Showing papers in "Journal of Clinical and Experimental Neuropsychology in 1984"
TL;DR: Use of a search procedure to control processing during learning results in apparently normal cued recall by some amnesic patients with impaired free-recall learning, which suggests that their ability to encode and retrieve may be relatively intact when they are induced to carry out effectiveprocessing during learning.
Abstract: Use of a search procedure to control processing during learning results in apparently normal cued recall by some amnesic patients with impaired free-recall learning. This suggests that their ability to encode and retrieve may be relatively intact when they are induced to carry out effective processing during learning. When processing is controlled during learning, cued recall should be useful for neuropsychological evaluation of residual learning and memory capacity.
487 citations
TL;DR: Questions concerning the incidence of memory failures in everyday life were used in a postal survey of the aftereffects of severe head injury and a minority of severely injured patients were reported to be significantly handicapped by memory failures at this stage in their recovery.
Abstract: Questionnaires concerning the incidence of memory failures in everyday life were used in a postal survey of the aftereffects of severe head injury. Several years after a severe injury, 50 patients were compared to 33 patients a similar period after a very mild injury. A questionnaire completed on behalf of each patient by someone living in daily contact with him appeared to have some validity as a memory measure. The pattern of memory failures reported was similar to that found in a previous study and this may primarily reflect the ease with which certain forms of memory failure can be observed. A questionnaire completed by the patients themselves had little validity, possibly because severely injured patients could not recall their own memory failures. Only a minority of severely injured patients were reported to be significantly handicapped by memory failures at this stage in their recovery.
228 citations
TL;DR: A number of specific methodological issues have arisen in studies of the social, emotional, and behavioural sequelae of head injury; the use of control groups may help disentangle specific and non-specific effects.
Abstract: A number of specific methodological issues have arisen in studies of the social, emotional, and behavioural sequelae of head injury. The accounts given by patients and relatives may differ: Patients may lack insight, and relatives – who are often under considerable stress – may themselves give distorted accounts. Moreover, the sequelae of head injury may not all be specific to brain injury but may include effects common to other forms of traumatic injury: The use of control groups may help disentangle specific and non-specific effects.
195 citations
TL;DR: The results revealed that, although the WAIS-R has excellent psychometric reliability as reflected in its standard error of measurement of a VIQ-PIQ difference and its impressively high test-retest Pearson r values, the actual magnitudes of the differences between the VIQ and PIQ assessed in a single examination were sufficiently high that such base-rate data should be routinely considered by clinical neuropsychologists and other practitioners.
Abstract: The data analyzed were the 14 WAIS-R scores from each of the individuals who comprised the WAIS-R standardization sample. Examined was the individual VIQ-PIQ difference from only the initial examination of each of the 1880 subjects, as well as the test-retest change in each of the 14 WAIS-R scores for each of the 119 subjects who were retested. The results revealed that, although the WAIS-R has excellent psychometric reliability as reflected in its standard error of measurement of a VIQ-PIQ difference and its impressively high test-retest Pearson r values, the actual magnitudes of the differences between the VIQ and PIQ assessed in a single examination, or the magnitudes of gain or loss in the 14 scores on retest, for some of these normal individuals were sufficiently high that such base-rate data should be routinely considered by clinical neuropsychologists and other practitioners.
190 citations
TL;DR: The anterograde and retrograde amnesias of patients with Huntington's Disease and with alcoholic Korsakoff's syndrome are compared to exemplify heterogeneity of amnesic symptoms.
Abstract: Many of the standardized memory tests employed by clinical neuropsychologists fail to demonstrate important differences in the memory disorders of amnesic and demented patients. To exemplify this heterogeneity of amnesic symptoms, the anterograde and retrograde amnesias of patients with Huntington's Disease (HD) and of patients with alcoholic Korsakoffs syndrome are compared. While both patient groups have similar MQs, they differ dramatically in their recall and recognition memory and in their ability to acquire procedural (rule-based) information. The Korsakoff patients are impaired in both recall and recognition memory but are able to acquire and retain mirror reading skills. In contrast, the patients with HD are impaired in their acquisition of procedural knowledge and in verbal recall although their recognition memory approaches normality. The importance of such information for the assessment of the patients' memory disorders is discussed.
121 citations
TL;DR: Comparisons of neuropsychological profiles indicated that the pattern of deficit after severe head injury is more distinctive than are those after mild and moderate injuries.
Abstract: Children who had sustained head injuries were divided into three groups on the basis of severity of injury defined according to neurological criteria, and their performance on a battery of neuropsychological tests was compared. The groups were matched for age and sex. Performance IQ and timed tests of motor speed, fine-motor coordination, tactual-spatial functions, and verbal fluency showed significantly greater deficits for severely injured patients than for those who were mildly or moderately injured. Relations between neurologic indices of severity of injury and psychological outcome measures were investigated. Glasgow Coma Scale severity scores and the duration of altered consciousness were related to performance on several major neuropsychological functions. Acute intracranial pressure measures were unrelated to outcome. Comparisons of neuropsychological profiles indicated that the pattern of deficit after severe head injury is more distinctive than are those after mild and moderate injuries...
105 citations
TL;DR: In this paper, a functional organization approach is proposed to separate the different types of variables underlying a developmental neuropsychology and focus on behavioral theory and research addressing the development of children's abilities.
Abstract: Neuropsychologists working with children commonly infer a CNS basis for many developmental disabilities on the basis of test performance and behavioral observations. While there is nothing inherently wrong with such inferences, the fact that there exists no specific set of brain-behavior relationships validating these inferences is frequently overlooked. In this respect, CNS inferences on the basis of the child's performance can lead to four potential fallacies concerning relationships between brain and behavior. Each of these fallacies involves a failure to recognize important behavioral and biological differences between children and adults, or simply rests on faulty logic and inadequate research. In an effort to outline a truly developmental neuropsychology for children--as opposed to diverse approaches that apply adult-based techniques to children--we propose a functional organization approach. This approach separates the different types of variables underlying a developmental neuropsychology and focuses on behavioral theory and research addressing the development of children's abilities. A specific emphasis of this approach is on processes of change--one of the primary psychological characteristics separating children and adults. The use of this approach as a general research strategy for children whose disabilities are associated with demonstrable or presumed CNS aberrations may lead to a set of behavioral laws that can be systematically related to a biological substrate.
102 citations
TL;DR: This study underscores the limitations of length of illness as a classificatory variable in studies of dementia in HD and suggests that future studies consider the contribution of defects in precise timing and sequential operations to the cognitive and adaptive deficits of these patients.
Abstract: The relationship of duration of illness and severity of neurological impairment to psychometric performance and activities of daily living was examined in 57 patients with Huntington's Disease (HD). As earlier studies suggested, a distinct cognitive profile characterized patients early in the disease. Duration of symptoms, however, proved to be a weaker correlate of cognitive decline than was motor impairment at the time of testing. For predicting adaptive functioning, both duration of symptoms and neurological status were important variables. This study underscores the limitations of length of illness as a classificatory variable in studies of dementia in HD. We further suggest that future studies consider the contribution of defects in precise timing and sequential operations to the cognitive and adaptive deficits of these patients.
87 citations
TL;DR: Results indicate that neuropathological and lateralization characteristics of neoplastic lesions (and probably of cerebral lesions in general) are important variables in understanding the behavioral correlates of cerebral damage.
Abstract: Four groups of patients with intrinsic cerebral neoplasms were compared to determine the differential effect of neoplasm (rapidly vs. slowly growing) and lateralization of damage (right vs. left hemisphere) upon neuropsychological functioning. No prior study has had enough subjects with neoplastic lesions to permit this kind of investigation. The group with rapidly growing neoplasms consistently had greater neuropsychological impairment. Lateralization of cerebral damage was found to have a differential effect on neuropsychological functions. Results indicate that neuropathological and lateralization characteristics of neoplastic lesions (and probably of cerebral lesions in general) are important variables in understanding the behavioral correlates of cerebral damage.
86 citations
TL;DR: It was concluded that the subtest profile could contribute to the differentiation of DAT from other dementias and suggested that the cholinergic deficiency of D AT might be responsible for the intellectual changes seen in this disease.
Abstract: A characteristic profile of subtest scores from the Wechsler Adult Intelligence Scale (WAIS) similar to that seen in clinically tested dementia patients was found in 10 of 19 normal young adult subjects with a drug-induced cholinergic deficiency of mental functioning but in only 4 of 22 control subjects. The same subtest profile was then found in test data from two groups of consecutive dementia patients (61 and 77 patients, respectively) with research diagnoses of Alzheimer-type dementia (DAT, senile and presenile), multi-infarct, and other dementias. The profile identified 44% of testable patients with AD and was 96% specific to DAT (only two false positives). A Verbal-Performance IQ discrepancy of 15 or more points was associated with cholinergic dysfunction in the normal drug subjects, but this IQ-score discrepancy did not differentiate AD from multi-infarct dementia patients. It was concluded that the subtest profile could contribute to the differentiation of DAT from other dementias. The association of this profile with drug-induced cholinergic deficiency suggested that the cholinergic deficiency of DAT might be responsible for the intellectual changes seen in this disease.
84 citations
TL;DR: A strong correlation between the presence and type of CT-scan abnormalities and attentional performance in long-term survivors of childhood ALL was revealed.
Abstract: Simple alerted auditory reaction time (SRT) behavior with various foreperiods was investigated in a group of long-term survivors of childhood ALL who were in continuous first remission. As part of therapy, the patients had received cranial irradiation and intrathecal chemotherapy to prevent the development of central nervous system leukemia. The patients were divided into three groups on the basis of CT brain scan findings: (1) those with normal CT scans (n = 10); (2) those with evidence of cortical atrophy (n = 8), and (3) those with intracerebral calcifications (n = 5). The SRT results indicated significant differences between patients with normal and abnormal CT scans. Specifically, patients with abnormal scans reacted slower, and this latency was exaggerated by increasing the length of the warning interval. Furthermore, they reacted with larger variability which increased with the prolongation of testing. Moreover, the severity of impairment was related to the type of CT-scan abnormality: patients with calcifications performed more poorly than patients with evidence of atrophy. The present results revealed a strong correlation between the presence and type of CT-scan abnormalities and attentional performance in long-term survivors of childhood ALL.
TL;DR: The results indicate that neuropsychological sequelae after concussion may be demonstrated, even when there are few subjective complaints and no perceptible lags in academic achievement.
Abstract: Fifty-six children, 9-13 years of age, underwent neuropsychological testing 4-8 months after concussion. They were individually matched with a control group on the variables of school grade, sex, and academic achievement. On 29 of the 32 test variables, the results of the control group were superior to those of the experimental group. Analysis of variance showed that the concussion factor explained most of the differences between the groups. The differences tended to decrease with increasing age, and to increase with increasing complexity of the tests. The results indicate that neuropsychological sequelae after concussion may be demonstrated, even when there are few subjective complaints and no perceptible lags in academic achievement.
TL;DR: The results of extensive research indicate that a large number of neuroanatomical, neurophysiological, neurochemical, and neuropsychological parameters of the animal brain can be modified through environmental manipulation, sensory experience, and systematic training.
Abstract: The mainstream of neuropsychological research and practice has been devoted to the impact of the brain as an independent variable on behavior as a dependent variable. Evidence is currently available to make clear that the order of causation may be reversed: Behavioral changes can have a durable impact on the brain. The results of extensive research indicate that a large number of neuroanatomical, neurophysiological, neurochemical, and neuropsychological parameters of the animal brain can be modified through environmental manipulation, sensory experience, and systematic training. Some evidence is available to show that psychological stimulation has certain effects on the physiology of the human brain. For instance, hemisphere-specific stimulation through the presentation of words flashed in a visual hemifield appears to modify the electrophysiological activity of the contralateral hemisphere in dyslexic children and to affect their subsequent reading performance. Neuropsychology may profit from pa...
TL;DR: Results suggest that the neuropsychological investigation of AD which emphasizes the deficiencies in cholinergic neurotransmission may be a fruitful avenue of further investigation.
Abstract: Sixty-two patients were classified as having Alzheimer-type dementia (AD) or multi-infarct dementia (MID) on the basis of clinical criteria. Protocols from the Wechsler Adult Intelligence Scale (WAIS) were scored according to a formula reported by Fuld to reflect the effects of scopolamine administration in young adults. The formula correctly classified 13 of 23 AD patients and 37 of 39 MID patients. The formula was similar to Wechsler's deterioration quotient, which produced a greater number of false positives. The formula did not appear to be biased by age, sex, or severity of impairments. Results suggest that the neuropsychological investigation of AD which emphasizes the deficiencies in cholinergic neurotransmission may be a fruitful avenue of further investigation.
TL;DR: A patient with a right-hemisphere lesion who showed a dissociation between the processing of affective and nonaffective faces is described, who was impaired in naming and pointing to facial expressions.
Abstract: In this report we describe a patient with a right-hemisphere lesion who showed a dissociation between the processing of affective and nonaffective faces. Although he performed normally on neutral facial tasks, he was impaired in naming and pointing to facial expressions. This dissociation is discussed in terms of four possible mechanisms: (a) a high-level visuoconfigurational defect; (b) an associative agnosic type of defect for facial expressions; (c) a specific “activation' defect; and (d) a visual-verbal disconnection resulting in an anomic type of defect for facial expressions.
TL;DR: The measurement of cognitive recovery after traumatic brain damage raises a number of methodological and practical problems and strenuous efforts must be made to achieve as high a follow-up rate as possible.
Abstract: The measurement of cognitive recovery after traumatic brain damage raises a number of methodological and practical problems. The precise schedule of testing, the specification of functions to be measured, the separation of practice from recovery, and the specification of appropriate control or comparison groups must all be considered by the researcher. In addition, strenuous efforts must be made to achieve as high a follow-up rate as possible.
TL;DR: A memory-retraining program was designed for a patient approximately 2 1/2 months after he suffered a closed-head injury and there was some drop in memory performance at a 9 month follow-up, and the patient was encouraged to resume active use of mnemonic strategies.
Abstract: A memory-retraining program was designed for a patient approximately 2½ months after he suffered a closed-head injury. Tests showed his memory deficit to be relatively isolated in the verbal sphere. An attempt was made to design a program in which tasks resembled the environmental demands on the patient for retention of verbal material. On a routine basis, the patient was read various paragraphs and was subsequently required to write them from memory. Three different strategies were used in an attempt to improve memory. After 15 days of training, the patient improved from an impaired level of verbal recall to a normal level. Strategies employing (a) visual imagery and other mnemonic devices and (b) questioning during presentation appeared to be most effective in facilitating retention. There was some drop in memory performance at a 9 month follow-up, and the patient was encouraged to resume active use of mnemonic strategies. Implications for further study are discussed.
TL;DR: It is concluded that, in neuropsychology, a group has no significance over and above the individual members it contains.
Abstract: We consider the logic of basing theories of normal and pathological cognitive functioning upon the selective deficits revealed by single-case studies. Objections to this strategy, concerned with the rarity of pertinent cases, the role of methodological artifacts, and the existence of normal variation in brain functions are refuted. We conclude that, in neuropsychology, a group has no significance over and above the individual members it contains.
TL;DR: The Florida Kindergarten Screening Battery is a unique new instrument for the early identification of learning disorders that incorporates a number of unique features of construction, standardization, and validation.
Abstract: The Florida Kindergarten Screening Battery (FKSB)1 is a unique new instrument for the early identification of learning disorders. The authors state that it is designed “…to predict the likehood that an individual kindergarten child will manifest learning problems three years later (end of Grade 2)” (Satz&Fletcher, 1982, p. 1). It incorporates a number of unique features of construction, standardization, and validation. For this reason, it seems appropriate to describe briefly the background of research and theory on which the Battery is based before examining the relative merits of the Battery itself.
TL;DR: Phonological error patterns are analyzed in a group of 10 children presenting symptoms consistent with Developmental Verbal Dyspraxia and indicate a dominance of "sequentially constrained" errors primarily involving sound and syllable omissions and timing errors.
Abstract: Phonological error patterns are analyzed in a group of 10 children presenting symptoms consistent with Developmental Verbal Dyspraxia. Results indicate a dominance of “sequentially constrained” errors primarily involving sound and syllable omissions and timing errors. Rank-order correlations among the phonological errors and between phonological errors and develomental indices suggest that these children have a specific expressive language problem dominated by phonological errors of sequential reduction. Interpretation of the data points to a central motor planning deficit. Comparisons are made with other studies depicting neuropsychological deficits in similar children.
TL;DR: Issues of uncertainty about the nature and course of normal aging, about the influence of disease and affective disturbance on performance, and about the significance of diverse interactive effects are addressed.
Abstract: Neuropsychological investigation of old age and dementia faces all the problems associated with more general gerontological study. In addition, some specific difficulties in attempting to infer cerebral status from behavioral observation arise. These include uncertainty about the nature and course of normal aging, about the influence of disease and affective disturbance on performance, and about the significance of diverse interactive effects. Further, the concept of dementia requires clarification. These issues are addressed and their clinical implications discussed.
TL;DR: It is argued that attribute variables, as a result of their statistical and theoretical nonindependence, break the underlying assumptions of these traditional designs, and may lead to incorrect inferences being drawn.
Abstract: This paper examines the conceptual and statistical difficulties created when neuropsychological research uses attribute variables in traditional orthogonal experimental designs. It is argued that attribute variables, as a result of their statistical and theoretical nonindependence, break the underlying assumptions of these traditional designs, and may lead to incorrect inferences being drawn. These difficulties are illustrated in a consideration of the typical use of analysis of variance designs, matched groups designs, and the analysis of covariance. Finally, a plea is made for the explicit consideration of the assumptions underlying the design models used in neuropsychological research, and a suggestion is made regarding the more appropriate use of correlational techniques in neuropsychology.
TL;DR: Some of the methodological problems encountered in studies of laterality of emotions, again looking at investigations of brain-damaged patients and of normal subjects, are examined.
Abstract: The findings of studies involving brain-damaged patients and those with normal subjects are considered separately in a review of the most important investigations that have led to the hypothesis that the right hemisphere is dominant for various aspects of emotional behavior. This paper examines some of the methodological problems encountered in studies of laterality of emotions, again looking at investigations of brain-damaged patients and of normal subjects. Future directions for research into emotional lateralization are suggested.
TL;DR: Three computer programs for automated interpretation of variants of the Halstead-Reitan Neuropsychological Test Battery were tested on cases and suggested that, while none of the programs do poorly at identifying the presence of brain damage, lateralization and possibly other localization/process predictions are not done well by these programs.
Abstract: Three computer programs for automated interpretation of variants of the Halstead-Reitan Neuropsychological Test Battery were tested on cases in two data sets. The Key approach of Russell, Neuringer, and Goldstein (1970), Brain I (Finkelstein, 1977), and Adams' (1975) ability-based algorithm were employed in the study. The first data set included 63 well-documented cases with precise criterion data and multiple sources of direct verification. The second data set consisted of 30 equally well-studied cerebrovascular disease patients whose cerebral circulation disorders resulted in clinical manifestations encompassing the entire range of stroke. Results suggested that, while none of the programs do poorly at identifying the presence of brain damage, lateralization and possibly other localization/process predictions are not done well by these programs. The failure described in this particular study does not imply that automated methods are potentially less effective than true actuarial or clinical one...
TL;DR: Although initial IQ correlated with severity of aphasia, no evidence was found for a relationship between IQ and subsequent language recovery and initial IQ level was found to relate to some measures of physical status and to death soon after testing.
Abstract: The relationship between IQ and language recovery in aphasic patients was investigated using Raven's Coloured Progressive Matrices, Functional Communication Profile, and Schuell scores. The study involved 148 stroke patients who were part of a controlled trial of speech therapy. Although initial IQ correlated with severity of aphasia, no evidence was found for a relationship between IQ and subsequent language recovery. Nevertheless, initial IQ level was found to relate to some measures of physical status and to death soon after testing.
TL;DR: Writing and auditory comprehension were found to make significant contributions to overall PLB performance and a lesion involving both parietal and frontal structures was the strongest predictor of impairment on the PLB.
Abstract: This study examined the performance of aphasics on those functions associated with the parietal lobe of the left hemisphere. Data from the Parietal Lobe Battery (PLB) (Goodglass & Kaplan, 1972) were analyzed in 163 right-handed male aphasics with unilateral left-hemisphere lesions. Factor analysis on the 18 subtests of the PLB yielded a substantial general factor before rotation and four meaningful factors following rotation, involving construction, visual schemata, verbal components of the Gerstmann Syndrome, and visual finger recognition. Diverse aphasia subtypes were relatively homogeneous in their performance on the PLB. Upon examination of the influence of linguistic, demographic, and neurological factors, writing and auditory comprehension were found to make significant contributions to overall PLB performance. When considering lesion localization, as verified by CT scans in 36% of our sample, a lesion involving both parietal and frontal structures was the strongest predictor of impairment on the PLB.
TL;DR: The usefulness of nonparametric statistical tools in evaluating irregular data sets is demonstrated in three cases examples and Methodological considerations arising from these examples are discussed.
Abstract: Research data in clinical neuropsychology frequently do not conform to the requirements for parametric statistical analysis. In some of these cases, data analysis by parametric techniques does not identify existing differences. The usefulness of nonparametric statistical tools in evaluating irregular data sets is demonstrated in three case examples. Methodological considerations arising from these examples are discussed.
TL;DR: The present commentary disputes this need for further research on the LNNB by neuropsychologists, pointing to the test author's and publisher's primary responsibility for such research.
Abstract: The Luria-Nebraska Neuropsychological Battery (LNNB) remains the subject of controversy among neuropsychologists. Substantial criticisms of a theoretical and applied nature have called into question its research basis as a clinical tool. In response to this, Stambrook (1983) has concluded that further research on the LNNB by neuropsychologists is required. The present commentary disputes this need, pointing to the test author's and publisher's primary responsibility for such research. Tests or batteries may be dropped from one's clinical practice without invoking an obligation on the part of neuropsychology.
TL;DR: Results suggested that shortening the Category Test may limit its applicability with certain populations, and subjects with focal right lesions could not be differentiated from normals either on the basis of error scores predicted from short form performance or the absolute number of errors made on subtests 1-4.
Abstract: This study attempted to cross-validate a short form of the Category Test (subtests 1-4) first used by Calsyn, O'Leary, and Chaney (1980). One hundred and sixty-eight subjects were assigned to one of six neurological categories, and Category Test scores predicted (via regression analysis) from performance on the short form were compared with actual scores obtained from the original long form. While there was a high correlation (r = .91) between the two sets of scores, a large number of normal subjects were misclassified as brain-damaged. Additionally, subjects with focal right lesions could not be differentiated from normals either on the basis of error scores predicted from short form performance or the absolute number of errors made on subtests 1-4. These results suggested that shortening the Category Test may limit its applicability with certain populations.
TL;DR: In this study the effects of familial sinistrality and strength of handedness on dichotic listening and tactual mental rotation were investigated and the results suggest a preference of left-handers for a verbal encoding strategy, especially in the right hemisphere.
Abstract: In this study the effects of familial sinistrality and strength of handedness on dichotic listening and tactual mental rotation were investigated. Nonfamilial left-handers were inferior to familial left-handers, particularly in right-ear performance. The decrement in right-ear performance is interpreted as indicative of a pathologically functioning left hemisphere in nonfamilial left-handers. The direction of ear asymmetry tends to be more predictable in strong left-handers than in weak left-handers, with nonfamilial strong left-handers showing a significant left-ear superiority and familial strong left-handers a nonsignificant right-ear superiority. In the tactual mental rotation task, the results suggest a preference of left-handers for a verbal encoding strategy, especially in the right hemisphere. This preferential strategy is particularly manifest in familial weak left-handers and nonfamilial strong left handers. The results are discussed in terms of their implications for underlying pattern...