Verbal Measures Research Articles

Of popsicles and crackers: when spatio-temporal memory is not integrated into children's decision-making.

Prior research has used innovative paradigms to show that some non-human animal species demonstrate behavioural choices (i.e. foraging for a food item at a specific location, and at a time that guarantees it has not yet decayed), reflecting episodic-like or 'WWW' memory (memory for 'what' happened, 'where' and 'when'). These results raised the question of whether similar approaches could be used to examine memory in young children in order to reduce verbal demands. The present research examines the extent to which children's WWW memory aligns with memory-based choices in 3- to 5-year-olds (n = 95; study 1) and in 7- to 11-year-olds and adults (n = 168; study 2). Results indicate that preschoolers' struggle with choice-based tasks probably reflects difficulty integrating their WWW memory with an understanding that certain items decay over time. Moreover, a convergence between verbal recall measures and choice-based measures is observable in 7-year-olds and beyond, reflecting a stronger integration of memory signals, understanding of state transformation, and decision-making. This article is part of the theme issue 'Elements of episodic memory: lessons from 40 years of research'.

B - 118 Exploration of Supplemental Recognition Measures for the RBANS

Abstract Objective RBANS is a widely used cognitive screener that lacks memory recognition measures for 2 recall tasks. Performance on verbal and visual recognition measures, relative to recall, may help inform clinical decision-making and treatment planning. Our pilot project aims to understand how individuals with valid cognitive data and normal memory functioning perform on newly developed RBANS story and figure memory recognition tests. Method Of those referred for outpatient neuropsychological assessment at a veterans hospital between 2017–2024, 89 received the newly established recognition measures as part of their clinical evaluation. Our analysis included veterans that displayed valid profiles (TOMM trial 1 ≥ 45, n = 53). Assessment occurred 30% face-to-face and 70% telehealth. In addition to key demographic factors listed in table 1, race/ethnicity breakdown included: 92% White, 4% Black, 2% Asian, 2% Hispanic. These veterans were subdivided into 3 intact memory groups: list recall (≥ 25%ile, n = 31), story recall (≥ 25%ile, n = 37), figure recall (≥ 25%ile, n = 42) to determine average recognition performances across domains. Results The individuals with valid cognitive data and normal memory recall performed as listed in table 1. Although our novel story and figure recognition measures differ from those published in Duff et al. (2021), our pilot project data largely overlapped with their reported findings despite demographic differences. Conclusion(s) These novel recognition scores can help establish normal story and figure recognition performance to assist with clinical diagnosis and treatment planning. With greater and more diverse samples, we may be able to establish relative cut points for expected recognition memory performances across intact, amnestic/cortical, and vascular/subcortical.

B - 11 Alien Limb and Corticobasal Degeneration: a Neuropsychological Case Study

Abstract Objective The patient presented with alien limb, frequently associated with corticobasal degeneration, an atypical parkinsonian syndrome with rigidity, akinesia, dystonia, cortical sensory deficit, and apraxia. Subjective memory complaints are also common. Neuropsychological performance typically includes poor performance on verbal fluency and measures tapping into executive functioning, but confrontation naming and verbal comprehension are initially well-preserved. Method The patient is a right-handed 69-year-old male who developed the sensation of alien limb in his left arm 2 years prior, in which his left hand did not feel “real.” Additionally, the patient presented with memory difficulties, mild word-finding problems, and physical/motor complaints (i.e., limb apraxia, tremor, bradykinesia, occasional limb dystonia, and postural instability) for approximately 2 years. The patient sought neuropsychological assessment to clarify his cognitive functioning in light of his neurologic symptoms. Results Premorbid functioning was in the exceptionally high range, with 18 years of education. Neuropsychologically, immediate memory was generally average, and generally low average delayed memory and recognition abilities. Mild inefficiencies were observed in executive functioning and semantic fluency. Otherwise, the patient performed generally average across other tasks of language, including confrontation naming, and attention. Conclusions In light of the literature, it is expected that corticobasal degeneration will be associated with subjective memory difficulties, executive dysfunction and poor verbal fluency. The patient presented with generally intact memory, mild executive dysfunction, and poor semantic fluency abilities. Given the patient’s high intelligence, he may be more sensitive to cognitive lapses. Neuropsychological results, along with his reported parkinsonian features, are fairly consistent with possible incipient corticobasal degeneration.

Does student sampling impact our understanding of argumentativeness and verbal aggressiveness?

Student samples are regularly used in research. While student samples are convenient and easy to access, the use of such samples has been criticized for exposing theories and research to internal validity threats, as students are not representative of the general population. Using argumentativeness and verbal aggressiveness as contexts for analysis, this study explores the extent to which student and non-student samples differ in published empirical research. We found that in the case of the original verbal aggression and argumentativeness measures, sample type did not moderate the means among argumentativeness and verbal aggressiveness studies. We discuss the implications of these findings in terms of student vs. non-student samples.

Underlying Working Mechanisms of Virtual Reality Exposure: Exploring the Role of Fearful Expectancies and Habituation

While research has primarily focused on establishing the efficacy of virtual reality (VR) exposure, relatively scant attention has been paid to the underlying working mechanisms that drive the effects. The present study examined the role of fearful expectancies and fear reduction (habituation) in VR exposure. Fearful expectancies were measured before, during (retrospectively), and after a VR exposure session in 121 participants with elevated fear of spiders. In addition, skin-conductance and heart rate were measured throughout the exposure session to examine fear reduction within the exercises and across the session. Fearful expectancies decreased after VR exposure. Larger decreases were associated with better outcomes 1 week (in the verbal and behavioral measures) and 3 months (in one of the verbal measures) after exposure. Levels of expectancies during exposure were not associated with the outcome. We did not find evidence that expectancies about own reactions were better testable in VR exposure than expectancies about the spider. Fear reduction within the exercises or across the session did generally not predict VR exposure outcome. It is recommended to focus on various operationalizations and experimental manipulations of the mechanisms, as well as to compare these mechanisms between VR and in vivo exposure in future research.

Could Accelerated Long-Term Forgetting Be a Feature of the Higher Rate of Memory Complaints Associated with Subjective Cognitive Decline? An Exploratory Study.

Recently, subjective cognitive decline (SCD) was proposed as an early risk factor for future Alzheimer's disease (AD). In this study, we investigated whether accelerated long-term forgetting (ALF), assessed with extended testing intervals than those adopted in clinical practice, might be a cognitive feature of SCD. Using an explorative MRI analysis of the SCD sample, we attempted to investigate the areas most likely involved in the ALF pattern. We recruited 31 individuals with SCD from our memory clinic and subdivided them based on their rate of memory complaints into mild SCDs (n = 18) and severe SCDs (n = 13). A long-term forgetting procedure, involving the recall of verbal and visuo-spatial material at four testing delays (i.e., immediate, 30 min, 24 h, and 7 days post-encoding) was used to compare the two sub-groups of SCDs with a healthy control group (HC; n = 16). No significant between-group difference was found on the standard neuropsychological tests, nor in the immediate and 30 min recall of the experimental procedure. By contrast, on the verbal test severe SCDs forgot significantly more than HCs in the prolonged intervals (i.e., 24 h and 7 days), with the greatest decline between 30 min and 24 h. Finally, in the whole SCD sample, we found significant associations between functional connectivity values within some cortical networks involved in memory (default mode network, salience network, and fronto-parietal network) and verbal long-term measures. Our preliminary findings suggest that long-term forgetting procedures could be a sensitive neuropsychological tool for detecting memory concerns in SCDs, contributing to early AD detection.

Using semantic verbal fluency to estimate the relative and absolute vocabulary size of bilinguals: An exploratory study of children and adolescents

IntroductionThe full assessment of bilingual children often involves at least one language for which formal vocabulary tests are lacking and which the examiner does not speak. We examined, in a sample of children with typical development (TD), whether a semantic verbal fluency task, typically used in research as a measure of executive function, could be used in the place of a formal vocabulary test to estimate vocabulary knowledge when formal tests are not available. Method113 TD monolingual French speakers and TD bilinguals and with varying degrees of exposure to French, age 6 to 17 years, completed tests of vocabulary knowledge and semantic verbal fluency. A subset of 64 participants spoke French and English and were tested in both languages. Verbal fluency measures calculated using a traditional method which uses specific rules for superordinate categories and for animals of different sex and age and a simplified scoring method which simply counts all words produced, included the total number of words produced in each language, Total Vocabulary and Conceptual Vocabulary measures combining both languages, as well as analyses of lexical composition and word frequency within the study sample. ResultsLinear regressions revealed that the number of words produced predicted vocabulary size in a language-specific way, with slightly stronger predictions made by the simplified scoring method. As expected, bilinguals produced more words and more unique words in their language of greater exposure, while different exposure groups were equivalent in measures combining both languages, including their Total vocabulary and Conceptual vocabulary. Producing unusual words (infrequently produced in the study sample) indicated higher vocabulary scores. ConclusionsThis study supports the use of the verbal fluency task as a quick and simple tool to obtain a rough estimate of vocabulary size in TD monolinguals and bilinguals. This tool shows promise as well in clinical work with other populations, subject to further verification.

Beyond words: an investigation of fine motor skills and the verbal communication spectrum in autism.

This study investigated the associations between fine motorskills and expressive verbal abilities in a group of 97 autistic participants (age 8-17, mean=12.41) and 46 typically developing youth (age 8-17, mean=12.48). Participants completed assessments of motor and verbal communication skills, including finger tapping speed, grooved pegboard, grip strength, visual-motor integration tasks, and measures of speech and communication skills. ASD group performance on motor tests was compared to controls. Non-parametric tests were used to analyze group differences and correlations between motor and verbal communication skills. Based on prior research, we hypothesized that individuals on the autism spectrum would exhibit deficits in fine motor speed, dexterity, pencil motor control, but not manual motor strength. Additionally, we expected that impaired fine motor skills would be linked to poorer performance on standardized measures of verbal abilities. The results indicated that 80% of autistic participants demonstrated an impairment on at least one measure of motor skills, and as a group, they exhibited significantly poorer fine motor performance compared to the non-ASD group in dominant hand finger tapping speed, bilateral fine motor dexterity measured via the grooved pegboard task, and pencil motor coordination and visual-motor integration measured on the Beery-Buktenica Developmental Test of Visual-Motor Integration-Sixth Edition. Moreover, impaired fine motor skills were associated with poorer performance on standardized clinical measures of verbal abilities, including articulation errors, receptive and expressive language and vocabulary, rapid naming, oromotor sequencing, and parent reported functional communication skills and social communication symptoms. Overall,our findings suggest there is a high prevalence of fine motor impairments in ASD, and these impairments were associated with a range of verbal abilities. Further research is warranted to better understand the underlying mechanisms of these associations and develop targeted interventions to address both fine motor and verbal impairments in ASD.

Parental and Child Sleep: Children with Vision Impairment, Autistic Children, and Children with Comorbid Vision Impairment and Autism.

Parents report associations between children's sleep disturbances and behaviors. Children with neurodevelopmental conditions (e.g., Williams Syndrome and autism) are consistently reported to experience increased sleeping problems. Sleep in children with vision impairment and children with a dual diagnosis of vision impairment and autism remains understudied. Our exploratory study compared sleep profiles in 52 children (aged 4-12 years) and their parents (n = 37), across four groups: children with vision impairment (VI; n = 9), autism (n = 10), comorbid vision impairment + autism (n = 6), and typically developing children (n = 27). Childhood sleep was measured using the parental report Childhood Sleep Habits Questionnaire and sleep diaries. Children's cognitive functioning was measured using digit span, semantic, and phonemic verbal fluency measures. Parental sleep was measured via the Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale. Clinically disordered sleep was reported in all child groups (p ≤ 0.001), particularly children with VI + autism. Age, not sleep quality/quantity, predicted cognitive task performance in TD and autistic groups, but not in VI and VI + autism groups. The child's diagnosis affected parental sleep, particularly in children with a dual diagnosis of VI + autism. All participants experienced problematic sleep to varying degrees. Those most affected were children and parents in the VI + autism group, suggesting that autism may be the main driver of sleep problems in our sample.

A comprehensive characterization of cognitive performance, clinical symptoms, and cortical activity following mild traumatic brain injury (mTBI)

Objective The objective of this study was to investigate clinical symptoms, cognitive performance and cortical activity following mild traumatic brain injury (mTBI). Methods We recruited 30 individuals in the sub-acute phase post mTBI and 28 healthy controls with no history of head injury and compared these groups on clinical, cognitive and cortical activity measures. Measures of cortical activity included; resting state electroencephalography (EEG), task related EEG and combined transcranial magnetic stimulation with electroencephalography (TMS-EEG). Primary analyses investigated clinical, cognitive and cortical activity differences between groups. Exploratory analyses investigated the relationships between these measures. Results At 4 weeks’ post injury, mTBI participants exhibited significantly greater post concussive and clinical symptoms compared to controls; as well as reduced cognitive performance on verbal learning and working memory measures. mTBI participants demonstrated alterations in cortical activity while at rest and in response to stimulation with TMS. Conclusions The present study comprehensively characterized the multidimensional effect of mTBI in the sub-acute phase post injury, showing a broad range of differences compared to non-mTBI participants. Further research is needed to explore the relationship between these pathophysiologies and clinical/cognitive symptoms in mTBI.

Predicting Emotional Distress, Based on Acquisition, Extinction, Avoidance, and Generalization Learning

This prospective study aimed to investigate whether fear conditioning parameters measured at baseline could predict the development of emotional distress over a 6‐month period among 655 first‐year university students. Verbal and behavioral measures of acquisition, extinction, avoidance, and generalization were obtained through an online task at the start of the academic year. Emotional distress was evaluated 4 to 6 months later, with questionnaires assessing anxiety, stress, depression, and coping trajectories. Initial analyses explored the interplay of conditioning parameters at baseline, hypothesizing that the corresponding learning processes may mutually reinforce each other, contributing to distinct vulnerabilities for emotional distress. Although no distinct profiles based on conditioning processes were identified, the analyses did uncover correlations between increased acquisition and avoidance of conditioned threat stimuli and reduced extinction, avoidance of safe stimuli, and generalization. Subsequent main analyses related the processes and their interactions to the development of emotional distress. Findings suggest that acquiring fear toward conditioned safety and threat stimuli, as well as avoiding conditioned threat stimuli, may be predictive of higher levels of emotional distress. Analyses relating extinction and generalization to emotional distress revealed mostly nonsignificant findings, emphasizing the need for methodological scrutiny in identifying anxiety‐related learning indices. This research contributes to understanding individual differences in the development of emotional distress and informs future investigations into learning processes and their implications for mental health.

Resting EEG correlates of neurodevelopment in a socioeconomically and linguistically diverse sample of toddlers: Wave 1 of the Kia Tīmata Pai best start New Zealand study

Development of communication and self-regulation skills is fundamental to psychosocial maturation in childhood. The Kia Tīmata Pai Best Start (KTP) longitudinal study aims to promote these skills through interventions delivered at early childcare centers across New Zealand. In addition to evaluating effects of the interventions on behavioral and cognitive outcomes, the study utilizes electroencephalography (EEG) to characterize cortical development in a subsample of participating children. Here, we present results of the baseline resting EEG assessment with 193 children aged 15 to 33 months. We identified EEG correlates of individual differences in demographics, communication abilities, and temperament. We obtained communication and behavior ratings from multiple informants, and we applied contemporary analytic methods to the EEG data. Periodic spectral power adjusted for aperiodic activity was most closely associated with demographic, language, and behavioral measures. As in previous studies, gamma power was positively associated with verbal language. Alpha power was positively associated with effortful control. Nonverbal and verbal language measures showed distinct associations with EEG indices, as did the three temperament domains. Our results identified a number of candidate EEG measurements for use as longitudinal markers of optimal cortical development and response to interventions in the KTP cohort.

Errors and repetitions on tests of language, verbal learning, and memory in cognitively unimpaired adults at increased risk for Alzheimer’s disease

AbstractBackgroundErrors and repetitions on verbal fluency and list learning tasks have been found to predict progression to MCI and differentiate between healthy aging, MCI, and dementia. This study examined whether errors and/or repetitions on verbal measures were cross‐sectionally associated with amyloid pathology in baseline cognitively unimpaired (CU) adults, and provided additional information beyond traditional total score measures.MethodWe included 437 participants from the Wisconsin Registry for Alzheimer’s Prevention who completed comprehensive neuropsychological testing and amyloid (Ab) positron emission tomography (PET) scans using Pittsburgh Compound‐B (PiB). Ab(+/‐) status was determined using an established threshold average distribution volume ratio(DVR) >1.19 across several brain regions. From the most recent testing visit, we extracted the total number of errors and repetitions from the Rey Auditory Verbal‐Learning Test (AVLT), animal fluency, and letter fluency; these were summed to form error and repetitions composites. We ran ANCOVAs with Ab(+/‐) as predictor; age, sex, and WRAT‐3 reading were covariates. Cohen’s D effect sizes characterized strength of relationships, where higher errors = negative effect sizes, and higher total scores = positive effect sizes. Sensitivity analyses examined errors and total scores from individual tests, and removal of participants who progressed to MCI.ResultSample characteristics are presented in Table1. Relationships between error, repetition and total score variables are shown in Figure1. Ab(+/‐) was a significant predictor of the error composite (p = .001) but not the repetition composite. Ab(+/‐) was significantly associated with AVLT learning total (p = .01), but not with animal or letter fluency totals. Secondary analyses revealed that AVLT errors alone were associated with Ab(+/‐) (p<.0001); effect sizes were greatest for AVLT errors (d = ‐.46) than for the error composite (d = ‐.39) or for AVLT total score (d = .39) (Figure 2). Removal of impaired participants yielded similar effect sizes.ConclusionFindings from this CU sample suggest that AVLT errors may be more sensitive to early AD pathology than traditional total score measures. Errors on list‐learning may represent other cognitive and/or sensory processes (e.g., auditory processing, hearing, attention, inhibition) that are sensitive to AD but are not represented in total scores. Future research includes examining longitudinal and additional error composites’ relationships with AD pathology to develop more sensitive cognitive measures.

Fluency generating emotion words correlates with verbal measures but not emotion regulation, alexithymia, or depressive symptoms.

How do you feel? To answer this question, one must first think of potential emotion words before choosing the best fit. However, we have little insight into how the ability to rapidly bring to mind emotion words-emotion fluency-relates to emotion functioning or general verbal abilities. In this study, we measured emotion fluency by counting how many emotion words participants could generate in 60 s. Participants (N = 151 in 2011-2012) also completed a behavioral measure of verbal fluency (i.e., how many words starting with "P" or "J" participants could produce in 60 s), a cognitive reappraisal emotion regulation task, and emotion functioning questionnaires. In preregistered analyses, we found that participants produced more negative emotion words than positive words and more positive words than neutral words in the emotion fluency task. As hypothesized, emotion fluency was positively related to verbal fluency, but contrary to hypotheses, emotion fluency was not related to self-reported or task-based emotion functioning (e.g., alexithymia, depression, and emotion regulation ability). As such, in community samples, emotion fluency may reflect general cognitive abilities rather than processes crucial to emotional well-being. While emotion fluency as measured here does not track indices of well-being, future research is needed to investigate potential contexts in which verbal fluency for emotion words may be key to emotion regulation. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Basal Forebrain Volume Mediates the Relationship Between Cortical Cholinergic Level and Cognition in Parkinson’s Disease

AbstractBackgroundCholinergic denervation is associated with cognitive decline in Parkinson’s disease (PD). This is likely due to atrophy of the basal forebrain, which is affected by α‐synuclein early in PD. Studies show associations between basal forebrain volume and cognition and between cortical cholinergic levels and cognition, but no study has determined if basal forebrain volume mediates the relationship between cholinergic levels and cognition.MethodParticipants included 103 non‐demented individuals with idiopathic PD (M:F = 76:27; Age = 67.3±7.6 yrs) who underwent structural MRI and [18F] fluoroethoxybenzovesamicol (FEOBV) cholinergic PET imaging. We averaged cholinergic PET values in 7 ROIs derived from FreeSurfer in a prior publication (van der Zee, 2022): 1) bilateral temporoparietal regions (PC1); 2) subcortical and limbic regions (PC2); 3) bilateral cingulate regions (PC3); 4) left frontal regions (PC4); 5) right frontal and temporal regions (PC5); 6) cerebellum (PC6); and 7) bilateral entorhinal and left temporal regions (PC7). We used an executive function composite (Stroop Color‐Word Inhibition/Switching, Trail Making Switching, Letter Fluency, WASI‐IV Matrix Reasoning) and a verbal recall measure (CVLT‐II Long Delay Free Recall) as outcome variables.ResultAfter controlling for age, basal forebrain volume fully mediated the associations between PC3 (indirect effect:β = 0.075, 95% CI = 0.002‐0.166; total effect:β = 0.235, p = .02; direct effect:β = 0.161, p = .13) and PC7 (indirect effect:β = 0.069, 95% CI = 0.007‐0.141; total effect:β = 0.212, p = .02; direct effect: β = 0.142, p = .15) and executive function. Basal forebrain volume fully mediated the association between PC1 and verbal recall (indirect effect:β = 0.079, 95% CI = 0.014‐0.163; total effect:β = 0.222, p = .02; direct effect:β = 0.141, p = .14) and partially mediated the association between PC3 (indirect effect:β = 0.076, 95% CI = 0.003‐0.156; total effect:β = 0.345, p<.001; direct effect:β = 0.269, p = .01), PC5 (indirect effect:β = 0.070, 95% CI = 0.003‐0.150; total effect:β = 0.341, p<.001; direct effect:β = 0.271, p<.01), and PC7 (indirect effect:β = 0.072, 95% CI = 0.005‐0.150; total effect:β = 0.298, p<.01; direct effect:β = 0.226, p = .02) and verbal recall.ConclusionThis is the first study to demonstrate that basal forebrain volume mediates the relationship between cholinergic level and cognitive function. Future studies will investigate additional cognitive domains and measure structural integrity of individual nuclei in the basal forebrain.

Predictive value for cerebrospinal fluid Alzheimer’s disease profile of different measures of verbal episodic memory in patients with mild cognitive impairment

AbstractBackgroundEpisodic memory deficits represent the typical manifestation of prodromal Alzheimer’s disease (AD), namely amnestic Mild Cognitive Impairment (a‐MCI). Current neuropsychological criteria for MCI recommend the use of at least two measures for each cognitive domain. Rey Auditory Verbal Learning Test (RAVLT) and Logical Memory (LM) are two widely used verbal episodic memory measures. Our aim was to investigate the value of these measures in predicting cerebrospinal fluid (CSF) AD biomarkers positivity in a retrospective fully characterized consecutive MCI cohort.MethodOne‐hundred and six MCI patients were included. All of them underwent a comprehensive neuropsychological assessment including RAVLT (sub‐measures: RAVLT‐imm, RAVLT‐del, RAVLT‐false_recognitions) and LM. All patients underwent lumbar puncture for the analysis of CSF core AD biomarkers (Aβ42/Aβ40 ratio, phospho‐tau, total tau). By applying the A/T/(N) classification model, patients were classified as AD (A+T+, MCI‐AD, n. 62) and non‐AD (A‐T*, MCI, n. 44). Pearson’s r correlation coefficient was used to assess the relationship of RAVLT and LM sub‐scores with diagnosis. WALD logistic regression model was used to find which memory sub‐measures show the best predictive value on biomarkers positivity. To evaluate the discriminatory power of different sub‐measures for CSF AD profile, receiver‐operating characteristic (ROC) curves were generated.ResultWith respect to non‐AD MCI, MCI‐AD patients showed worse scores on all RAVLT and LM sub‐measures. RAVLT‐del could predict both positivity of each biomarker (p<0.01) and CSF AD‐like profile (p<0.01). The combination of RAVLT‐del with other measures (RAVLT‐imm+RAVLT‐false_recognition+LM) discriminated these groups (AUC: 0.76, 95% CI: 0.67‐0‐85) with a sensitivity of 0.74 and a specificity of 0.66.ConclusionOur study shows that the combination of all RAVLT memory sub‐measures and LM reaches the higher diagnostic accuracy in discriminating non‐AD MCI from MCI‐AD patients. Since RAVLT and LM measure different aspects of verbal episodic memory, they should be considered as complementary, rather than interchangeable, tasks. Our findings support the use of different memory measures in the neuropsychological assessment of MCI patients.

A preliminary study of the effects of stimulant medications on estimates of psycholinguistic abilities for children with attention-deficit/hyperactivity disorder

ABSTRACT Underlying deficits in inattention, hyperactivity, and/or impulsivity might contribute to suboptimal test-taking behaviours during language assessments that can lead to diagnostic errors. Considerations of potential medication effects on estimates of children’s nonword repetition, sentence recall, tense-marking, and narrative abilities are warranted given long-standing enthusiasm for these indices to serve as clinical markers for developmental language disorder (DLD). A battery consisting of 1 nonverbal, 1 reading, and 6 verbal measures was administered twice to 26 children (6–9 years) with independently diagnosed combined-type attention-deficit/hyperactivity disorder (ADHD). All participants had been prescribed stimulant medications for the management of their ADHD symptoms and were assessed off- and on-medication, with order counter-balanced across participants. Half of the participants had concomitant DLD. Examiners were unaware of children’s clinical status during assessments or when they were testing children who had received medication. Effect sizes were calculated for each measure. Significant score differences indicating a beneficial impact of stimulant medications on children’s performances were observed on the recalling sentences subtest of the Clinical Evaluation of Language Fundamentals and the Picture Peabody Vocabulary Test. Adjustments may be needed when speech language pathologists use sentence recall or receptive vocabulary measures to make diagnostic decisions with children who have ADHD.

Sex differences in the association of sleep spindle density and cognitive performance among community-dwelling middle-aged and older adults with obstructive sleep apnea.

Recent studies have found associations between obstructive sleep apnea and cognitive decline. The underlying mechanisms are still unclear. Here, we investigate the associations between changes in micro-architecture, specifically sleep spindles, and cognitive function in community-dwelling middle-aged and older adults, some with obstructive sleep apnea, with a focus on sex differences. A total of 125 voluntary participants (mean age 66.0 ± 6.4 years, 64 females) from a larger cohort (participants of the Brain in Motion Studies I and II) underwent 1 night of in-home polysomnography and a neuropsychological battery (sleep and cognitive testing were conducted within 2 weeks of each other). A semi-automatic computerized algorithm was used to score polysomnography data and detect spindle characteristics in non-rapid eye movement Stages 2 and 3 in both frontal and central electrodes. Based on their apnea-hypopnea index, participants were divided into those with no obstructive sleep apnea (apnea-hypopnea index < 5 per hr, n = 21), mild obstructive sleep apnea (5 ≥ apnea-hypopnea index < 15, n = 47), moderate obstructive sleep apnea (15 ≥ apnea-hypopnea index < 30, n = 34) and severe obstructive sleep apnea (apnea-hypopnea index ≥ 30, n = 23). There were no significant differences in spindle characteristics between the four obstructive sleep apnea severity groups. Spindle density and percentage of fast spindles were positively associated with some verbal fluency measures on the cognitive testing. Sex might be linked with these associations. Biological sex could play a role in the associations between spindle characteristics and some verbal fluency measures. Obstructive sleep apnea severity was not found to be a contributing factor in this non-clinical community-dwelling cohort.

72 Boston Naming Test Performance Improves with Increasing Age: What's Wrong with this Picture?

Objective:As word finding or "naming" impairment is a symptom of multiple neurological conditions, naming assessment is an integral component of most neuropsychological evaluations. For decades, the Boston Naming Test (BNT) has been, and remains, the most widely used measure of naming. Although it has been shown that naming is generally stable from young adulthood through middle age, we have observed, clinically, that young adults tend to have greater difficulty on the BNT than older adults. Considering that the BNT was developed more than 50 years ago, and that language and culture change over time, we hypothesized that 1) increasing age would be associated with stronger performance on the BNT, whereas 2) there would be no association between age and naming performance on more recently developed naming measures.Participants and Methods:Participants were healthy adults who served as normative subjects in the revision study of the Auditory (ANT) and Visual Naming (VNT) Tests. Due to known effects of education level on BNT performance, we excluded those with less than 16 years of education, targeting young adults through middle age, resulting in 118 adults, 20 through 50 years of age (mean age: 32.9 ± 9.2 years; mean education: 16.8 ± 1.2 years; mean FSIQ: 106.0 ± 12. 6). All participants were native English speakers or learned English by age 5 and were fully educated in English. Untimed accuracy (i.e., response within 20 seconds) is the standard performance measure for the BNT; the ANT and VNT additionally include tip-of-the-tongue (TOT) scores, which incorporate response time and reliance on phonemic cueing (TOT score = number of items named in &gt; 2 seconds but &lt; 20 seconds, plus items named correctly after 20 seconds, following a phonemic cue). Pearson correlations examined the relation between age and naming performance on the BNT, ANT and VNT.Results:Pearson correlations revealed a small but significant, positive correlation between age and BNT performance (r =.22, p = .017), yet no correlation between age and performance on the ANT (ANT Accuracy: r = .05, p=.60, ANT-TOT: r = -.14, p = .12) or VNT (VNT Accuracy: r = .04, p=.67, VNT-TOT; r = -.03, p = .72).Conclusions:In this sample of healthy adults, naming performance improved with increasing age on the BNT; however, while vocabulary knowledge may broaden, naming efficiency should not improve with age. By contrast, we found no relation between age and naming performance on the more recently developed ANT and VNT. Results underscore the need to revise test stimuli on verbal measures, particularly those that assess naming, and suggest caution in interpreting BNT performance in young adults, as poor BNT performance might not accurately represent their true naming ability.

28 Challenges to Lateralizing Visual Memory Dysfunction in TLE Patients

Objective:Neuropsychological assessment is an essential part of presurgical evaluation for epilepsy patients with refractory temporal lobe epilepsy. Evaluations assist in localizing and lateralizing epileptogenic focal points and identifying possible risks for cognitive decline following surgery. Researchers and clinicians consistently find that verbal memory dysfunction is an accurate indicator of left temporal lobe epilepsy (TLE) through verbal measures such as the CVLT-II. Although visual memory structures are assumed to be in the right (nondominant) hemisphere, visual memory assessments have not been reliable in identifying right TLE. It is hypothesized that assessments to test visual memory are confounded by verbal cueing to assist in visual learning. To account for this, researchers have identified that comparing verbal and visual score asymmetries does accurately differentiate left and right TLE patients. This study aimed to determine if verbalvisual asymmetry using the CVLT-II and BVMT-R accurately identifies left and right TLE relative weaknesses potentially associated with epileptogenic regions.Participants and Methods:As part of a pre-surgical neuropsychological evaluation, 37 well-characterized medically refractory TLE patients (18 right TLE; 19 left TLE) were administered the Brief Visuospatial Memory Test-Revised to evaluate visuospatial memory and the CVLT-II to evaluate verbal memory. A multivariate analysis of variance was used to compare RTLE and LTLE group performances on BVMT-R delay recall subscales, using T-scores. Then memory asymmetry scores were calculated by converting CVLT-II verbal delay memory scores to T-scores and subtracting BVMT-R delayed recall T-score from the verbal memory T-score. An independent samples t-test was used to compare asymmetry scores between the groups.Results:There were no significant differences between patients with RTLE and LTLE for BVMT-R Delay [F(2,34) = 0.11, p = .895]. There was not a significant difference when accounting for verbal-visual asymmetry (t (35) = 0.422, p = 0.675, d = 12.566) between left (M = -2.42, SD = 13.82) and right side (M = -4.17, SD = 11.09).Conclusions:The BVMT-R did not identify nondominant hemisphere dysfunction in this sample of 18 right TLE patients. Because visual memory performance did not inform lateralization, we investigated the usefulness of memory asymmetry. Inconsistent with our hypothesis, verbal-visual memory asymmetry scores did not differentiate RTLE from LTLE in this sample. These findings add to existing findings that the BVMT-R may not be able to identify visuospatial memory dysfunction in epilepsy. Additionally, these data indicate the inability to assess for visuospatial memory even when accounting for verbal abilities in epilepsy patients. Future research should consider alternate visuospatial measures for the evaluation of epilepsy patients.