Right-left Orientation Research Articles

Intermittent Alexia

A case of intermittent alexia, sometimes accompanied by severe dysgraphia and sometimes by mild dysgraphia, which had a probable migrainous origin, is described. On some occasions the patient could write to dictation, although with many errors, while unable to read words or letters. On other occasions the patient's writing to dictation was seriously disordered in terms of content and the letters were produced clumsily. Reading of numbers, colour vision and colour naming were normal although impairments on right-left orientation and visual short term memory were present and a mild finger agnosia was apparent. Blood flow scans (SPECT) taken under normal and alexic conditions support the view that the disturbance had a vascular origin.

Right‐1eft disorientation in dementia of the Alzheimer type

We demonstrated that right-left orientation (R/L-O) on a confronting subject is more impaired in patients with dementia of the Alzheimer type than in patients with multi-infarct dementia of comparable degree of dementia. The impairment in R/L-O is independent of aphasia and spatial disorientation.

Defective Revisualization: Dissociation Between Cognitive and Imagistic Thought Case Report and Short Review of the Literature

A 38-year-old shifted-sinistral patient displayed a definite deficit in visual imagery accompanied by defective dreaming capacity, loss of hypnagogic imagery, some defects in topographical memory, a mild unilateral right spatial neglect and mild difficulties in right-left orientation on the examiner's body. CT-scan and NMR studies showed evidence of an inborn hypoplasia of the right hemisphere and a stretched corpus callosum in its posterior and superior part. The vicarious compensatory action of the cognitive-verbal function of the defect of visual imagery was obvious. It is concluded that: (i) there are various forms of visual imagery deficits: some are “pure” whereas in the great majority of reported cases the loss of visual imagery is associated to different forms of visual agnosia; (ii) the brain mechanisms underlying cognitive thought and imagistic thought could be obviously dissociated.

The role of verbal labels in the judgment of orientation and location.

In an earlier study it was found that judgments of right-left orientations and locations were more difficult than judgments of up-down only when spatial words were used in the tasks. Experiments are reported in which pictures of many objects were presented to eliminate the possibility that subjects in previous studies had used strategies specific to single-stimulus tasks. In experiment 1, right-left orientations were judged more slowly than up-down orientations both when the spatial words were used and when arbitrary letters replaced the spatial words. In experiment 2, judgments of the right-left locations of pictures took longer than judgments of their up-down locations only when spatial words were used in the task; the right-left difficulty was eliminated when arbitrary letters replaced the words. The differential effect of words and letters in location judgments seems to be due to the different coding strategies adopted by subjects under the two conditions. It is concluded that a right-left difficulty does not depend on the use of spatial terms: word and letter conditions yield different results only when the task permits different judgments to be made under the two conditions.

Neurological Findings in High-Risk Children: Childhood Assessment and 5-Year Followup

The results of the two neurological examinations of the Israeli children, both original and followup, are presented. The multidimensional scalogram analysis technique was used to identify children with multiple areas of neurological dysfunction. These children consisted almost exclusively of the offspring of schizophrenic patients: 22 of the 50 index cases were in this region of poor functioning during at least one of the testing periods, as compared with only 3 of the 50 control cases. The most common neurological signs were "soft" perceptual-sensory signs, poor motor coordination, poor right-left orientation, poor balance, and motor overflow. No "hard" neurological differences were found between the groups. This is the first major report of long-term stability of neurological soft signs in the offspring of schizophrenic persons.

Dyslexia and spatial thinking

Impairment in spatial thinking has figured prominently as an assumed cause of developmental reading disability. The empirical findings relevant to the idea, with special reference to right-left orientation, visuomotor and visuoconstructive performances, and finger recognition are examined. It is concluded that, although some dyslexic children do show spatial disabilities, there is little evidence to support the existence of a visuospatial type of developmental dyslexia.

Low-level lead exposure in childhood influences neuropsychological performance.

Cumulative lead exposure in 193 inner-city black children was assessed by measuring lead concentrations in the primary and circumpulpal dentine of their deciduous teeth. Lead concentrations for these children were comparable to the concentrations reported in population studies of low-income children living in inner-city areas. Analysis of the children's neuropsychological test performance showed that elevated lead levels were associated with deficits in visual-motor functioning and perceptual integration, right-left orientation, and verbal abstraction; other verbal abilities and motor functioning were not affected. Possible alternative explanations for these findings were evaluated by examining the relationships between lead and maternal intelligence, family socioeconomic status, and perinatal indicators of neurological impairment. None of these relationships was significant. It was concluded that, even at levels usually regarded as asymptomatic, lead in the environment represents a hazard to inner-city children.

Predicting Academic Achievement: Preliminary Analysis of the McCarthy Scales

This preliminary study determined the extent to which the McCarthy Scales of Children's Abilities ( I ) , the McCarthy Screening Test ( 2 ) , and a McCarthy shorr form ( 3 ) predict achievement scores after a year for 50 kindergarren students from a predominantly white, middle-class community who were ~ n d ~ v ~ d u a l l y administered the hicCarthy Scales in March 1978. About a year later in March 1979, 23 students of the initial 50 were administered the Peabody Individual Achievement Test. The large attrition was accounted for by absences or conflict of schedules on test days. Scores for the McCarthy Screening Test, which includes the right-left orientation, verbal memory, draw-a-design, numerical memory, conceptual grouping, and leg coordination subtests, and the McCarthy Short Form, which includes rhe counting and sorting, pictorial memory, number questions, verbal fluency, numerical memory, and tapping sequence subtests, were also obtained. The Pearson correlations of the full McCarthy Scales and two abbreviated forms with the scores from the Peabody appear in Table 1.' Correlations of the General Cognitive Index with various Peabody achievement scales ranged from .48 ( p < .05) to .76 ( p < .01). The verbal scale correlated .58, .56, and .61 with Spelling, General Information, and Total score. Quantirative and memory scores correlated .58 and .16 respectively with Reading recognition. The McCarthy short form scores correlated .58, .57, and .63 with Peabody scores on Mathematics, Reading recognition and Total.. These values should be considered preliminary data as the sample size is small. Given moderate correlations yielded by the McCarthy Scales and the McCarthy short form with achievement, these instruments might effectively be used for screening and readiness. If other studies yield similar results, one might administer the short form first and continue with the rest of the McCarthy if the shorr form score is lower than a predetermined cut-off point. Information might be useful for those in need of further evaluation.

Right-left orientation and writing hand in children referred for neurodevelopmental assessment.

22 boys and 10 girls with school problems were referred to a pediatrician for medical and neurodevelopmental evaluation--children ranged in ages from 5-4 to 14-7. As part of the pediatric developmental assessment a simple test was used to evaluate each child's ability to identify his own right or left eye, ear, hand and foot. Hand preference for writing was also noted. 32 control children from the same population matched for age and sex with patients were also tested. Patients over 5 yr. old were more likely to have difficulty identifying right and left body parts than control children. All controls over age 7 correctly identified their body parts. 5 patients and 5 controls showed left-hand preference for writing. It is concluded that a more sensitive test for hand preference should be utilized as part of the pediatric neuro-developmental assessment.

Difficulties in right-left discrimination in a normal population.

In a group of physicians and their spouses, 17.5% of 382 women, and 8.8% of 408 men stated that they experienced frequent confusion in right-left orientation. Right-left confusion occurs often in adults, even of superior intellect, and is statistically commoner in women.

On the Symptomatology of Cerebral Lesions in the Transitional Area of the Lower Parietal and Middle Occipital Convolutions

... The subject of this paper is the peculiar symptom that I first described several years ago (1924) 2 under the name of finger agnosia. It manifests itself as an isolated disturbance in the recognition, naming, choosing, and differential exhibition of the various fingers of both hands—one's own fingers as well as those of another person. There is also a certain lack of freedom in the movements of individual fingers .... Furthermore, I will discuss the association that I noted between this symptom and a disturbance in rightleft orientation (in one's own as well as in another's body), agraphia and acalculia. 3 And finally, I will relate the presence of this syndrome to focal lesions ... in the transitional area between the angular and second occipital convolution. Since my first observation, ... I have established this syndrome with a considerable series of patients, in some of whom it existed as an independent

Punishment in the goldfish as a function of electrode orientation

For each response to a nipple from which they were trained to take liquid food, goldfish were punished with a brief ac shock administered through a pair of stainless steel electrodes placed either to the right and left of the animal, over and under it, or in front and back of it. As anticipated, on the assumption that the aversiveness of shock is a function of the potential difference across the animal's body, the right-left orientation of the electrodes was found to produce the least suppression of feeding and the front-back orientation the most.

Form Discrimination: Spatial Relationships between a Standard and Comparison Figure

This study investigated the relative difficulty with which 5-yr.-old children learn to discriminate between simultaneously presented standard and comparison figures in various relative positions and orientations. Figures in skewed relative position were easier to discriminate than those in aligned relative position; figures with an up-down orientation were easier than the same figures in right-left orientation. There were no significant differences in the number of errors made when the figures were placed so that the open sides of the figures faced each other, e.g., Group 1A, and the number of errors made when the figures were placed so that they were back to back, e.g., Group 1B.

Phylogeny, Ontogeny, and Brain-Damaged Children

To the Editor:— I note with interest that the AMA discredits the unwarranted growing use of the Doman-Delacato treatment for brain-damaged children (205, Aug 19, 1968, adv p10). Doman and Delacato quote ontogeny recapitulates phylogeny as the basis of their theory. Applied to the development of reading and handedness, Doman and Delacato have things reversed.1 Phylogenetically, writing originated about 5,000 BC, but handedness developed during the Bronze age (1500 to 700 BC) Ontologically, the ability to read, may come as late as 10 to 12 years of age but right-left orientation may be as late as 12 to 15 years of age. Investigation of the tonic neck reflex for determination of cerebral dominance showed neither hemisphere dominant in 50% of the 500 children in the first three elementary grades1(total population done), and at the seventh-grade level 40% showed neither hemisphere dominant. Controlled studies by Freeman

Gerstmann's Syndrome and Aphasia

An unselected group of 50 patients with cerebral disease was examined: 21 patients with left-sided, 12 with right-sided and 17 with bilateral lesions. The patients were given tests of right-left orientation, finger localization, arithmetic calculation, writing, reading, verbal memory, an examination for aphasia and a test for constructional praxis. In contradiction to Gerstmann's view, the so-called Gerstmann syndrome does not occur in an isolated form. Instead, it is regularly accompanied by concurrent neuropsychological deficits. The correlation study proved that the four Gerstmann symtoms are no closer connected to each other than to a number of various other deficits. The occurrence of less than 3 Gerstmann symptoms has little localizing value. Only 3 or 4 Gerstmann symptoms indicate a left-sided brain lesion. The complete “Gerstmann syndrome” however is rarely observed without aphasia. It is suggested that aphasia is the common denominator of the four symptoms. The performances which are disturbed in the so-called Gerstmann syndrome are closely related to language. However, aphasia also produces other behavioral deficits, appearing as “concurrent” symptoms. It is therefore not justified to regard the four symptoms as a natural syndrome. They are an arbitrary partial grouping of the numerous neuropsychological disturbances resulting from lesion of the leading hemisphere.

DEVELOPMENTAL LANGUAGE DISABILITY SIMULATING MENTAL RETARDATION

There are a number of children, estimated at from 5 to 15 per cent of the American grade school population, boys outnumbering girls three to one, who, without any demonstrable evidence of structural damage to the central or peripheral nervous systems, have difficulty in dealing with stimuli on a symbolic level. These children are suffering from developmental language disorders (Brain, 1961; Chess, 1944), variously described as congenital language disorders or lags (Head, 1927), specific language disorders (Silver and Hagin, 1960), developmental aphasias or dysphasias, dyslexias, dysgraphias, and dyspraxias (Bender, 1958; Money, 1962), congenital auditory imperception (Weisenberg and McBride, 1935; Worster-Drought and Allen, 1929a, b), congenitally word-deaf (Weisenberg and McBride, 1935) or wordblind children (Hallgren, 1950; Morgan, 1896), strephosymbolic (Orton, 1937) or sinlingualism (Peacher, 1950). These children have certain characteristics in common: 1. There is a strong family history of language disturbance (Hallgren, 1950). 2. All have evidence that the neurophysiological organization, corresponding to cerebral dominance, is not fully established (Silver and Hagin, 1960). 3. All have specific perceptual problems in more than one perceptual area. These specific perceptual problems are characterized by difficulty in orientation in space and in time, so that there are errors in right-left orientation; disturbance in body image relative to orien-

LATERAL DOMINANCE, LATERAL AWARENESS, AND READING DISABILITY

Lateral preferences for hand and eye and awareness of right-left relations were studied in an age-homogeneous sample of 200 boys selected from the total population of 9and 10-year-old boys attending school in Aberdeen, Scotland. One hundred and fifty boys represented the poorest readers selected on the basis of four reading tests. The remaining 50 boys were controls matched for birth date and school placement and were drawn from the remaining readers. There were no differences in the lateralization of preferential hand and eye usage between the two groups. Significant differences were found in the level of right-left orientation. Confusion in right-left identification of own body parts in retarded readers was associated with the lowest scores on tests of sequential reading. Analysis of intellectual performance in the retarded readers indicated that disturbance in lateralization was more strongly associated with performance than with verbal IQ. The developmental course of the functions is considered, and the findings are compared with those found among samples in which selection biases may have occurred.

Disorders of topographical and right-left orientation in adults compared with its acquisition in children

A series of simple tests involving Right-Left orientation and the appreciation of spatial relationships were given to 129 school children between the ages of 4 and 11 years who were regarded as educationally and developmentally “average”. It was found that ability to perform a task preceded the ability to express it in verbal terms by some 2 to 5 years. Similar tasks were given to 23 adults with verified intracranial lesions (11 Left hemisphere and 12 Right hemisphere). Performances were compared with those of the children and scored in terms of Mental Year decrements. The decrements found on this basis agreed with expectations based on clinical observation. Greater overall decrements were found in the Left hemisphere lesions than in the Right, but in both groups of patients decrements were greater in association with parietal lobe lesions than with lesions in other areas.

Right-left orientation and reading disability.

Right-left orientation and reading disability.

Loss of Spatial Orientation, Constructional Apraxia and Gerstmann'S Syndrome

In recent years important additions to the knowledge of the symptomatology in cases with involvement of the parietal lobe have been made. Both constructional apraxia (Kleist, 1922) and Gerstmann's syndrome, consisting of finger-agnosia, disturbance of right-left orientation, agraphia and acalculia (1924) have been related to lesions of the angular gyrus of the dominant hemisphere. Before the description of those symptoms, a loss of spatial orientation had been described in cases with lesions of the same localization. Balint (1910), Riddoch (1917), and others had observed that symptom in single cases, but the most comprehensive description was given by Gordon Holmes (1918), who studied it in a case-material of war injuries. When Holmes and his co-workers published their observations, constructional apraxia and Gerstmann's syndrome were still unknown. Loss of spatial orientation as a fully developed symptom is rare, while the other two disorders are not uncommon. For this reason the psychopathological relationship of those symptoms is still insufficiently understood. The following case offers an opportunity for studying the problem: