Acalculia, aphasia and spatial disorders in left and right brain-damaged patients

The paper reports the performance of 50 left- and 26 vascular right-brain-damaged (LBD, RBD) patients in the EC301 Calculation Battery, which explores different aspects of number and calculation processing. All patients underwent a comprehensive neuropsychological testing that also included evaluation for the presence and type of aphasia in LBD patients, and of spatial disorders in RBD patients. LBD were subdivided in three groups: non-aphasic (NA), Broca and Wernicke aphasics. Results indicate that language and calculation disorders can dissociate. The relationship between spatial and calculation disorders in RBD patients is less clear. No significant difference was found between Broca and Wernicke aphasics, nor between NA and RBD patients. In the transcoding tasks (reading or writing to dictation numbers and number words, for instance) syntactic errors were the most frequent type of errors in all groups. They were also present when neither the input nor the required response was in the Arabic code, and a word-by-word strategy could have been used to read the number word or write a spoken number in the orthographic code.     

Code-dependent pathways for number transcoding: evidence from a case of selective impairment in written verbal numeral to arabic transcoding

This article presents a brain-damaged patient (RR) suffering from cognitive deficits following neurological insults, who showed a selective impairment in number transcoding. Except for written verbal numeral to arabic transcoding, his ability to transcode numerals, including writing arabic numerals to dictation, is largely preserved. Other number processing skills, including numeral recognition, numeral comprehension, and calculation, were unimpaired. Semantic and asemantic models of number processing cannot easily account for the patient's performance and it is suggested that the number transcoding system should include different code-dependent pathways for arabic transcoding from spoken verbal numerals and from written verbal numerals. Since the errors produced in the impaired transcoding rely upon the syntactical structure of numeral stimuli, it is also proposed that transcoding code-dependent pathways should reflect the structure of the verbal numeral system, especially the difference between sum and product relationships.     

The influence of processing mode on the sentence productions of language-disordered and normal children

This study examined the effects of linguistic complexity on children's language encoding performances. There were four groups with 15 subjects each: (a) language-disordered; (b) chronologically-age-matched with normal language abilities; (c) language-age-matched; (d) language-age-matched with articulatory errors. The experimental tasks were sentence repetition and elicitation. Phonological complexity (syllable length of words) was a common factor and syntactic complexity was varied for sentence repetition. For both tasks, errors simplified phonological and syntactic structures. Older normals performed with the fewest errors. The language-disordered children performed like the younger normals on the creative sentence production task, but made many more errors on the sentence repetition task. There was no difference in performance between the language-age-matched groups, for those with and without articulatory errors. The uniform effects of phonological complexity on productions across tasks and groups adds support for a limited processing capacity explanation of phonological disorders within a framework of language and cognitive development.     

Language Disorder in a Child with Early Left Thalamic Lesion

The present paper describes two patients, AB and FS, whose deficit in transcoding verbal to Arabic numerals was greatly affected by the format of the input. Despite intact comprehension of written verbal numerals and otherwise intact production of Arabic numerals they both transcode inefficiently the former into the latter. Yet, their ability to write the same Arabic numerals on dictation was fully preserved. Moreover, in both patients’ performance, a systematic error pattern emerged reflecting the influence of the lexico-syntactic structure of the input numerals in the transcoding processes. Current models of number transcoding may not easily account for this pattern of dissociation without postulating different code-dependent pathways for verbal to Arabic transcoding. Within a more parsimonious approach, it is tentatively suggested that spoken and written verbal codes activate with different efficiency the same transcoding algorithm.     

Writing and rewriting arabic numerals: dissociated processing pathways?

The present paper describes two patients, AB and FS, whose deficit in transcoding verbal to Arabic numerals was greatly affected by the format of the input. Despite intact comprehension of written verbal numerals and otherwise intact production of Arabic numerals they both transcode inefficiently the former into the latter. Yet, their ability to write the same Arabic numerals on dictation was fully preserved. Moreover, in both patients' performance, a systematic error pattern emerged reflecting the influence of the lexico-syntactic structure of the input numerals in the transcoding processes. Current models of number transcoding may not easily account for this pattern of dissociation without postulating different code-dependent pathways for verbal to Arabic transcoding. Within a more parsimonious approach, it is tentatively suggested that spoken and written verbal codes activate with different efficiency the same transcoding algorithm.     

Treating number transcoding difficulties in a chronic aphasic patient

Background : Number transcoding comprises the ability to read and write Arabic numerals and number words. Although number transcoding and counting are frequently impaired in aphasic patients, little attention has been given to the development of specific treatment methods and the evaluation of their efficiency. We report the treatment of the chronic aphasic patient PK who had severe difficulties in reading Arabic numerals. Number words could only be produced with an automatic counting strategy, always beginning with one. Aims : The therapy study was aimed at examining whether PK's numeral transcoding abilities could be improved by an intensive remediation programme that comprised tasks in which Arabic numerals had to be transcoded into number words. Methods & Procedures : Treatment consisted of specific training blocks of gradually increasing complexity. Therapy started with reading one-digit Arabic numerals, followed by teens, decades, and two- to five-digit numerals, which were divided into different subgroups according to complexity. Outcomes & Results : After an 8-week therapy period significant improvement in the processing of one- to five-digit numbers was observed. PK was able to read 49.4% of the Arabic numerals as compared to 2.2% before treatment. Performance was influenced significantly by number length and number word structure. Transcoding abilities improved remarkably for two- and three-digit numbers containing a zero or ending with two zeros. Stability of the treatment effects was assessed in a follow-up study 6 months after termination of the treatment programme. PK was still able to read 48.3% of the Arabic numerals successfully. Conclusions : In a single-case study of patient PK, suffering from chronic severe aphasia that was also characterised by severe transcoding and calculation impairments it could be demonstrated that these transcoding problems could be remedied to a substantial degree when employing a carefully graded intensive retraining programme for Arabic number naming.     

Number representation deficit: a bilingual case of failure to access written verbal numeral representations

This study reports the case of a Greek–German bilingual patient (S.V.) with specific deficit in Arabic number production from written German number words. S.V. was able to successfully complete the reverse task, i.e. to convert Arabic numerals into written or oral German number words. She also showed preserved ability to produce both German and Greek numbers and to accurately make oral magnitude judgments in both languages. However, when transcoding two-digit numbers from German written numerals to Arabic numbers she consistently reversed the digits. A series of in-house tasks were used to test her general abilities of number processing, i.e. number synesthesia and calculation. Moreover, a number magnitude comparison task was developed specifically for pairs of numbers with reverse digits and we found that out of pairs of numbers with reverse digits with magnitude less than 100, there exist 19 pair combinations for which distance and relative distance are not concordant. The results suggest that S.V.’s performance was significantly worse as the absolute distance between the numbers in the number pairs increased. These investigations are discussed in analogy with a grammatical rule problem related to absolute and relative distance effects.     

One language, two number-word systems and many problems: Numerical cognition in the Czech language

Comparing numerical performance between different languages does not only mean comparing different number-word systems, but also implies a comparison of differences regarding culture or educational systems. The Czech language provides the remarkable opportunity to disentangle this confound as there exist two different number-word systems within the same language: for instance, “25” can be either coded in non-inverted order “dvadsetpät” [twenty-five] or in inverted order “pätadvadset” [five-and-twenty].To investigate the influence of the number-word system on basic numerical processing within one culture, 7-year-old Czech-speaking children had to perform a transcoding task (i.e., writing Arabic numbers to dictation) in both number-word systems.The observed error pattern clearly indicated that the structure of the number-word system determined transcoding performance reliably: In the inverted number-word system about half of all errors were inversion-related. In contrast, hardly any inversion-related errors occurred in the non-inverted number-word system.We conclude that the development of numerical cognition does not only depend on cultural or educational differences, but is indeed related to the structure and transparency of a given number-word system.     

Characteristics of number transcoding errors of Chinese- versus English-speaking Alzheimer's disease patients

ABSTRACT

Number processing disorder is an acquired deficit in mathematical skills commonly observed in Alzheimer’s disease (AD), usually as a consequence of neurological dysfunction. Common impairments include syntactic errors (800012 instead of 8012) and intrusion errors (8 thousand and 12 instead of eight thousand and twelve) in number transcoding tasks. This study aimed to understand the characterization of AD-related number processing disorder within an alphabetic language (English) and ideographical language (Chinese), and to investigate the differences between alphabetic and ideographic language processing. Chinese-speaking AD patients were hypothesized to make significantly more intrusion errors than English-speaking ones, due to the ideographical nature of both Chinese characters and Arabic numbers. A simplified number transcoding test derived from EC301 battery was administered to AD patients. Chinese-speaking AD patients made significantly more intrusion errors (p = 0.001) than English speakers. This demonstrates that number processing in an alphabetic language such as English does not function in the same manner as in Chinese. The impaired inhibition capability likely contributes to such observations due to its competitive lexical representation in brain for Chinese speakers.     

Executive function deficits in persons with mild cognitive impairment: a study with a Tower of London task

Although paced serial addition (PSA) tasks are considered to be tests of general information-processing capacity, recent work suggests that performance on such tasks is influenced by arithmetic-specific variables. We designed two visual PSA experiments to determine whether the performance of normal adults would support predictions derived from the cognitive psychology of calculation. Experiment 1 showed that mixing familiar (Arabic numeral) and less familiar (Roman numeral) stimulus formats reduced scores below the averaged scores for pure Arabic and Roman lists. The Roman-Arabic order of addends was more difficult than the Arabic-Roman order. Experiment 2, which involved only Arabic numerals as addends, showed that performance could be impaired by constraining the trial-to-trial variability of sums. The results of both experiments confirm the importance of arithmetic-specific variables in PSA and provide support for an associative network model of calculation. In addition, the findings implicate interference from extraneous addends and responses as the performance-limiting factor.     

Performance on paced serial addition tasks indicates an associative network for calculation

Although paced serial addition (PSA) tasks are considered to be tests of general information-processing capacity, recent work suggests that performance on such tasks is influenced by arithmetic-specific variables. We designed two visual PSA experiments to determine whether the performance of normal adults would support predictions derived from the cognitive psychology of calculation. Experiment 1 showed that mixing familiar (Arabic numeral) and less familiar (Roman numeral) stimulus formats reduced scores below the averaged scores for pure Arabic and Roman lists. The Roman-Arabic order of addends was more difficult than the Arabic-Roman order. Experiment 2, which involved only Arabic numerals as addends, showed that performance could be impaired by constraining the trial-to-trial variability of sums. The results of both experiments confirm the importance of arithmetic-specific variables in PSA and provide support for an associative network model of calculation. In addition, the findings implicate interference from extraneous addends and responses as the performance-limiting factor.     

The role of noun syntax in spoken word production: Evidence from aphasia

We describe MH who presents with agrammatic aphasia and anomia, and who produces semantic errors in the absence of a central semantic impairment. This pattern of performance implies damage to syntactic processes operating between semantics and phonological output. Damage here may lead to lexical selection errors and a deficit in combining words to form phrases.We investigated MH's knowledge and processing of noun syntax in mass and count nouns. She produced more count nouns than mass nouns. She showed impaired knowledge of noun syntax in judgement tasks and production tasks, with mass noun syntax being more impaired than count.We interpret these results in terms of a two-stage model of lexical retrieval. We propose that syntactic information represented at the lemma level is activated even in bare noun production, and can be differentially impaired across noun categories. That same damage can lead to semantic errors in production. For MH limited syntactic options are available to support production, and these favour count noun production. The data provide a new account of output semantic errors.     

Dissociating Arabic Numeral Reading and Basic Calculation: A Case Study

This study is about JS, a patient who suffered from anomia, phonological dyslexia and severe writing problems following a left hemispheric stroke. He showed good arabic numeral comprehension as evidenced in number-comparison tasks, but impairment in transcoding arabic numerals into verbal numbers and verbal numbers into arabic numerals. Although JS had several operand reading errors, the four arithmetic operations were not affected. In calculations with arabic numerals, he produced the correct results both in oral and written responses. For instance, when presented with the multiplication “7×3”, JS read the operation as “four times five”, but provided the correct response orally “twenty one” and written “21”. This behavior goes against those hypotheses which posit that multiplication facts are verbally-based, and those which establish the same route for verbal number production in calculation and arabic numeral reading.     

Dissociating arabic numeral reading and basic calculation: a case study

This study is about JS, a patient who suffered from anomia, phonological dyslexia and severe writing problems following a left hemispheric stroke. He showed good arabic numeral comprehension as evidenced in number-comparison tasks, but impairment in transcoding arabic numerals into verbal numbers and verbal numbers into arabic numerals. Although JS had several operand reading errors, the four arithmetic operations were not affected. In calculations with arabic numerals, he produced the correct results both in oral and written responses. For instance, when presented with the multiplication "7 x 3", JS read the operation as "four times five", but provided the correct response orally "twenty one" and written "21". This behavior goes against those hypotheses which posit that multiplication facts are verbally-based, and those which establish the same route for verbal number production in calculation and arabic numeral reading.     

The development of numerical magnitude processing and its association with working memory in children with mild intellectual disabilities

The present research examined numerical magnitude processing and its association with working memory in children with mild intellectual disabilities (MID). We investigated the performance of 8-year-old children with MID on a symbolic (Arabic digits) and non-symbolic (dot patterns) magnitude comparison task by means of a chronological-age/ability-level-match design. We also examined whether the predicted problems with numerical magnitude comparison could be explained by working memory by using three working memory tasks. Findings revealed that children with MID performed more poorly than their chronological age-matched peers on both the symbolic and non-symbolic magnitude comparison tasks, suggesting impairments in these children's ability to represent numerical magnitudes. They also performed more poorly on working memory compared to their typically developing age- and ability-matched peers, but when these differences in working memory performance were additionally controlled for, the group differences on the numerical magnitude comparison tasks remained. Both symbolic numerical magnitude processing and central executive functioning predicted addition performance in children with MID.     

Mental health case management: Characteristics,job function,and occupational stress

Although case management is an important component of treatment for persons with major mental illnesses, little is known about who works in case management, what functions are performed and how much occupational stress case managers experience. Mental health case managers (CM's) throughout the state of Oregon (N=216) completed an inventory of case management functions and the job dissatisfaction and occupational stress scales of the Medical Personnel Stress Survey-Revised. The average expected tenure for a CM was 11 years, although one fifth expect to be a CM for four years or less. CM's spend 36% of their time performing administrative tasks, 20% in therapy, 17% with skills training, and 18% in case coordination tasks. CM level of education was associated with a different distribution of effort across case management functions. Greater job dissatisfaction was associated with specialized training, larger case load size and greater intention to leave the position. Consumer CM's demonstrated equivalent levels of job satisfaction as their non-consumer colleagues. The relevance of the project's findings for human resource management are discussed.The contents of this publication were developed under a grant from the National Institute on Disability Rehabilitation and Research, Department of Education cooperative agreement number H133B00011, and the National Institute of Mental Health, Systems Development and Community Support Branch. The contents of this publication do not necessarily reflect the views of the Institute and do not imply endorsement by the U.S. Government.     

Transcoding zeros within complex numerals

This paper describes a patient (LD) showing a selective syntactic deficit in the production of Arabic numerals. Unlike in previously reported cases, LD's syntactic difficulties result in deletions rather than insertions of zeros, with a reduction of the number magnitude. The pattern of errors highlighted a distinction between "lexical zeros", i.e. the zeros in tens, that are semantically derived, and "syntactic zeros" that are syntactically produced as the result of specific production rules. In LD, only syntactic zeros were affected. Furthermore, the processing of numerals with final zeros was found to be easier than the processing of numerals with internal zeros. This pattern of errors is compatible with the lexical-semantic model of Power and Dal Martello. In this model, in fact, lexical zeros originate from a numerical concept, while syntactic zeros originate from a concatenation operation, plus an overwriting operation leaving one or more intermediary zeros. Thus, lexical zeros may be easier to manipulate than syntactic zeros that merely represent a null quantity associated to a specific power of 10.     

Unconscious processing of Arabic numerals in unilateral neglect

This study explores the processing of Arabic numerals in three patients with dense left unilateral neglect. Three tasks have been used: a test of visual awareness (is the stimulus on the left, on the right or on both sides?), a number comparison task (is the number larger or smaller than 5?), a number parity judgment task (is the number odd or even?). The test of visual awareness indicated that all three patients were completely unaware of the stimuli presented in the left hemifield. Despite this, the number comparison and number parity judgment tasks clearly indicated that Arabic numerals were unconsciously processed at semantic level (i.e. quantity). These results show that patients with left unilateral neglect can still semantically process Arabic numerals unconsciously.     

Degrees of severity and recovery in agrammatism: Climbing up the syntactic tree

Background : Agrammatic aphasia impairs syntactic abilities in production and comprehension. The Tree Pruning Hypothesis (TPH) suggests that the syntactic deficit in production can be described in terms of inability to access the high nodes of the syntactic tree. Aims : The current study explored patterns of individual differences between individuals with agrammatic aphasia, and suggested a characterisation for different degrees of agrammatic severity using the syntactic tree. A second aim was to test the path of spontaneous recovery in agrammatic aphasia. Methods & Procedures : The first experiment tested 18 individuals with agrammatism: 16 were Hebrew speakers, and 2 were speakers of Palestinian Arabic. The syntactic ability of the participants was assessed with respect to three levels of the syntactic tree. To test the ability at the Agreement Phrase (AgrP) level, a task of agreement completion was used. To test the ability at the Tense Phrase (TP) level, a task of tense inflection completion was used. The ability at the highest level of the tree, the Complementiser Phrase (CP), was tested using elicitation tasks for two structures: Wh-questions and relative clauses. The second experiment tested the recovery of these four abilities over time in SB, an individual with agrammatism, starting 4.5 months post her brain injury until 18 months post-onset. Outcomes & Results : The main findings were that the variation between the performance of different individuals with agrammatism and degrees of agrammatic severity could be accounted for by different sites of pruning on the syntactic tree. Severe agrammatism results from inability to access TP and the nodes above it, which impairs both tense inflection and CP-related abilities like the production of embedded sentences and Wh-questions. Milder agrammatism results from the inaccessibility of a higher node, CP, which causes a deficit to embedded sentences and Wh-questions, but leaves tense unimpaired. For both degrees of severity, agreement inflection was unimpaired. The second experiment showed that the spontaneous recovery of SB proceeded on the syntactic tree: the starting point was impairment in AgrP, TP, and CP, at the next stage AgrP recovered, and at the following stage TP recovered too. Conclusions : The results show that the syntactic tree is not only a useful tool for the characterisation of agrammatic aphasia at one point in time; it can also account for individual differences as well as for degrees of agrammatic severity, and can describe stages of spontaneous recovery. A milder impairment, or improvement in agrammatism, manifests itself in the ability to access higher nodes of the syntactic tree.     

On-line detection of transient neuropsychological disturbances during EEG discharges in children with epilepsy

Short-term memory tasks (visual-spatial and verbal) were devised to identify the influence of transient EEG discharges, without clinically manifest disturbances, on neuropsychological performance. 53 children with subclinical focal and generalized EEG discharges were tested 72 times and 16-channel telemetered EEG and video-recordings were made. 36 per cent of test sessions showed a significant preponderance of errors when discharges were recorded. Children with right-sided discharges had impaired performance in 50 per cent of their test sessions, with performance on the visual-spatial task most affected: left-sided discharges appeared to exert greater influence on the verbal task. These tests can easily be used to monitor six- to 15-year-old children.