Nonverbal Cognitive Measures Research Articles

Cluttering in the Speech of Young Men With Fragile X Syndrome.

Cluttering is a fluency disorder that has been noted clinically in individuals with fragile X syndrome (FXS). Yet, cluttering has not been systematically characterized in this population, hindering identification and intervention efforts. This study examined the rates of cluttering in male young adults with FXS using expert clinical opinion, the alignment between expert clinical opinion and objectively quantified features of cluttering from language transcripts, and the association between cluttering and aspects of the FXS phenotype. Thirty-six men with FXS (aged 18-26 years; M = 22, SD = 2.35) contributed language samples and completed measures of nonverbal cognition, autism symptoms, anxiety, and symptoms of attention-deficit/hyperactivity disorder (ADHD). The presence of cluttering was determined by the consensus of two clinical experts in fluency disorders based on characteristics exhibited in the language sample. Cluttering features (speech rate, disfluencies, etc.) were also objectively quantified from the language transcripts. Clinical experts determined that 50% of participants met the criteria for a cluttering diagnosis. Phrase repetitions were the most salient feature that distinguished individuals who cluttered. Although the presence of cluttering was not associated with autism symptoms or mean length of utterance, cluttering was more likely to occur when nonverbal cognitive ability was higher, ADHD symptoms were elevated, and anxiety symptoms were low. Half of the male young adults with FXS exhibited cluttering, which supports FXS as a genetic diagnosis that is highly enriched for risk of cluttering. Cluttering was associated with increased ADHD symptoms and cognitive ability and reduced anxiety symptoms. This study contributes a new description of the clinical presentation of cluttering in men with FXS and may lead to improved understanding of the potential underlying mechanisms of cluttering and eventual refinements to treatment and diagnosis.

From a Molar to a Molecular Approach to the Developmental Trajectory of Syntax Comprehension of Persons with Intellectual Disability

AbstractThe aim of our study was to investigate whether the developmental trajectories of syntax comprehension of participants with or without intellectual disability are comparable. We obtained results from a syntax comprehension test of 615 typically developing participants (mean chronological age = 4.61 years, SD = 0.85) and 615 participants with intellectual disability (mean chronological age = 12.22 years, SD = 3.14) matched on a nonverbal cognitive measure. We examined these results by applying several statistical approaches to the overall scores for the syntax test and then to the scores for each of its 92 items. Results showed negligible between‐group differences in developmental trajectories, at both levels of analysis (overall and item scores). This lack of effect suggests that the relationship between cognitive development and syntax comprehension is comparable for the two groups of participants. Theoretical and practical implications of these findings are discussed.

Food Should not be Forgotten: Impacts of Combined Cash Transfer Receipt and Food Security on Child Education and Cognition in South Africa and Malawi

Social protection can take many forms. Both cash transfers and food security may have important contributions to child cognitive development. This study examines the potential impact of combinations of cash transfers and food security status on child cognitive development and educational outcomes. Cross-sectional data for 796 HIV-affected children in the Child Community Care study were utilised for this analysis. Children and caregivers completed interview schedules comprised of standardised items on socio-demographics, household data, cash grant receipt and food security status, school achievement, and cognition. A series of logistic and linear regression models and marginal effects analyses were undertaken to explore the impacts of differing levels of social protection (none; either cash grant receipt or food secure status or, both in combination) on child educational and cognitive outcomes. Although all children lived in poverty-stricken households, 20% (157/796) of children did not live in a household in receipt of a cash grant and did not report food security; 32.4% (258/796) reported either component of social protection and, 47.9% (381/796) received both measures of social protection in combination. Compared to no social protection, being in receipt of either component of social protection was found to be significantly associated with being in the correct class for age, higher scores of non-verbal cognition, and higher working memory scores. Receiving both social protection measures in combination was found to be significantly associated with reduced educational risk scores, improved odds of being in the correct class for age, regular school attendance, missing less than a week of school in the previous two weeks, higher scores on measures of nonverbal cognition, higher working memory scores, and learning new things more easily. Educational and cognitive outcomes for children can be bolstered by social protection measures (cash grant receipt or food security). Benefits are enhanced when social protection is received in combination. Such findings support the notion of synergistic social protection responses for children living in environments impacted by high levels of HIV burden and deprivation.

Relations between language, non-verbal cognition, and conceptualization in non- or minimally verbal individuals with ASD across the lifespan.

Individuals with non- or minimally verbal autism (nvASD) are primarily characterized by a severe speech production deficit, with speech limited to no or only a few words by school age. Significant unclarity remains over variability in language profiles across the lifespan, the nature of the language impairment seen, and (dis-) associations between linguistic and nonverbal cognitive measures. To address these questions, we recruited both a school-age and an adult group with nvASD (total N = 49) and investigated relations between expressive and receptive language, and between these and nonverbal intelligence quotient (NVIQ) and sense-making capacities (the ComFor test). Results revealed limited variation across this sample in receptive language, which in turn predicted expressive language levels. Importantly, an upward trend in verbal mental age (VMA) across increasing chronological age was seen in the youngsters (only). A radical dissociation between NVIQ and both expressive and receptive language transpired as well, and a subset of individuals with normal NVIQ were comparable in terms of any other cognitive aspect. Sense-making reached symbolic levels in 62.2% of the sample and loaded on both verbal and nonverbal factors. These patterns inform theories of nvASD by revealing an impairment that is not conceptualizable as one of expressive language only, sharply limits learning opportunities across the lifespan, and cannot be compensated for by nonverbal cognition. These findings stress the need to seize developmental opportunities that may disappear when youngsters turn into adults, via therapies that specifically target language as a central cognitive system comprising both production and comprehension.

Interpreting Mini-Mental State Examination Performance in Highly Proficient Bilingual Spanish-English and Asian Indian-English Speakers: Demographic Adjustments, Item Analyses, and Supplemental Measures.

Performance on the Mini-Mental State Examination (MMSE), among the most widely used global screens of adult cognitive status, is affected by demographic variables including age, education, and ethnicity. This study extends prior research by examining the specific effects of bilingualism on MMSE performance. Sixty independent community-dwelling monolingual and bilingual adults were recruited from eastern and western regions of the United States in this cross-sectional group study. Independent sample t tests were used to compare 2 bilingual groups (Spanish-English and Asian Indian-English) with matched monolingual speakers on the MMSE, demographically adjusted MMSE scores, MMSE item scores, and a nonverbal cognitive measure. Regression analyses were also performed to determine whether language proficiency predicted MMSE performance in both groups of bilingual speakers. Group differences were evident on the MMSE, on demographically adjusted MMSE scores, and on a small subset of individual MMSE items. Scores on a standardized screen of language proficiency predicted a significant proportion of the variance in the MMSE scores of both bilingual groups. Bilingual speakers demonstrated distinct performance profiles on the MMSE. Results suggest that supplementing the MMSE with a language screen, administering a nonverbal measure, and/or evaluating item-based patterns of performance may assist with test interpretation for this population.

Differential effects of factors influencing cognitive development at the age of 5-to-6 years

This study aims to determine whether early predictors of cognitive development affect some cognitive functions more than others. Children (N=1129) from the EDEN mother-child cohort were assessed at the age of 5-to-6 years using verbal and nonverbal cognitive tests. We used structural equation modeling to simultaneously examine the effects of a broad range of predictors on each cognitive dimension and to test to what extent each predictor differentially affected these dimensions. Effects of family stimulation, breastfeeding duration and number of older siblings were more strongly related to verbal than nonverbal cognitive measure. Our findings provide robust evidence that some modifiable aspects of the early environment are associated with children’s cognitive development and may be more strongly associated with their verbal than nonverbal skills.

Who Benefits From an Intensive Comprehensive Aphasia Program?

Purpose: This article summarizes current outcomes from intensive comprehensive aphasia programs (ICAPs) and examines data from one ICAP to identify those who respond and do not respond to treatment. Methods: Participants were divided into 2 groups, responders and nonresponders, based on ±5-point change score on the Western Aphasia Battery–Revised Aphasia Quotient. Independent-samples t tests and χ2 tests were performed to identify differences between groups on demographic (age and gender) and aphasia-related factors (months postonset, type of aphasia, aphasia severity, naming, nonverbal cognition measure, and self-rating of communication confidence). Logistic regression determined if factors contributed to a treatment response. Results: There were significant differences between the groups on age and months postonset. Gender, type of aphasia, naming, nonverbal cognitive measure, and communication confidence were not significantly different. Logistic regression indicated that age was the only predictive factor contributing to treatment response. Conclusions: This study only identified age as a predictor of responders. Future research may need to examine a broader scope of variables that can impact recovery in aphasia.

The Effect of Differential Listening Experience on the Development of Expressive and Receptive Language in Children With Bilateral Cochlear Implants

Growing evidence suggests that children who are deaf and use cochlear implants (CIs) can communicate effectively using spoken language. Research has reported that age of implantation and length of experience with the CI play an important role in a predicting a child's linguistic development. In recent years, the increase in the number of children receiving bilateral CIs (BiCIs) has led to interest in new variables that may also influence the development of hearing, speech, and language abilities, such as length of bilateral listening experience and the length of time between the implantation of the two CIs. One goal of the present study was to determine how a cohort of children with BiCIs performed on standardized measures of language and nonverbal cognition. This study examined the relationship between performance on language and nonverbal intelligence quotient (IQ) tests and the ages at implantation of the first CI and second CI. This study also examined whether early bilateral activation is related to better language scores. Children with BiCIs (n = 39; ages 4 to 9 years) were tested on two standardized measures, the Test of Language Development and the Leiter International Performance Scale-Revised, to evaluate their expressive/receptive language skills and nonverbal IQ/memory. Hierarchical regression analyses were used to evaluate whether BiCI hearing experience predicts language performance. While large intersubject variability existed, on average, almost all the children with BiCIs scored within or above normal limits on measures of nonverbal cognition. Expressive and receptive language scores were highly variable, less likely to be above the normative mean, and did not correlate with Length of first CI Use, defined as length of auditory experience with one cochlear implant, or Length of second CI Use, defined as length of auditory experience with two cochlear implants. All children in the present study had BiCIs. Most IQ scores were either at or above that found in the general population of typically hearing children. However, there was greater variability in their performance on a standardized test of expressive and receptive language. This cohort of children, who are mainstreamed in schools at age-appropriate grades, whose mothers' education is high, and whose families' socioecononomic status is high, had, as a group, on average, language scores within the same range as the normative sample of hearing children. Further research identifying the predictors that contribute to the high variability in both expressive and receptive language scores in children with BiCIs will provide useful information that can aid in clinical management and decision making.

Language proficiency and metacognition as predictors of spontaneous rehearsal in children.

Despite decades of research on fundamental memory strategies such as verbal rehearsal, the potential underlying skills associated with the emergence of rehearsal are still not fully understood. Two studies examined the relative roles of language proficiency and metamemory in predicting rehearsal use, as well as the prediction of metamemory performance by language proficiency. In Study 1, 59 children, 5 to 8 years old, were administered a serial recall task, 2 language measures, a nonverbal cognitive measure, and a rapid automatized naming (RAN) task. Language proficiency, RAN, and age were significant individual predictors of rehearsal use. In hierarchical regression analyses, language proficiency mediated almost completely the age → rehearsal use relation. In addition, automatized naming was a strong but partial mediator of the contribution of language proficiency to rehearsal use. In Study 2, 54 children were administered a metamemory test, a language measure, and a serial recall task. Metamemory skills and, again, language proficiency significantly predicted rehearsal use in the task. The predictive strength of metamemory skills was mediated by the children's language proficiency. The mutually supportive roles of automatized naming, language, and metamemory in the emergence of spontaneous cumulative verbal rehearsal are discussed in the context of the resulting model, along with the minimal roles of age and aspects of intelligence.

Word‐finding difficulties confound performance on verbal cognitive measures in adults with intractable left temporal lobe epilepsy

This study sought to determine if word-finding difficulties (WFDs), which are common in adults with dominant temporal lobe epilepsy (TLE), are related to performance on verbal cognitive measures, including memory. One hundred six individuals with left TLE and pathologically confirmed mesial temporal sclerosis completed comprehensive preoperative neuropsychological evaluations. Patients were divided into two groups based on the degree of benefit received from phonemic cueing on a confrontation naming task. Cognitive performance was then compared between patients with greater and fewer WFDs. Patients with greater WFDs demonstrated poorer performance on many verbal cognitive measures compared to those with fewer WFDs. In contrast, there were no significant differences between groups on any of the nonverbal cognitive measures. Chi-square analyses indicated that below average verbal memory performance occurred at a significantly higher rate for patients with greater WFDs (42-46%) as compared to patients with fewer WFDs (18-24%). Results showed that WFDs confound performance on verbal cognitive measures in adult patients with left TLE, particularly on measures with high demands for lexical retrieval. This suggests that when patients have word-retrieval difficulties, measures of verbal memory and verbal intelligence may be underestimated and potentially lead to misinterpretation of test performance and misinformation regarding risk of declines after surgical resection.

Prevalence and nature of late-emerging poor readers.

Some children demonstrate adequate or better reading achievement in early school grades, but fall significantly behind their peers in later grades. These children are often referred to as late-emerging poor readers. In this study, we investigated the prevalence and heterogeneity of these poor readers. We also examined the early language and nonverbal cognitive abilities of late-emerging poor readers. Participants were 493 children who were a subsample from an epidemiological study of language impairments in school-age children. In kindergarten, children were administered a battery of language, early literacy, and nonverbal cognitive measures. Word reading and reading comprehension achievement was assessed in second, fourth, eighth, and tenth grades. Latent transition analysis was used to model changes in reading classification (good vs. poor reader) across grades. Population estimates revealed that 13.4% percent of children could be classified as late-emerging poor readers. These children could be divided into those with problems in comprehension alone (52%), word reading alone (36%), or both (12%). Further results indicated that late-emerging poor readers often had a history of language and/or nonverbal cognitive impairments in kindergarten. Subtypes of poor readers also differed significantly in their profiles of language, early literacy, and nonverbal cognitive abilities in kindergarten. Results are discussed in terms of causal factors and implications for early identification.

Foetal antiepileptic drug exposure and verbal versus non-verbal abilities at three years of age

We previously reported that foetal valproate exposure impairs intelligence quotient. In this follow-up investigation, we examined dose-related effects of foetal antiepileptic drug exposure on verbal and non-verbal cognitive measures. This investigation is an ongoing prospective observational multi-centre study in the USA and UK, which has enrolled pregnant females with epilepsy on monotherapy from 1999 to 2004. The study seeks to determine if differential long-term neurodevelopmental effects exist across four commonly used drugs (carbamazepine, lamotrigine, phenytoin and valproate). This report compares verbal versus non-verbal cognitive outcomes in 216 children who completed testing at the age of three years. Verbal and non-verbal index scores were calculated from the Differential Ability Scales, Preschool Language Scale, Peabody Picture Vocabulary Test and Developmental Test of Visual-Motor Integration. Verbal abilities were lower than non-verbal in children exposed in utero to each drug. Preconceptional folate use was associated with higher verbal outcomes. Valproate was associated with poorer cognitive outcomes. Performance was negatively associated with valproate dose for both verbal and non-verbal domains and negatively associated with carbamazepine dose for verbal performance. No dose effects were seen for lamotrigine and phenytoin. Since foetal antiepileptic drug exposure is associated with lower verbal than non-verbal abilities, language may be particularly susceptible to foetal exposure. We hypothesize that foetal drug exposure may alter normal cerebral lateralization. Further, a dose-dependent relationship is present for both lower verbal and non-verbal abilities with valproate and for lower verbal abilities with carbamazepine. Preconceptional folate may improve cognitive outcomes. Additional research is needed to confirm these findings, extend the study to other drugs, define the risks associated with drug treatment for seizures in the neonates, and understand the underlying mechanisms.

The Aetiology of High Cognitive Ability in Early Childhood

Both the environment and genetics are likely to influence the development of cognitive talent during the preschool years. It is not known to what degree or how these influences differ from those throughout the range of ability. 1943 twin pairs were assessed at 2, 3 and 4 years of age using diverse verbal and nonverbal cognitive measures. Consistently high scoring children were selected on a general cognitive factor. From behavioural genetic model fitting analyses, substantial shared environmental (70%) and modest genetic influences (20%) were found in the high group and this matched the aetiology of the entire sample. Strong genetic predisposition was not apparent. Individual differences in cognitive ability and high ability is largely due to shared environment during the preschool years.

Verbal association for simple common words in high-functioning autism.

We investigated conceptual relationships in semantic memory using an indirect priming technique in high-functioning autistic adolescents and their controls who were matched for age, verbal IQ, performance IQ, and nonverbal reasoning ability. The prime was a single word and the target task was completing a word fragment that was semantically related or unrelated to the prime word. The autistic subjects and controls showed similar semantic priming effects, indicating intact conceptual relationships for simple common words in those with autism. Only in the autistic group was a significant correlation found between performance for the related items and two nonverbal cognitive measures, which suggests a possibility that semantic processing in individuals with autism might be qualitatively different from that in controls.

Estimating the Risk of Future Reading Difficulties in Kindergarten Children: A Research-Based Model and Its Clinical Implementation.

Speech-language pathologists have the skills and knowledge needed to play an important role in the early identification of children who are at risk for reading difficulties. Whereas research has identified language and other factors that may be predictive of future reading problems, studies have not provided the statistical models and classification data needed for the implementation of early identification programs. In this paper, we report the results of a longitudinal study that examined kindergarten predictors of second-grade reading outcome. Six hundred and four children were given a battery of language, early literacy, and nonverbal cognitive measures in kindergarten as part of an epidemiologic study of language impairments in children. Follow-up testing of reading achievement was completed in second grade. Participants were divided into those children with and without reading difficulties. Findings indicated that five kindergarten variables (letter identification, sentence imitation, phonological awareness, rapid naming, and mother's education) uniquely predicted reading outcome in second grade. A logistic regression formula and classification data based on these results are provided. Suggestions are offered concerning how this information could be used in an early identification and intervention program for children who are at risk for reading difficulties.

Understanding referential expressions in context: use of common ground by children and adolescents with mental retardation.

Listeners interpret utterances against the common ground, or network of presuppositions shared with the speaker. The first purpose of the study was to determine whether individuals with mental retardation use the major sources of common ground (i.e., physical copresence, linguistic copresence, and community membership) to resolve referential ambiguity. The second purpose was to determine whether they seek confirmation of their referent choices in accordance with the certainty of interpretation afforded by the common ground. The third purpose was to determine whether they signal noncomprehension when faced with ambiguity and common ground that is not informative. The final purpose was to evaluate the relationship between within-group variability in common ground use and measures of nonverbal cognition, receptive and expressive language, and social cognition. Participants were school-age individuals with mental retardation and typically developing children matched to them on nonverbal MA. Common ground use was examined in a role-playing task in which the participant responded to ambiguous utterances. Common ground was manipulated within participants. We determined whether referent selections were appropriate for the common ground, whether they were accompanied by confirmation requests, and whether noncomprehension was signaled. Both groups used all sources of common ground to resolve referential ambiguity at better than chance levels but were less successful in using community membership. Both groups also requested confirmation of their referent choices most often when the common ground was based on community membership. Both groups signaled noncomprehension when the common ground was not informative. Different aspects of common ground use were related to different predictors for the group with mental retardation.

Identifiers of predominantly Spanish-speaking children with language impairment.

The purpose of this study was to identify a set of measures that would discriminate 31 predominantly Spanish-speaking children with normal language (NL children) from 31 children with language impairment (LI children). The LI children were identified as such by experienced, bilingual (Spanish/English), ASHA-certified, speech-language pathologists who were currently seeing the children in their caseloads. Children ranged in age from 5 to 7 years and were matched for age, gender, and school. Additionally, nonverbal cognitive measures assured that they did not differ significantly intellectually. Measures of vocabulary, novel bound-morpheme learning skills, and language form were randomly administered to all children. Further, parents responded to questions about their perceptions of their children's speech and language skills and family history of speech and language problems. A stepwise discriminant analysis indicated that 4 measures discriminated the groups of children with a sensitivity of 91.3% and a specificity of 100% (p < .0001): parental report of the child's speech and language skills, number of errors per T-unit, mean length per T-unit, and family history of speech and language problems. A second discriminant analysis indicated that the sensitivity and specificity could be maintained when only the first 2 measures were included. Confirmatory discriminant analyses of the 2- and 4-measure models indicated that the discriminant accuracy was stable on an independent sample.

Puerto Rican Children's Codeswitching and their Performance on Receptive Vocabulary Instruments and a Nonverbal Cognitive Measure

Analyses of Puerto Rican bilingualism reveal the unique role of Spanish/English codeswitching in their communication. In the present study, 34 bilingual students (aged 9 to 13 years) of both sexes were administered forms of the Test de Vocabulario en Imágenes Peabody—Adaptación Hispanoamericana (TVIP-H) (Dunn, Padilla, Lugo &amp; Dunn, 1986) and Peabody Picture Vocabulary Test-Revised (PPVT-R) (Dunn &amp; Dunn, 1981), along with translations of both aforementioned tests. The Standard Progressive Matrices (SPM) (Raven, 1958) was administered as a nonverbal cognitive measure. Standard scores were recorded; then, a separate set of combined scores was derived for the TVIP-H and PPVT-R and their respective translations, in which the student was given credit for items answered incorrectly in one language but correctly in the other. Standard scores were also recorded for the SPM. Results revealed significant mean differences between the TVIP-H monolingual vocabulary tests and its respective combined/bilingual scores. Both combined/bilingual instruments' results positively correlated with the nonverbal measure. These findings suggest that the influence of codeswitching/bilingualism on verbal tests must be accounted for with this population.

An Investigation of Test Bias in Two Nonverbal Cognitive Measures for Two Ethnic Groups

One hundred fifteen second- and third-grade Anglo and Mexican-American boys and girls from an isolated rural town in Arizona were tested on two nonverbal measures of cognitive skills to examine test bias when GPA and achievement test scores were being predicted. The issue of bias was addressed by regression analysis, which allowed examination of slopes and intercepts. The children from both ethnic groups were roughly equated on SES variables due to the nature and location of the community. Results suggested that the Raven's Coloured Progressive Matrices exhibited both slope and/or intercept bias on three of the four criterion variables, whereas the Nonverbal Test of Cognitive Skills (NTCS) demonstrated slope bias only in terms of GPA. The findings suggest that the Raven, contrary to previous research, may be a biased predictor for Mexican-Americans. NTCS bias may be due to factors unrelated to achievement.