problems in addition to the signs of the Wernicke-Korsakoff syndrome. Many of the patients were closely examined over long periods and the authors make the point that repeated examinations for as long as ten years in some instances allowed them to describe the natural history of the syndrome. and this they do in their third chapter. Again the description of the pathological findings is precise and comprehensive and the authors stress the periventricular distribution of the lesions and their bilateral symmetry. The authors consider specifically the neuropathological substrate on which are based the defective memory, ocular motor signs, the ataxia, the global confusional state and the occasional disturbance of olfactory and gustatory function. They argue a unity between Wernicke's disease and Korsakoff's psychosis and discuss the relationship between these two and alcoholic cerebellar degeneration, central pontine myelinolysis and other myelinolytic syndromes and interestingly discuss the problem of \"alcoholic dementia\" concluding that the nosological status ofalcoholic dementia is by

https://jnnp.bmj.com/content/jnnp/52/10/1218.2.full.pdf

Neuropsychology Mental Structure

Foundations of Clinical Research: Applications to Practice, 2nd Edition, Leslie Gross Portney, Mary P. Watkins. Prentice Hall, Upper Saddle River, NJ (2000), 752 pages. $60

This article systematically reviews the research design and methodological characteristics of single-case experimental design (SCED) research published in peer-reviewed journals between 2000 and 2010. SCEDs provide researchers with a flexible and viable alternative to group designs with large sample sizes. However, methodological challenges have precluded widespread implementation and acceptance of the SCED as a viable complementary methodology to the predominant group design. This article includes a description of the research design, measurement, and analysis domains distinctive to the SCED; a discussion of the results within the framework of contemporary standards and guidelines in the field; and a presentation of updated benchmarks for key characteristics (e.g., baseline sampling, method of analysis), and overall, it provides researchers and reviewers with a resource for conducting and evaluating SCED research. The results of the systematic review of 409 studies suggest that recently published SCED research is largely in accordance with contemporary criteria for experimental quality. Analytic method emerged as an area of discord. Comparison of the findings of this review with historical estimates of the use of statistical analysis indicates an upward trend, but visual analysis remains the most common analytic method and also garners the most support among those entities providing SCED standards. Although consensus exists along key dimensions of single-case research design, and researchers appear to be practicing within these parameters, there remains a need for further evaluation of assessment and sampling techniques and data analytic methods.

Single-case experimental designs: a systematic review of published research and current standards.

Down syndrome (DS) is associated with abnormalities in multiple organ systems and a characteristic phenotype that includes numerous behavioral features. Language, however, is among the most impaired domains of functioning in DS and, perhaps, also the greatest barrier to independent meaningful inclusion in the community. In this article, we review what is known about the extent, nature, and correlates of the language and related problems of individuals with Down syndrome. In doing so, we focus largely on the syndrome-specific features of the language phenotype, although we also consider within-syndrome variation. The review focuses on the prelinguistic foundations of language and the major components of language (i.e., vocabulary, syntax, and pragmatics). We also consider two topics in the treatment and education of individuals with DS: prelinguistic communication intervention and the acquisition of literacy skills.

Language development in Down syndrome: From the prelinguistic period to the acquisition of literacy

"Meaningful Differences in the Everyday Experience of Young American Children" is the story of the landmark research study that uncovered the widely cited &#34word gap" between children from low-income homes and their more economically advantaged peers. This groundbreaking research has spurred hundreds of studies and programs, including the White Housea s "Bridging the Word Gap" campaign and "Too Small to Fail," a joint initiative of the Bill, Hillary, and Chelsea Clinton foundation. Betty Hart and Todd Risley wanted to know why, despite best efforts in preschool programs to equalize opportunity, children from low-income homes remain well behind their more economically advantaged peers years later in school. Each month, they recorded one full hour of every word spoken at home between parent and child in 42 families, categorized as professional, working class, or welfare families. Two and a half years of coding and analyzing every utterance in 1,318 transcripts followed. By age 3, the recorded spoken vocabularies of the children from the professional families were larger than those of the parents in the welfare families. Between professional and welfare parents, there was a difference of almost 300 words spoken per hour. Extrapolating this verbal interaction to four years, a child in a professional family would accumulate experience with almost 45 million words, while an average child in a welfare family would hear just 13 million coining the phrase "the 30 million word gap." The implications of this painstaking study are staggering: Hart and Risley's follow-up studies at age 9 show that the large differences in children's language experience were tightly linked to large differences in child outcomes. As the authors note in their preface to the 2002 printing of "Meaningful Differences," "the most important aspect to evaluate in child care settings for very young children is the amount of talk actually going on, moment by moment, between children and their caregivers." By giving children positive interactions and experiences with adults who take the time to teach vocabulary, oral language concepts, and emergent literacy concepts, children should have a better chance to succeed at school and in the workplace. Learn more about how parent and children's language interactions affect learning to talk in Hart & Risley's companion book The Social World of Children Learning to Talk."

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Meaningful Differences in the Everyday Experience of Young American Children

This study investigated the effectiveness of a phonological awareness intervention for 4‐year‐old children with Down syndrome. Seven children with Down syndrome who attended an early intervention centre participated in the intervention. Their performance on measures of phonological awareness (initial phoneme identity), letter name and sound knowledge, and print concepts pre‐intervention and post‐intervention, was compared with that of a randomly selected group of age‐matched peers with typical development. The intervention involved print referencing techniques whereby the children’s parents were instructed to bring the children’s attention to targeted letters and sounds within words and to draw their attention to the initial phonemes in words during daily shared book reading activities. The intervention was presented for a 6‐week period. The results indicated a significant treatment effect on phonological awareness and letter knowledge for the children with Down syndrome. Additionally, above‐chance perfor...

Enhancing Phonological Awareness and Letter Knowledge in Preschool Children with Down Syndrome

The present study was designed to examine how preadolescents gain an understanding of idioms. In particular, it examined the role of idiom familiarity in conjunction with students’ language-based a...

Idiom Understanding in Preadolescents: Synergy in Action

In this study, narrative and expository discourse-retelling abilities were compared in 9 children with closed head injury (CHI) age 9;5–15;3 (years;months) and 9 typically developing age-matched pe...

Discourse formulation in children with closed head injury.

This study investigated inference comprehension performance in adolescents who had suffered a traumatic brain injury (TBI). Using stimuli adapted from Lehman-Blake and Tompkins, participants listen...

Inference comprehension of adolescents with traumatic brain injury: A working memory hypothesis

The performance of adolescents who suffered a traumatic brain injury in childhood, on language comprehension tasks with varying working memory demands, was examined. It was hypothesized that adolescents with a traumatic brain injury would perform more poorly than their non-injured peers, particularly on those tasks with high working memory demands. A case study design allowed for both group and intra-participant comparisons. A battery of language comprehension and working memory tasks was administered to six adolescents aged 12-16 years. Their performance was compared with six individually age-matched peers with typical development and to the normative data of the standardized tests. Intra-participant performance was examined by comparing results across language tasks that varied in working memory demands. Analysis revealed that individuals with traumatic brain injury performed poorly compared with their age-matched peers. However, the pattern of listening comprehension impairment differed across individuals and marked variability within the comprehension profiles for some individuals with traumatic brain injury was evident. Language comprehension tasks with high working memory demands generally posed the most difficulty for individuals with traumatic brain injury.

Catherine Moran

Papers

Enhancing Phonological Awareness and Letter Knowledge in Preschool Children with Down Syndrome

Idiom Understanding in Preadolescents: Synergy in Action

Discourse formulation in children with closed head injury.

Inference comprehension of adolescents with traumatic brain injury: A working memory hypothesis

Language and memory profiles of adolescents with traumatic brain injury.