childrenweredelayedTheonlychildofthe15subjectstoshowmaturestrategyontheNNVwasonewithRHPVHSummaryUnexpecteddevelopmentaldelaysinchildrenwithLHandRHbraininjuriesinsentencecomprehensionstrategiesVariabilityinperformanceacrossthegroupWouldbeusefultoassesschildren>age12yearsDevelopmentalcourseafterearlybraininjuryInformationprocessingtasks

(Feldman,MacWhinney,Sacco,Valdez-Perez,2000)Goal:toidentifyspecificpatternsofimpairmentasafunctionoflesionlocationassourceoflanguageandsentencecomprehensionprofilesTasks—computerizedtasksPicturenaming,numbernaming,wordrepetitionAlso,digitspantaskMeasures—accuracyandreactiontimeDataanalysis—profiledsubjects’scoresincomparisontoscoresto150childrenatappropriategradeforageResultsOutofrange:Ss10/20Cs12/150ResultsOutofrangeSs7/20Cs10/150ResultsOutofrange:Ss5/20Cs7/150ResultsOutofrangeSs5/20Cs7/150Children’snetoutlierscoresLanguageSparingFocallesionskidsdidn’tdopoorlyoverallAllscoredwithin95%confidenceintervalfromthenormalmeanonatleasthalfofthetestsLanguageDeficitChildrenwiththelowestscoreswereusuallythefocallesionkidsEachfocallesionchildhadatleastonetestforwhichtheyscoredsignificantlybelownormalSummaryNohighlyspecificpatternassociatedwithlesionlocationIngeneral,childrenwithbraininjuryperformsimpleinformationprocessingtasksmoreslowlythanpeersSuggestionthatchildrenwithLHDhaveselectivedifficultyinnamingNeedforlargersampleandmorelanguage-relatedtasksHowisthebrainorganizedtoservelanguageinchildren?fMRI:assessesfunctionthroughhemodynamicconsequences

InactivestateActivestatezzzI’mup!!UsesoffMRIBasicquestion:Whereisaspecificoperationperformedinthebrain?MeasuresIdentityofbrainregionsinvolved:RegionofinterestMagnitudeofactivityinthoseregionsSpatialextentofactivationCorrelationsamongactivityinbrainregionsBrainactivationduringsentencecomprehension

(Booth,MacWhinney,Thulborn,Sacco,Voyvodic,Feldman,2000)Goals:DescribedevelopmentaldifferencesinbrainactivationduringsentencecomprehensionDescribefunctionalorganizationofsentenceprocessinginchildrenwithearlybraininjuryHypotheses:LHactivationinadultsandchildrenRHactivationinchildrenwithLHDMethodsSubjectsA:20-28yearoldrighthanded(n=5)C-NN:9-12yearoldright-handed(n=7)C-BI:9-12yearold(n=6)3LHstroke2LHperiventricularhemorrhage1RHstrokeSentencecomprehensiontaskAuditorypresentationof3sentencetypesCVP:Thecatchasedtherabbitandenjoyedthehunt.SR:Theprincipalthattrippedthejanitorusedthephonetocallhome.OR:Thepigthatthedogfollowedatethetrashinthestreet.ComprehensiontestaftereachpresentationT/F:Theprincipalusedthephonetocallhome.(T)T/F:Thedogatethetrashinthestreet.(F)Analysis:17ROIResults:Percenterrors

SentenceTypesParticipantsCVPSRORAdults11%7%18%Children36%32%36%Childrenwithbraininjury42%51%42%ResultssentenceprocessingAdultsChildrenSJBRMKMMGMDKLeftRightResultsbyROIColoredbarsRHOpenbarsLHNetworkforsentencecomprehensionSummaryActivationpatternsforsentencecomprehensionshowdevelopmentalchangeGreaterlevelsofactivationinadultsBilateralactivationinadultsChildrenwithbraininjuriesshowmoreerrorsthandochildrenandadultsChildrenwithLHinjuriesshowshifttoincreasedRHactivationsVerbgenerationandmentalrotationVerbgenerationPresentationofpicturesofcommonobjectsInstruction:“Saytoyourselfasmanyactionsasyoucandotoorwitheachobjectpresented”MentalrotationPresentationof2,Gat00,1350,1800,and2250Decisionaboutdirectionofletter/numberRestforbothconditionsPresentationofcrossPost-acquisitionSPM99processing:

AdultandChildrengroupsStepsingroupanalysesRealignmentCo-registrationSmoothtoFWHM3xvoxelStepsinindividualAnalysesInspectionandComparisonsNormalizedSmoothtoFWHM3xvoxelAnalysesPost-acquisitionprocessing–

Children-BIRealignmentCo-registrationSmoothtoFWHM3xvoxelCasestudyapproachInspectionandComparisons

Verbgeneration-adultsLLVerbgeneration--childrenLLAdultsminuschildrenVerbgeneration—childrenwithLHstrokeRLRVerbgeneration–childrenwithL-PVHLateralityindexProportionofanterioractivationMentalRotationStimuliTargetsDistractorsMentalrotation-adultsMentalrotation--childrenLateralityindexProportionofanterioractivationOverallsummaryDevelopmentofchildrenwithearlybraininjuryfavorsdevelopmentalspecializationview;languageareasnotcompletelypredeterminedIntegrityoftheentirebra