Errorless Leaning of Face-Name Associations in Early Alzheimer's Disease

Clare, L., Wilson, B.A., Breen, K., & Hodges, J.R. (1999). Errorless learning of face-name associations in early Alzheimer’s disease. Neurocase: The Neutral Basis of Cognition, 5(1), 37-46.

Dementia refers to the loss of memory and other mental abilities that are severe enough to interfere with daily life. Many patients with dementia complain of major problems in face-name recognition. There is evidence that people with Alzheimer’s (a common type of dementia) can learn and retain new information by using strategies such as elaboration of material at encoding and expanding rehearsal. Another effective strategy that has been used with brain injured and learning disabled people is errorless learning. Errorless learning aims to prevent or significantly reduce errors made by the learner during the learning process.

This paper reports a multiple baseline intervention single case study of a 72 year old man (VJ) with Alzheimer’s disease and memory problems for the last three years aimed at improving face-naming. The first phase, initial baseline, involved showing VJ Polaroid pictures of 14 club members and testing which names he already knew. The second phase, the intervention, consisted of teaching the remaining face name associations over 21 sessions in his home. Phase three, generalization, took place at the social club and required VJ to identify individuals in person. In phase four, post intervention baseline, sessions were conducted in which VJ’s ability to name the photographs was tested. Finally, phase 5 included a follow-up at 1,3,6, and 9 months.

Errorless learning principles were applied throughout the phases by instructing VJ to provide a name only if he was sure. If he was unsure of a name, prompts were given. Each name-face association was trained in the same way during the intervention phase. VJ was shown a photograph and told the name. Next a mnemonic was chosen that related the name to a physical feature (example: Caroline with the curl on her forehead). Next, vanishing cues were used during the learning trials. Finally, an expanding rehearsal procedure took place.

The results of the study showed a significant increase in the number of faces VJ correctly named, rising from 22% at baseline to 98% following training with improvements maintained after 3, 6, and 9 months. The results provide some evidence that the errorless learning technique may be useful in learning face-name relationships in individuals with Alzheimer’s. However, mnemonic and vanishing cues may also have contributed to the improvement in VJ’s memory.

Blogger: Allison Partridge

The Cognitive and Academic Profiles of Reading and Mathematics Learning Disabilities. Journal of Learning Disabilities

Compton, D.L., Fuchs, L.S., Fuchs, D., Lambert, W., & Hamlett, C. (2012). The cognitive and academic profiles of reading and mathematics learning disabilities. Journal of Learning Disabilities, 45, 79-95.

This study examined the profiles of strengths and weaknesses across cognitive dimensions and across academic domains in children with learning disabilities. Over 600 children completed academic measures of reading comprehension, word reading, applied problems, and calculations, as well as cognitive measures of nonverbal problem solving, processing speed, concept formation, language, and working memory. Data were available at 3 time points for each child allowing modeling of the final learning disability status for each academic measure (at 5th grade) based on cognitive or academic performance.

Results revealed specific rather than general learning profiles in those with a learning disability, but a relatively flat profile for those without a learning disability. Children identified with a learning difficulty in each of the four academic measures tested tended to be low on that measure only (i.e., reading comprehension) and not the other academic tasks (i.e., word reading, applied problems, and calculations). As well, the cognitive profiles of these learning disability groups reflected specific impairments. A learning disability in reading comprehension was associated with low language relative to the other cognitive dimensions measured. Word reading disability was linked to relatively low working memory and language, and applied problems learning disability to relatively low concept formation. A learning disability in calculations was associated with a flat cognitive profile.

Overall results suggest that a specific deficit profile may characterize children with learning disabilities. Nevertheless, caution is warranted in interpreting these findings given the sample size within each profile group.

Blogger: Lisa Archibald

Accelerating Preschoolers’ Early Literacy Development Through Classroom-Based Teacher-Child Storybook Reading and Explicit Print Referencing

Justice, L.M., Kaderavek, J.N., Fan, X., Sofka, A., & Hunt, A. (2009). Accelerating Preschoolers’ Early Literacy Development Through Classroom-Based Teacher-Child Storybook Reading and Explicit Print Referencing. Language, Speech, & Hearing Services in Schools, 40, 67-85.

Like phonological awareness, print knowledge (awareness of words on the page, how to hold a book, direction to read) has been shown to positively influence children’s early literacy achievements; however print knowledge has been given less attention in research and practice. In this study, Justice et al. evaluated a 30 week, 120 book print referencing shared reading intervention implemented by teachers. Effects were measured in terms of changes in print awareness of preschool children. The teachers of 14 classrooms used the print referencing style of storybook reading while 9 comparison control classrooms used their regular style of reading. 106 preschool children were assessed on 3 measures of print knowledge: print concept knowledge, alphabet knowledge, and name writing. Results showed that preschoolers in the intervention group made significantly greater gains in print concepts and alphabet knowledge over control peers.

This article is comprehensive and includes examples of the stories used with their print referencing focus. It offers practical knowledge for any SLP or teacher.

Blogger: Laura Vanderlaan

The Relation Between Music and Phonological Processing in Normal-Reading Children and Children with Dyslexia

Forgeard, M., Schlaug, G., Norton, A., Rosam, C., & Iyengar, U. (2008). The relation between music and phonological processing in normal-reading children and children with dyslexia. Music Perception 25(4), 383-390.

Research has shown that a core deficit of dyslexia is phonological. Other research has found that musical ability is related to reading and phonological ability in both normal-reading children and those with dyslexia. If musical ability is supported by the same underlying process as phonological skill, then it is possible that musical intervention could play a role in remediating the phonological deficits present in children with dyslexia.

Forgeard et al. examined this relationship between music ability and reading ability through a series of four studies. In the first two studies, they compared musical skills to phonological and reading skills among normal readers with and without musical training. Results of the first study confirmed the relationship between phonological processing and pitch processing. Findings from the second study showed that reading ability was related to auditory music skills. They also found that children receiving musical training showed greater improvement in phonemic decoding than children receiving no musical training.

The third study tested the hypothesis that phonological and reading deficits in children with dyslexia should predict deficits in music processing. Results showed that musical discrimination predicted phonological discrimination, which in turn predicted reading ability; however, musical ability did not predict reading ability. The final study compared musical processing abilities of normal-reading children, both with and without musical training, to those of children with dyslexia. The researchers found that normal-readers with musical training performed better than normal readers without musical training, who performed significantly better than children with dyslexia.

This study offers some evidence of the relationship between musical processing and phonological processing. Forgeard et al. suggest that musical intervention may be a helpful addition in intervention programs targeting phonological processing skills. Results should be interpreted with caution due to small sample sizes.

Blogger: Laura Pauls is completing an independent study examining the agreement between standardized language tests and parent and teacher concerns about language development. She is finishing her final year in the Masters of Clinical Science program in Speech Pathology.

Interventions Targeting Attention in Young Children With Autism

Patten, E. & Watson, L. R. (2011). Interventions targeting attention in young children with autism. American Journal of Speech-Language Pathology, 20, 60-69.

The importance of attention in one’s ability to learn cannot be understated. While research on autism is quite prevalent, autism studies that focus on attention are rare. Patten and Watson (2011) provide a guide for clinicians which showcases autistic children’s attention characteristics as well as interventions which successfully improve attention.

Patten and Watson (2011) identify three main categories of attention commonly affected in children with autism: orienting, sustaining, and shifting. Orienting describes the physical adjustment to a stimulus (i.e., a head turn or eye shift), sustaining refers to the maintenance of attention to a stimulus, and shifting is the act of both disengaging from one stimulus and then shifting and reorienting to a new one. These three factors all influence social interaction through joint attention, which refers to the shared attention between two individuals and an object or stimulus. Children with autism have trouble orienting to stimuli, and sometimes overfixate on them when they do.

The authors review intervention methods which either “habilitate or improve attention skills in the long term” (therapeutic interventions) or “focus on compensatory strategies or accommodations that effectively improve attention relatively quickly and contingently” (accommodations). The therapeutic interventions presented are based on 12 studies, and can be generally categorized into four methods: Child-directed play, in which the child chooses an activity and adult intervention is implemented within that context; reinforcement, in which children get a reward for performance; imitation, in which adults imitate children with the hopes that eventually the roles will reverse and children will imitate the adults’ behaviour; and prompting, in which physical prompts begin in an over exaggerated manner, and the exaggeration is gradually reduced until the children display the correct behaviour by themselves. The accommodations which the authors suggest are strategies such as referring to objects of attention by specific labels or offering rewards for good behaviour, which seem to be effective in the short term, but offer no long term advances.

The authors conclude that research results largely indicate that attention interventions benefit children with autism. This conclusion is based on findings of a systematic review in the National Standards Project (NSP) report (National Autism Center, 2009). Furthermore, the authors suggest that interventions are beneficial regardless of who administers the intervention (they suggest it can be a therapist, parent, or peer).

Blogger: John Berger

School-Age Children Talk About Chess: Does Knowledge Drive Syntactic Complexity?

Nippold, N.A. (2009). School-age children talk about chess: Does knowledge drive syntactic complexity? Journal of Speech, Language, and Hearing Research, 52, 856-871.

Speech-language pathologists who work with school-age children are continually searching for an effective method for obtaining a spontaneous language sample that is quick yet yields accurate information regarding a child’s linguistic abilities. Previous studies have demonstrated that when speaking in the expository genre, vs conversation or narrative, children exhibit greater syntactic complexity. Nippold (2009) hypothesized that complex thought supported by a knowledge base would result in the use of complex syntax. She examined the language productivity and syntactic complexity of 32 children using chess as the topic of discussion.

18 expert and 14 novice chess players, aged 7;3 – 15;4 provided language samples during an interview format across three different speaking tasks: general conversation, chess conversation, and chess experience. All interviews were audio recorded, transcribed verbatim and entered into SALT. Syntactic complexity measurements of the transcriptions included mean length of t unit, clausal density, and use of nominal, relative, and adverbial subordinate clauses. Group comparisons were made using a series of one-way analyses of variance with each child’s chronological age, raw score, chess knowledge, and years of play serving as the dependent variables. Pearson product-moment correlation coefficients were calculated using the same data.

Results indicated that both novice and expert chess players produced substantially greater amounts of language and spoke with higher levels of syntactic complexity during the expository task (chess explanation) compared to the conversation tasks (chess and general). The relationship between mean length of T-unit and each of the other syntactic measures revealed that mean length of T-unit alone was found to be an effective tool when scoring conversation and expository tasks for complexity.

This study provided support for using language-sampling tasks involving sufficient opportunities for children to talk about their knowledge areas. Speech-language pathologists may want to consider incorporating questioning techniques that stimulate children to reflect on complicated issues relative to their areas of expertise such as video gaming, arts, or computers when obtaining a language sample to investigate syntactic complexity.

Blogger: Rosine Salazer

Rapid Automatized Naming (RAN) Taps a Mechanism That Places Constraints on the Development of Early Reading Fluency

Lervag, A., & Hulme, C. (2009). Rapid automatized naming (RAN) taps a mechanism that places constraints on the development of early reading fluency. Psychological Science, 20, 1040-1048.

This study explored the relationship between the ability to rapidly name items (RAN) and to learn to read. Three possible relationships were postulated: RAN may tap causal mechanisms for differences in learning to read; differences in learning to read might be the cause of differences in RAN; there might be a bidirectional causal relationship.

A group of 233 unselected, grade 1 children from Norway completed RAN tasks at 5 time points over a 37-month period. The first and second testing time points were compared for the children before and after reading instruction, and text reading fluency was also measured at time points 2-5.

Structural equation modeling examined how well Time 2 RAN and reading were predicted from Time 1 RAN. Results revealed that reading fluency, phoneme awareness, and RAN at Time 2 were strongly predicted from Time 1 RAN measures. Additionally, rapid naming of letters and numbers was strongly predicted by RAN for nonalphanumeric items. RAN was found to be an important predictor of later text-reading fluency. In latent growth curve analysis, nonaphanumeric RAN predicted the non-linear growth of text-reading fluency over all time points.

The results showed that nonalphanumeric RAN is a good predictor of later variations in reading skill, and that early variations in reading ability are not good predictors of later variations in RAN. Therefore, after reading instruction has started, RAN continues to exert an influence on the development of reading fluency over the next 2 years. However, there is no evidence of a reciprocal influence of reading fluency on the growth of RAN skill. Later in development, once literacy skills had started to develop, alphanumeric RAN predicted the further growth of text-reading fluency. However, text-reading fluency did not predict growth in RAN. Therefore, RAN and reading do not show reciprocal influences on one another.

From these findings, the researchers suggested that RAN may underlie a child’s word-recognition abilities but acknowledged previous findings that RAN related training has had limited success.

Jenna Coady is completing an independent study examining RAN, phonemic awareness, and reading in young children. She is finishing her final year in the Masters of Clinical Science program in Speech Language Pathology.

Risk for Poor Performance on a Language Screening Measure for Bilingual Preschoolers and Kindergartens

Pena, E.D., Gillam, R.B., Bedore, L.M., & Bohman, T. M. (2011). Risk for Poor Performance on a Language Screening Measure for Bilingual Preschoolers and Kindergartens. American Speech-Language-Hearing Association, 302-314.

This study examines the relationship between language experience and Latino children’s performance on Bilingual measures (English and Spanish). The primary purpose of the study is to examine whether preschooler and kindergarteners children who are learning two languages at the same time present with risk for language impairment more than the monolingual children. Also, this study explored the relationship between maternal education and length of exposure in both languages (English and Spanish).

A total of 1,029 children completed subtests assessing semantics and morphsyntax in both languages (English and Spanish) of the Bilingual English Spanish Oral Screener (BESOS; currently in development). From parental report the study identified each child to be in one of five groups of languages: (1) functionally monolingual English (FME), (2) bilingual English dominant (BED), (3) balanced bilingual (BL), (4) bilingual Spanish dominant (BSD), and (5) functionally monolingual Spanish (FMS). The bilingual not-at-risk group scored lower than the monolingual and language dominant groups in both languages. In addition, in English subtest tasks, the balance bilingual with no risk earned the same scores as the English monolingual at risk group. Moreover, the two bilingual dominant groups had the same score as their bilingual groups in their stronger language.

The study reported that bilingual children might be at risk for poor performance on language measures. However, bilingualism is not related to increased risk for language impairment because performance of the at-risk groups did not differ significantly for across all five language groups. In sum, the study found that monolingual and bilingual child had the same overall language knowledge provided measures in both languages were included for the bilingual groups. The results underlined the problem of assessing bilingual children in only one language.

Blogger: Areej Balilah.

Precursors to numeracy in kindergartners with specific language impairment

Kleemans, T., Segers, E., & Verhoeven, L. (2011). Precursors to numeracy in kindergartners with specific language impairment. Research in Developmental Disabilities, 32, 2901-8.

Kleemans et al. examined whether children with SLI significantly differed on measures of numeracy in comparison to typically developing children and which precursors were more closely related to numerical processing skills in children with SLI. A group of 111 typically developing children and 61 with SLI completed measures of working memory, naming speed, phonological awareness and grammatical ability, as well as measures of logical operations, numeral representations and numeral estimations. The researchers found that phonological awareness and grammatical ability predicted logical operations and numerical representations. Furthermore, there was an interaction between group and naming speed, with naming speed being significantly correlated with logical operations and numerical representations in the SLI group, but the typically developing group.

These findings are consistent with the Triple Code Model proposed by Dehaene et al. (2003). This model predicts that depending on the tasks, there are three distinct systems of representation that may be recruited: the quantity system (nonverbal), a verbal system (where numerals are represented lexically, phonologically and syntactically) and visual system. The verbal system is associated with activating the left angular gyrus (located in the parietal lobe), which has been found to be associated with arithmetic fact retrieval, but also other language mediated processes such as verbal STM and reading. The findings of a relationship between language abilities and the verbally based numerical tasks in the Kleemans et al. study are consistent with the verbal numeracy system proposed in the Triple Code Model.

Although the paper is consistent with previous findings, the hierarchical regression analysis reported was confusing. Furthermore, multiple t-tests were conducted increasing the chance of finding a type I error. The correlation analyses would have been stronger if partial correlations controlling for age were reported. As well, the numeracy tasks that measured numerical operations and numerical representations were very similar to one another and relied heavily on language processes to perform. Given the fact that the numeracy tasks were not independent of language skills, the results are not surprising.

These findings may have clinical and diagnostic implications. Although further research is necessary, the rapid naming may be related to number deficits in children with SLI. However, given the statistical methods used, the results should be interpreted with caution.

Blogger: Stephanie Bugden is our guest blogger and a PhD candidate working in the lab of Dr. Daniel Ansari, Canada Research Chair in Developmental Psychology at the University of Western Ontario. Stephanie’s research examines the developmental trajectories of cognitive impairments in children with math learning disabilities. Stephanie currently holds the record for the shortest time between finishing our lab meeting and writing her post for this blog!

Domain-specific treatment effects in children with language and/or working memory impairments: A pilot study

Wener, S.E., & Archibald, L.M.D. (2011). Domain-specific treatment effects in children with language and/or working memory impairments: A pilot study. Child Language Teaching and Therapy, 27, 313-330.

Archibald & Joanisse (2009) identified three groups of children: (1) Those with a Specific Language Impairment (SLI), an impairment in language development but not working memory; (2) those with a Specific Working Memory Impairment, an impairment in working memory but not language; and (3) those with both language and working memory impairments (L&WMI). Given these separable groups, it would be reasonable to hypothesize that these children may respond differently to treatment aimed either at improving language or working memory. It was the purpose of this pilot study to evaluate this hypothesis.

We employed a single subject design with 9 participants, 3 with SLI, 2 with SWMI, and 4 with L&WMI. Performance was measured using 3 probes (picture recall, sentence formulation, geometric puzzle completion) throughout the baseline phase (2 wks), treatment phase 1 (4 wks), no treatment (4 wks), and treatment phase 2 (4 wks). Standardized tests of language and working memory were completed before and after each treatment phase, and at 4 months post treatment. The treatment in the 2 phases involved 4 tasks (word recall, n-back, story retelling, memory updating) but differed in the strategies taught. For the language-based intervention, verbal strategies were targeted whereas for the working memory-based intervention, imagery strategies were taught as a memory strategy. Five of the participants did the language-based intervention first followed by the working memory intervention.

Results revealed that performance improved on the picture recall probe after the language-based intervention, and on the geometric puzzle completion probe after the working memory-based intervention. No reliable effects were found for the sentence formulation probe. Improvements of 10 points on standard scores were considered clinically significant. Based on this criterion, 6 of 7 of the children with a language impairment (SLI or L&WMI) showed an improvement on a language measure and 3 of 5 (SWMI or L&WMI) on a working memory measure at 4 months post onset.

This study provides some preliminary evidence of a domain-specific treatment effect in that performance on a language task improved after language-based intervention and on a visuospatial task after working memory-based intervention focusing on imagery strategies. The findings also suggest a profile-specific effect in that children with a language impairment tended to improve on a language measure and children with a working memory impairment on a working memory test. Given the small sample size, these results must be interpreted with caution.

Blogger: Lisa Archibald