A randomised controlled crossover trial evaluating Television Assisted Prompting (TAP) for adults with acquired brain injury

Assistive technologies for cognition (ATC) provide an effective means to compensate for prospective memory failures among adults with acquired brain injury (ABI; de Joode, van Heugten, Verhey, & van Boxtel, 2010 de Joode, E., van Heugten, C., Verhey, F. and van Boxtel, M. 2010. Efficacy and usability of assistive technology for patients with cognitive deficits: A systematic review. Clinical Rehabilitation, 24: 701–714. doi:10.1177/0269215510367551[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]; Sohlberg et al., 2007 Sohlberg, M. M., Kennedy, M., Avery, J., Coelho, C., Turkstra, L., Ylvisaker, M. and Yorkston, K. 2007. Evidence-based practice for the use of external aids as a memory compensation technique. Journal of Medical Speech-Language Pathology, 15(1): 15–51.  [Google Scholar]). This study evaluated a novel ATC device, the Television Assisted Prompting (TAP) system, which provides audiovisual reminders at scheduled prospective times on a person's home television. A randomised, controlled crossover design evaluated task completion for two preferred, two non-preferred, and two structured experimental tasks among 23 adults with ABI between two conditions: TAP prompting or typical (TYP) practice, without TAP reminders. Main outcomes showed a significant advantage of prospective memory prompting (72% completion) over no prompting (43% completion) and higher task completion with TAP prompting for researcher-assigned experimental tasks (81%) compared to self-selected preferred (68%) or non-preferred (68%) tasks. Results are discussed in the context of ATC efficacy to support prospective memory prompting following ABI, with contributions and future directions for continued investigation of customisation of prompts to maximise task completion.     

Indirect versus direct feedback in computer-based Prism Adaptation Therapy

Prism Adaptation Therapy (PAT) is an intervention method in the treatment of the attention disorder neglect (Frassinetti, Angeli, Meneghello, Avanzi, & Ladavas, 2002 Frassinetti, F., Angeli, V., Meneghello, F., Avanzi, S. and Ladavas, E. 2002. Long-lasting amelioration of visuospatial neglect by prism adaptation. Brain, 125: 608–623. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar]; Rossetti et al., 1998 Rossetti, Y., Rode, G., Pisella, L., Farne, A., Li, L.Boisson, D. 1998. Prism adaptation to a rightward optical deviation rehabilitates left hemispatial neglect. Nature, 395(6698): 166–169. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar]). The aim of this study was to investigate whether one session of PAT using a computer-attached touchscreen would produce similar after-effects to the conventional box normally used in PAT.

In four experiments, 81 healthy subjects and 7 brain-injured patients diagnosed with neglect were subjected to a single session of PAT under two conditions: (1) using the original box, and (2) using a computer-based implementation of PAT. The session of PAT included a pre-exposure step involving pointing at 30 targets without feedback; an exposure step involving pointing at 90 targets with prism goggles and feedback; and a post-exposure step involving pointing at 60 targets, with no goggles and no feedback.

The results indicate that the expected similarity in the after-effect produced by the two conditions seems to occur only if subjects receive feedback on pointing precision by seeing their fingertip during the exposure step. Attempts to provide feedback indirectly via icons on the computer screen failed to produce the expected size in the after-effect. The findings have direct implications for computer-based treatment of visuospatial disorders in the future and computer-assisted rehabilitation in general.     

Psychometric Evaluation of the Behavior Problems Inventory-01 and the Nisonger Child Behavior Rating Form with Children and Adolescents

This study was conducted to assess the psychometric properties of 2 assessment instruments, the Behavior Problems Inventory-01 (BPI-01; Rojahn, Matson, Lott, Esbensen, & Smalls, 2001 Rojahn, J., Matson, J. L., Lott, D., Esbensen, A. J. and Smalls, Y. 2001. The Behavior Problems Inventory: An instrument for the assessment of self-injury, stereotyped behavior, and aggressive/destructive behavior in individuals with developmental disabilities. Journal of Autism and Developmental Disorders, 31: 577–588. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar]) and the Nisonger Child Behavior Rating Form (NCBRF; Aman, Tassé, Rojahn, & Hammer, 1996 Aman, M. G., Tassé, M. J., Rojahn, J. and Hammer, D. 1996. The Nisonger CBRF: A child behavior rating form for children with developmental disabilities. Research in Developmental Disabilities, 17: 41–57. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar]). The sample consisted of 237 ethnically diverse children and adolescents with intellectual disabilities who ranged in age from 4 to 22 years. Reliability parameters included internal consistency, interteacher agreement, teacher-parent agreement, and test-retest reliability. Factorial validity was assessed first by bivariate Spearman rank (ρ) correlations and then by examining the factor structure fit via confirmatory factor analysis (CFA). Convergent and discriminant validity was assessed by multiple regression analyses across the 2 instruments. Reliability coefficients (internal consistency, interteacher agreement, and test-retest reliability) of the BPI-01 and of the NCBRF subscales ranged from fair to excellent and from poor to excellent, respectively. The CFA suggested a poor fit between the present and the original BPI-01 and NCBRF factor structures, although item-total correlations were reasonable. Convergent and discriminant validity between the BPI-01 and the NCBRF, however, was strong. Limitations of the study are discussed and recommendations for future studies are presented.     

Psychometric Evaluation of Romanian Translations of the Behavior Problems Inventory-01 and the Nisonger Child Behavior Rating Form

Psychometric properties of Romanian translations of the Behavior Problems Inventory-01 (BPI-01; Rojahn, Matson, Lott, Esbensen, & Smalls, 2001 Rojahn, J., Matson, J. L., Lott, D., Esbensen, A. J. and Smalls, Y. 2001. The Behavior Problems Inventory: An instrument for the assessment of self-injury, stereotyped behavior, and aggression/destruction in individuals with developmental disabilities. Journal of Autism and Developmental Disorders, 31: 577–588. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar]) and the Nisonger Child Behavior Rating Form (NCBRF; Aman, Tassé, Rojahn, & Hammer, 1996 Aman, M. G., Tassé, M. J., Rojahn, J. and Hammer, D. 1996. The Nisonger CBRF: A child behavior rating form for children with developmental disabilities. Research in Developmental Disabilities, 17: 41–57. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar]) were explored. Respondents completed the instruments for 115 children and adolescents with intellectual disabilities. Internal consistency of both instruments' total scales was good to excellent (Cronbach's α ranging from .88 to .95) and the subscale internal consistencies were fair to excellent (with α ranging from .74 to .94). The results based on bivariate Spearman correlations and multiple regression analyses provided strong convergent and discriminant validity of both instruments. Overall, the Romanian versions of the behavior rating scales had very good reliability (internal consistencies) and convergent and discriminant validity. It is hoped that this study will be a catalyst for Romanian clinicians and researchers as well as for transcultural researchers working with Romanian individuals with intellectual disabilities to continue the exploration of the utility and psychometric quality not only of the BPI-01 and the NCBRF but also of other English language psychopathology assessment instruments.     

Agrammatic patterns in Alzheimer's disease: Evidence from tense,agreement, and aspect

Background: Little research has been conducted on functional categories in probable Alzheimer's disease (pAD). Furthermore, the findings are contradictory, since some studies report ceiling performance on tense and/or subject–verb agreement (Kaprinis & Stavrakaki, 2007 Kaprinis, S. and Stavrakaki, S. 2007. Morphological and syntactic abilities in patients with Alzheimer's disease. Brain and Language, 103: 59–60. doi:10.1016/j.bandl.2007.07.044[Crossref], [Web of Science ®] , [Google Scholar]; Kavé & Levy, 2003 Kavé, G. and Levy, Y. 2003. Sensitivity to gender, person and tense inflection by persons with Alzheimer's disease. Brain and Language, 87: 267–277. doi:10.1016/S0093-934X(03)00106-8[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]), whereas others report morphosyntactic deficits and agrammatic profiles (e.g., Altmann, Kempler, & Andersen, 2001 Altmann, L. G. P., Kempler, D. and Andersen, E. S. 2001. Speech errors in Alzheimer's disease: Reevaluating morphosyntactic preservation. Journal of Speech, Language, and Hearing Research, 44: 1069–1082. doi:10.1044/1092-4388(2001/085)[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]).

Aims: This study investigates the ability of Greek-speaking pAD individuals to produce and judge subject–verb agreement, tense, and aspect. Given pAD individuals have working memory limitations (e.g., Baddeley, 1996 Baddeley, A. 1996. Exploring the central executive. The Quarterly Journal of Experimental Psychology, 49: 5–28. doi:10.1080/713755608[Taylor & Francis Online], [Web of Science ®] , [Google Scholar]), and given the differential processing demands of agreement, tense and aspect (e.g., Fyndanis, Varlokosta, & Tsapkini, 2012a Fyndanis, V., Varlokosta, S. and Tsapkini, K. 2012a. Agrammatic production: Interpretable features and selective impairment in verb inflection. Lingua, 122: 1134–1147. doi:10.1016/j.lingua.2012.05.004[Crossref], [Web of Science ®] , [Google Scholar]), pAD participants are expected to perform better on agreement than on tense/aspect. Based on the hypothesis that reference to the past is computationally more demanding than reference to the future/present (e.g., Bastiaanse et al., 2011 Bastiaanse, R., Bamyaci, E., Hsu, C-J., Lee, J., Yarbay Duman, T. and Thompson, C. K. 2011. Time reference in agrammatic aphasia: A cross-linguistic study. Journal of Neurolinguistics, 24: 652–673. doi:10.1016/j.jneuroling.2011.07.001[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]), a within-tense dissociation is expected to emerge. Further, on the assumption that unmarked values of functional categories are less demanding than marked values (e.g., Lapointe, 1985 Lapointe, S. 1985. A theory of verb form use in the speech of agrammatic aphasics. Brain and Language, 24: 100–155. doi:10.1016/0093-934X(85)90100-2[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]), the imperfective (unmarked) aspect is expected to be better preserved than the perfective (marked) aspect.

Methods & Procedures: Ten Greek-speaking mild pAD individuals and six healthy controls participated in a sentence completion task, a grammaticality judgement task, and a sentence–picture matching task. Non-parametric tests were used for analysis of results.

Outcomes & Results: PAD participants were found to be significantly more impaired in aspect compared to tense and agreement, in both production and grammaticality judgement/comprehension. Agreement was found significantly better preserved than tense in production. Similar patterns of performance have been attested in agrammatism (e.g., Fyndanis et al., 2012a Fyndanis, V., Varlokosta, S. and Tsapkini, K. 2012a. Agrammatic production: Interpretable features and selective impairment in verb inflection. Lingua, 122: 1134–1147. doi:10.1016/j.lingua.2012.05.004[Crossref], [Web of Science ®] , [Google Scholar]). Reference to the past and reference to the future did not dissociate, whereas the imperfective aspect was found to be significantly more impaired than the perfective aspect in production.

Conclusions: PAD participants' better performance on producing agreement, compared to tense/aspect, is accounted for in terms of the differential demands these categories pose on the processing system. Agreement is computationally less demanding than tense/aspect, because the former involves processing of grammatical information only, whereas the latter involve processing and integration of grammatical and extralinguistic/conceptual information. The preponderance of tense over aspect is attributed to the subjectivity of the latter, which renders it either a category “difficult” to test, or a computationally more demanding condition. The results also show that reference to the past is as demanding as reference to the future. The hypothesis that unmarked values are easier than marked ones is not supported by our data.     

Depression as a Function of Eating Disorder Diagnostic Status and Gender

The purpose of the present study was to examine depressive symptoms as a function of eating disorder (ED) diagnostic status and gender. A demographic questionnaire, the Beck Depression Inventory-II (BDI-II; Beck, Steer & Brown, 1996 Beck, A. T., Steer, R. A. and Brown, G. K. 1996. Manual for the Beck Depression Inventory, 2nd, San Antonio, TX: The Psychological Corporation.  [Google Scholar]), and the Questionnaire for Eating Disorder Diagnoses (Q-EDD; Mintz, O'Halloran, Mulholland & Schneider, 1997 Mintz, L. B., O'Halloran, M. S, Mulholland, A. M. and Schneider, P. A. 1997. Questionnaire for Eating Disorder Diagnoses: Reliability and validity of operationalizing DSM–IV criteria into a self-report format: Correction. Journal of Counseling Psychology, 44: 63–79. [Crossref], [Web of Science ®] , [Google Scholar]) were administered to a nonclinical sample of college-aged men (n = 115) and women (n = 136). Contrast tests revealed significant differences in mean BDI-II scores as a function of Q-EDD diagnostic status. This effect did not differ as a function of gender and the pattern was the same for both cognitive and somatic-affective depressive symptoms. The nature of the comorbid relationship between ED and depressive symptoms appears markedly similar across both genders.     

Decision-making after Traumatic Brain Injury in Children: A Preliminary Study

Decision-making under conditions of uncertainty was studied in 11 children with moderate to severe post-acute traumatic brain injury (TBI) using a modification of the Iowa Gambling Task (Bechara et al., 1994 Bechara, A, Damasio, AR, Damasio, H and Anderson, SW. 1994. Insensitivity to future consequences following damage to human prefrontal cortex. Cognition, 50: 7–15. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar]). We hypothesized that decision-making would be compromised in children with TBI. The results revealed that when divided into subgroups by lesion location, children with lesions in the amygdala (AM) were impaired on modified gambling task performance, but children with ventromedial (VM) lesions did not appear to be impaired on the task. These results are in contrast to studies of decision-making in adults with focal lesions of vascular etiology.     

Modified ACT and CART in severe aphasia

Background: Anagram and Copy Treatment (ACT) and Copy and Recall Treatment (CART) have been shown to improve written communication for those with severe aphasia (Beeson, 1999 Beeson, P. M. 1999. Treating acquired writing impairment: Strengthening graphemic representations. Aphasiology, 13: 767–785. [Taylor & Francis Online], [Web of Science ®] , [Google Scholar]; Beeson, Hirsch, & Rewega, 2002 Beeson, P. M., Hirsch, F. M. and Rewega, M. A. 2002. Successful single-word writing treatment: Experimental analysis of four cases. Aphasiology, 16: 473–491. [Taylor & Francis Online], [Web of Science ®] , [Google Scholar]; Beeson, Rising, & Volk, 2003 Beeson, P. M., Rising, K. and Volk, J. 2003. Writing treatment for severe aphasia: Who benefits?. Journal of Speech, Language, and Hearing Research, 46: 1038–1060. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar]). More recently, the addition of a spoken repetition component to the CART programme has been suggested to enhance oral naming in moderate aphasia (Beeson & Egnor, 2006 Beeson, P. M. and Egnor, H. 2006. Combining treatment for written and spoken naming. Journal of the International Neuropsychological Society, 12: 816–827. [PubMed], [Web of Science ®] , [Google Scholar]; Wright, Marshall, Wilson, & Page, 2008 Wright, H. H., Marshall, R. C., Wilson, K. B. and Page, J. L. 2008. Using a written cueing hierarchy to improve verbal naming in aphasia. Aphasiology, 22: 522–536. [Taylor & Francis Online], [Web of Science ®] , [Google Scholar]) and in cases with co-existing apraxia of speech (AOS) (de Riesthal, 2007 de Riesthal, M. Changes in written and spoken naming with a modified CART programme. Paper presented at the American Speech and Hearing Association. Boston, MA [Google Scholar]). No studies have investigated the use of a modified ACT and CART with spoken repetition in individuals with severe aphasia and AOS.

Aims: The purpose of the study was to examine ACT and CART modified with spoken naming repetition, using visual and auditory stimuli in the ACT sessions and home practice videos in the CART sessions, for individuals with severe aphasia.

Methods & Procedures: Three individuals, RC, AC, and MJ, with severe aphasia and coexisting AOS post left middle cerebral artery strokes participated in a 3-month programme. Participants were enrolled in modified ACT and CART with spoken repetition of the target word. For the CART programme a video was created for each word in a treatment set to facilitate repetition in the home practice programme. Probes of spoken and written performance were obtained at the onset of each session, and during baseline, treatment, and follow-up maintenance

Outcomes & Results: All participants improved in their ability to write the treatment stimuli. A 5-point scoring system (Helm-Estabrooks & Albert, 2003 Helm-Estabrooks, N. and Albert, M. L. 2003. Manual of Aphasia and Aphasia Therapy, Austin, TX: Pro-.  [Google Scholar]) was a more sensitive tool than the traditional binary scoring. None of the participants improved in the spoken naming condition with task stimuli. Mild improvement was noted in comparing pre- and post-test naming for MJ.

Conclusions: Our study supports evidence that ACT and CART may improve written naming skills in persons with severe aphasia. The inclusion of spoken repetition in the home practice CART programme may not be appropriate for cases with severe aphasia with AOS. However, further research using the technique with moderate aphasia with AOS may reveal that the technique of practice with auditory and visual stimuli is beneficial. The ease of using digital video tools with computer or augmentative devices has exciting and practical clinical application.     

Methodological Problems in the Neuropsychological Assessment of Effects of Exposure to Welding Fumes and Manganese

Recently, Kaiser (2003) Kaiser, J. 2003. Manganese: A high-octane dispute. Science, 300: 926–928.  [Google Scholar] raised concerns over the increase in brain damage claims reportedly due to exposure to welding fumes. In the present article, we discuss methodological problems in conducting neuropsychological research on the effects of welding exposure, using a recent paper by Bowler et al. (2003) Bowler, R. M., Gysens, S., Diamond, E., Booty, A., Hartney, C. and Roels, H. A. 2003. Neuropsychological sequelae of exposure to welding fumes in a group of occupationally exposed men. International Journal of Hygiene & Environmental Health, 206: 517–529. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar] as an example to illustrate problems common in the neurotoxicity literature. Our analysis highlights difficulties in conducting such quasi-experimental investigations, including subject selection bias, litigation effects on symptom report and neuropsychological test performance, response bias, and scientifically inadequate casual reasoning.     

Connectionist diagnosis of lexical disorders in aphasia

Background: In the cognitive neurolinguistic approach to lexical deficits in aphasia, impaired levels of processing are localised in a cognitive model. Model-oriented treatment may target these impaired components. Thus a precise assessment of the disorder is crucial. Connectionist models add to this by using computer simulation to specify the details of the functioning of these components. The connectionist semantic-phonological model of lexical access (Dell, Martin, & Schwartz, 2007 Dell, G. S., Martin, N. and Schwartz, M. F. 2007. A case-series test of the interactive two-step model of lexical access: Predicting word repetition from picture naming. Journal of Memory and Language, 56: 490–520. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar]; Schwartz, Dell, Martin, Gahl, & Sobel, 2006 Schwartz, M. F., Dell, G. S., Martin, N., Gahl, S. and Sobel, P. 2006. A case-series test of the interactive two-step model of lexical access: Evidence from picture naming. Journal of Memory and Language, 54: 223–264.  [Google Scholar]) explores the impairment by simulating error patterns in naming and repetition.

Aims: The purpose of the present study was to investigate the model's range of application as a diagnostic tool, and to derive recommendations for the model's use in clinical settings.

Methods & Procedures: We demonstrate how we adapted the error analysis to 15 German-speaking patients with aphasia, analysed the model's accuracy in assessing naming and repetition disorders, and explained deviations between the error pattern produced by each patient and the one produced by the model's simulation by appealing to an extended version of the model.

Outcomes & Results: Overall, the model yielded good fits of the patients' error patterns. Larger model–patient deviations could be explained by the model's limited set of lesionable components.

Conclusions: The “connectionist diagnosis” of naming and repetition disorders in the semantic-phonological model is a reasonable tool in model-oriented assessment. However, the diagnosis needs to be complemented by further language tests.     

Cross-Validation of a Manual form of the Letter Memory Test Using a Known-Groups Methodology

A manual form of the Letter Memory Test (LMT: Orey, Cragar, & Berry, 2000 Orey , S. A. , Cragar , D. E. , & Berry , D. T. R. ( 2000 ). The effects of two motivational manipulations on the neuropsychological performance of mildly head-injured college students . Archives of Clinical Neuropsychology , 15 , 335 – 348 .[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]) was compared in neuropsychological evaluees classified as honest (HON: n = 39) or probable cognitive feigners (PCF: n = 10) using results from two well-validated motivational tests. With the exception of lower educational level and higher rate of compensation seeking in the PCF, the groups were equivalent on most important demographic and injury severity parameters. PCF participants scored significantly lower on most neuropsychological tests (median Cohen's d = 1.2), as well as on the manual LMT (Cohen's d = 4.2). Operating characteristics of the manual LMT in the present sample were comparable to those reported in a similar study using the computerized version of the LMT in neuropsychiatric patients (Vagnini et al., 2006 Vagnini , V. L. , Sollman , M. J. , Berry , D. T. R. , Granacher , R. P. , Clark , J. A. , et al. . ( 2006 ). Known-groups cross-validation of the Letter Memory Test in a sample of compensation-seeking mixed neurologic sample . The Clinical Neuropsychologist , 20 , 289 – 304 .[Taylor & Francis Online], [Web of Science ®] , [Google Scholar]).     

Chance in agrammatic sentence comprehension: What does it really mean? Evidence from eye movements of German agrammatic aphasic patients

Background: In addition to the canonical subject-verb-object (SVO) word order, German also allows for non-canonical order (OVS), and the case-marking system supports thematic role interpretation. Previous eye-tracking studies (Kamide et al., 2003 Kamide, Y., Scheepers, C. and Altmann, G. M. 2003. Integration of syntactic and semantic information in predictive processing: Cross-linguistic evidence from German and English. Journal of Psycholinguistics Research, 32: 37–54. doi: 10.1023/A:1021933015362 [Google Scholar]; Knoeferle, 2007 Knoeferle, P. 2007. “Comparing the time-course of processing initially ambiguous and unambiguous German SVO/OVS sentences in depicted events”. In Eye movement research. A window on mind and brain, Edited by: van Gompel, R., Fischer, M., Murray, W. and Hill, R. 517–531. Oxford, , UK/Amsterdam: Elsevier.  [Google Scholar]) have shown that unambiguous case information in non-canonical sentences is processed incrementally. For individuals with agrammatic aphasia, comprehension of non-canonical sentences is at chance level (Burchert et al., 2003 Burchert, F., De Bleser, R. and Sonntag, K. 2003. Does morphology make the difference? Agrammatic sentence comprehension in German. Brain and Language, 87: 323–342. doi: 10.1016/S0093-934X(03)00132-9[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]). The trace deletion hypothesis (Grodzinsky 1995 Grodzinsky, Y. 1995. A restrictive theory of agrammatic comprehension. Brain and Language, 50: 27–51. doi: 10.1006/brln.1995.1039[Crossref], [PubMed], [Web of Science ®] , [Google Scholar], 2000 Grodzinsky, Y. 2000. The neurology of syntax: Language use without Broca's area. Behavioral and Brain Sciences, 23: 1–71. doi: 10.1017/S0140525X00002399[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]) claims that this is due to structural impairments in syntactic representations, which force the individual with aphasia (IWA) to apply a guessing strategy. However, recent studies investigating online sentence processing in aphasia (Caplan et al., 2007 Caplan, D., Waters, G., DeDe, G., Michaud, J. and Reddy, A. 2007. A study of syntactic processing in aphasia I: Behavioral (psycholinguistic) aspects. Brain and Language, 101: 103–150. doi: 10.1016/j.bandl.2006.06.225[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]; Dickey et al., 2007 Dickey, M. W., Choy, J. J. and Thompson, C. K. 2007. Real-time comprehension of Wh-movement in aphasia: Evidence from eyetracking while listening. Brain and Language, 100: 1–22. doi: 10.1016/j.bandl.2006.06.004[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]) found that divergences exist in IWAs' sentence-processing routines depending on whether they comprehended non-canonical sentences correctly or not, pointing rather to a processing deficit explanation.

Aims: The aim of the current study was to investigate agrammatic IWAs' online and offline sentence comprehension simultaneously in order to reveal what online sentence-processing strategies they rely on and how these differ from controls' processing routines. We further asked whether IWAs' offline chance performance for non-canonical sentences does indeed result from guessing.

Methods & Procedures: We used the visual-world paradigm and measured eye movements (as an index of online sentence processing) of controls (N?=?8) and individuals with aphasia (N?=?7) during a sentence–picture matching task. Additional offline measures were accuracy and reaction times.

Outcomes & Results: While the offline accuracy results corresponded to the pattern predicted by the TDH, IWAs' eye movements revealed systematic differences depending on the response accuracy.

Conclusions: These findings constitute evidence against attributing IWAs' chance performance for non-canonical structures to mere guessing. Instead, our results support processing deficit explanations and characterise the agrammatic parser as deterministic and inefficient: it is slowed down, affected by intermittent deficiencies in performing syntactic operations, and fails to compute reanalysis even when one is detected.     

Deep Brain Stimulation and the Role of the Neuropsychologist

Deep brain stimulation (DBS) now plays an important role in the treatment of Parkinson's disease, tremor, and dystonia. DBS may also have a role in the treatment of other disorders such as obsessive-compulsive disorder, Tourette's syndrome, and depression. The neuropsychologist plays a crucial role in patient selection, follow-up, and management of intra-operative and post-operative effects (Pillon, 2002 Pillon , B. ( 2002 ). Neuropsychological assessment for management of patients with deep brain stimulation . Movement Disorders , 17 ( Suppl 3 ), S116 – 122 .[Crossref], [PubMed] , [Google Scholar]; Saint-Cyr & Trepanier, 2000 Trepanier , L. L. , Kumar , R. , Lozano , A. M. , Lang , A. E. , & Saint-Cyr , J. A. ( 2000 ). Neuropsychological outcome of GPi pallidotomy and GPi or STN deep brain stimulation in Parkinson's disease . Brain and Cognition , 42 ( 3 ), 324 – 347 .[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]). There is now emerging evidence that DBS can induce mood, cognitive, and behavioral changes. These changes can have dramatic effects on patient outcome. There have been methodological problems with many of the studies of DBS on mood, cognition, and behavior. The neuropsychologist needs to be aware of these issues when following up patients, and constructing future studies. Additionally, this article will review all aspects of the DBS procedure that can result in mood, cognitive, and behavioral effects and what role(s) the neuropsychologist should play in screening and follow-up.     

(Morpho)syntactic comprehension in agrammatic aphasia: Evidence from Greek

Background: A number of hypotheses have been formulated to account for comprehension data in agrammatic aphasia. They explain deficits in comprehending specific structures, such as semantically reversible non-canonical sentences, for example, Trace Deletion Hypothesis (TDH, Grodzinsky, 1986 Grodzinsky, Y. 1986. Language deficit and the theory of syntax. Brain and Language, 27: 135–159. doi:10.1016/0093-934X(86)90009-X[Crossref], [PubMed], [Web of Science ®] , [Google Scholar], 1990 Grodzinsky, Y. 1990. Theoretical perspectives on language deficits, Cambridge, MA: MIT Press. [Crossref] , [Google Scholar], 1995 Grodzinsky, Y. 1995. A restrictive theory of agrammatic comprehension. Brain and Language, 51: 26–51. doi:10.1006/brln.1995.1039[Crossref], [Web of Science ®] , [Google Scholar]), or functional categories, for example, Tree Pruning Hypothesis (TPH, e.g., Friedmann, 2006 Friedmann, N. 2006. Generalizations on variations in comprehension and production: A further source of variation and a possible account. Brain and Language, 96: 151–153. doi:10.1016/j.bandl.2005.06.002[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]); Tense Underspecification Hypothesis (TUH, Wenzlaff & Clahsen, 2004 Wenzlaff, M. and Clahsen, H. 2004. Tense and agreement in German agrammatism. Brain and Language, 89: 57–68. doi:10.1016/S0093-934X(03)00298-0[Crossref], [PubMed], [Web of Science ®] , [Google Scholar], 2005 Wenzlaff, M. and Clahsen, H. 2005. Finiteness and verb-second in German agrammatism. Brain and Language, 92: 33–44. doi:10.1016/j.bandl.2004.05.006[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]); Interpretable Features’ Impairment Hypothesis (IFIH; e.g., Varlokosta et al., 2006 Varlokosta, S., Valeonti, N., Kakavoulia, M., Lazaridou, M., Economou, A. and Protopapas, A. 2006. The breakdown of functional categories in Greek aphasia: Evidence from agreement, tense, and aspect. Aphasiology, 20: 723–743. doi:10.1080/02687030500513703[Taylor & Francis Online], [Web of Science ®] , [Google Scholar]). Several studies, however, report evidence contradicting these theories (e.g., Caramazza, Capasso, Capitani, & Miceli, 2005 Caramazza, A., Capasso, R., Capitani, E. and Miceli, G. 2005. Patterns of comprehension performance in agrammatic Broca's aphasia: A test of the Trace Deletion Hypothesis. Brain and Language, 94: 43–53. doi:10.1016/j.bandl.2004.11.006[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]; Dickey, Milman, & Thompson, 2008 Dickey, M. W., Milman, L. H. and Thompson, C. K. 2008. Judgment of functional morphology in agrammatic aphasia. Journal of Neurolinguistics, 21: 35–65. doi:10.1016/j.jneuroling.2007.08.001[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]) and propose new accounts to explain the comprehension deficits in agrammatic aphasia, for example, Distributed Morphology Account (DMA, Dickey et al., 2008 Dickey, M. W., Milman, L. H. and Thompson, C. K. 2008. Judgment of functional morphology in agrammatic aphasia. Journal of Neurolinguistics, 21: 35–65. doi:10.1016/j.jneuroling.2007.08.001[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]).

Aims: Against the background above, this study investigates the ability of three Greek-speaking agrammatic individuals to comprehend a wide range of structures and functional categories: semantically reversible (canonical) active and (non-canonical) passive sentences, Complementizer Phrase, subject-verb Agreement, Tense, and Aspect.

Methods & Procedures: We administered: (a) two sentence-picture matching tasks to test comprehension of reversible active and passive sentences, and Tense; (b) a sentence grammaticality judgement task to test judgement of Tense, Aspect, and subject-verb Agreement; and (c) a picture-pointing task to test comprehension of Complementizer Phrase.

Outcomes & Results: (a) Two of the three agrammatic participants performed at chance on reversible passive sentences and above chance on active sentences. The third participant performed equally high on the two sentence types. Two participants performed at chance on Tense comprehension and one above chance. (b) The three participants were selectively or across-the-board impaired in judgement of Agreement, Tense, and Aspect. One of the two selectively affected participants had chance performance on Aspect and above chance performance on Agreement and Tense. The other one performed at chance on Aspect and Tense, and above chance on Agreement. The third participant's performance was equally poor on all three categories. (c) All three agrammatic participants performed above chance on the comprehension of Complementizer Phrase.

Conclusions: In comprehension/judgement, canonical and non-canonical sentences do not dissociate in all agrammatic speakers, while functional categories associated with the verb morphology may be compromised in the face of relatively well-preserved categories that are located higher in the syntactic hierarchy. All three agrammatic participants support the DMA, and two of them support the TDH. Instead, none of them provided support to the TPH, TUH, and IFIH.     

The Booklet Category Test and Malingering in Traumatic Brain Injury: Classification Accuracy in Known Groups

A known-groups design was used to determine the classification accuracy of 12 Booklet Category Test variables in the detection of malingered neurocognitive dysfunction (MND) in traumatic brain injury (TBI). Participants were 206 TBI and 60 general clinical patients seen for neuropsychological evaluation. Slick, Sherman, and Iverson's (1999 Slick , D. J. , Sherman , E. M. S. , & Iverson , G. L. (1999). Diagnostic criteria for malingering neurocognitive dysfunction: Proposed standards for clinical practice and research. The Clinical Neuropsychologist , 13, 545–561.[Taylor & Francis Online], [Web of Science ®] , [Google Scholar]) criteria were used to classify the TBI patients into non-malingering, suspect, and MND groups. Classification accuracy of the BCT depended on the specific variable and injury severity examined, with some scores detecting more than 40% of malingerers with false positive error rates of 10% or less. However, the BCT variables are often influenced by cognitive ability as well as malingering, so caution is indicated in applying the BCT to the diagnosis of malingering. Application of these data in clinical practice is discussed.     

Classification Accuracy of the Portland Digit Recognition Test in Traumatic Brain Injury: Results of a Known-Groups Analysis

The present study used a known-groups design to examine the accuracy of the Portland Digit Recognition Test (PDRT) in the detection of malingering in traumatic brain injury (TBI). Data were derived from 262 TBI patients who were classified as not malingering, possibly malingering, and malingering based on the Slick, Sherman, and Iverson (1999 Slick , D. J. , Sherman , E. M. S. , & Iverson , G. L. ( 1999 ). Diagnostic criteria for malingering neurocognitive dysfunction: Proposed standards for clinical practice and research . The Clinical Neuropsychologist , 13 , 545 – 561 .[Taylor & Francis Online], [Web of Science ®] , [Google Scholar]) criteria. The original PDRT cutoffs detected between 20 and 50% of malingering TBI patients with a false positive error rate of 5% or less. When the false positive error rate was held at 5%, across all item sets, sensitivity was as high as 70%. The results show that the original PDRT cutoffs are conservative and that higher scores detect more MND patients without causing the false positive error rate to become unacceptably high. Clinical application and future research needs are discussed.     

What goes wrong during passive sentence production in agrammatic aphasia: An eyetracking study

Background: Production of passive sentences is often impaired in agrammatic aphasia and has been attributed both to an underlying structural impairment (e.g., Schwartz, Saffran, Fink, Myers, & Martin, 1994 Schwartz, M. F., Saffran, E. M., Fink, R. B., Myers, J. L. and Martin, N. 1994. Mapping therapy: A treatment program for agrammatism. Aphasiology, 8: 19–54. [Taylor & Francis Online], [Web of Science ®] , [Google Scholar]) and to a morphological deficit (e.g., Caplan & Hanna, 1998 Caplan, D. and Hanna, J. 1998. Sentence production by aphasic patients in a constrained task. Brain and Language, 63: 184–218. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar]; Faroqi-Shah & Thompson, 2003 Faroqi-Shah, Y. and Thompson, C. K. 2003. Effect of lexical cues on the production of active and passive sentences in Broca's and Wernicke's aphasia. Brain and Language, 85: 409–426. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar]). However, the nature of the deficit in passive sentence production is not clear due to methodological issues present in previous studies.

Aims: This study examined active and passive sentence production in nine agrammatic aphasic speakers under conditions of structural priming using eyetracking to test whether structural impairments occur independently of morphological impairments and whether the underlying nature of error types is reflected in on-line measures, i.e., eye movements and speech onset latencies.

Methods & Procedures: Nine participants viewed and listened to a prime sentence in either active or passive voice, and then repeated it aloud. Next, a target picture appeared on the computer monitor and participants were instructed to describe it using the primed sentence structure.

Outcomes & Results: Participants made substantial errors in sentence structure, i.e., passives with role reversals (RRs) and actives-for-passives, but few errors in passive morphology. Longer gaze durations to the first-produced noun for passives with RRs as compared to correct passives were found before and during speech. For actives-for-passives, however, this pattern was found during speech, but not before speech.

Conclusions: The deficit in passive sentence production does not solely arise from a morphological deficit, rather it stems, at least in part, from a structural level impairment. The underlying nature of passives with RRs is qualitatively different from that of actives-for-passives, which cannot be clearly differentiated with off-line testing methodology.     

Is the Boston Naming Test Still Fit For Purpose?

The Boston Naming Test (BNT) (Kaplan, Goodglass, & Weintraub, 1983 Kaplan, E., Goodglass, H., & Weintraub, S. (1983). The Boston Naming Test. Philadelphia, PA: Lea & Fibiger. [Google Scholar]) is the most commonly used test of confrontation naming in neuropsychology (Rabin, Barr, & Burton, 2005 Rabin, L., Barr, W., & Burton, L. (2005). Assessment practices of clinical neuropsychologists in the United States and Canada: A survey of INS, NAN, and APA Division 40 members. Archives of Clinical Neuropsychology, 20, 33–65. doi:10.1016/j.acn.2004.02.005.[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]). However, there are significant criticisms of the BNT which suggest that it might not be the assessment measure of choice. These criticisms are that the BNT has poor psychometric properties, is not adequately standardized, and has inadequate norms. It is further suggested that when considered in the context of contemporary conceptualizations of the neuropsychology of naming, the BNT does not adequately capture the processes known to be required for successful naming, and does not sample widely enough from the content domain of “naming”. These criticisms suggest that the BNT is flawed as a measure of naming, and are discussed in detail in this review. Other stand-alone visual confrontation naming tasks are reviewed to evaluate whether any might be viable substitutes for the BNT in clinical neuropsychology. The Naming Test from the Neuropsychological Assessment Battery (Stern & White, 2009 Stern, R., & White, T. (2009). NAB Naming Test: Professional manual. Lutz, FL: Psychological Assessment Resources. [Google Scholar]) was identified as a possible alternative to the BNT, however, neither of these tests was designed with reference to models of the neuropsychology of naming, and development of a new test of naming is indicated.     

A case of semantic variant primary progressive aphasia with severe insular atrophy

Insular degeneration has been linked to symptoms of frontotemporal dementia (FTD). Presented in this case is a patient exhibiting semantic variant primary progressive aphasia, behavioral disturbance. Upon autopsy, he was found to have severe insular atrophy. In addition, selective serotonin reuptake inhibitors were ineffective in reducing symptoms of obsessive–compulsive behaviors or emotional blunting. This case suggests that Seeley et al.'s (2007 Seeley, W. W., Allman, J. M., Carlin, D. A. and et al. 2007. Divergent social functioning in behavioral variant frontotemporal dementia and Alzheimer disease: Reciprocal networks and neuronal evolution. Alzheimer Disease & Associated Disorders, 21: S50–S57. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar], Alzheimer Disease & Associated Disorders, 21, S50) hypothesis that von Economo neurons and fork cell-rich brain regions, particularly in the insula, are targeted in additional subtypes of FTD beyond the behavioral variant.     

Ecological validity of the Dysexecutive Questionnaire: Results from the PariS-TBI study

The Dysexecutive Questionnaire (DEX; Wilson, Pettigrew, & Teasdale, 1998 Wilson, J. T. L., Pettigrew, L. E. L., & Teasdale, G. M. (1998). Structured interview for the Glasgow Outcome Scale and the Extended Glasgow Outcome Scale: Guidelines for their use. Journal of Neurotrauma, 15, 573–585. doi: 10.1089/neu.1998.15.573[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]) has been designed to assess executive dysfunctions in daily life. However, its relationships with cognitive testing, mood, and the ability to fulfil daily life demands, have not yet been systematically addressed. The objective of this study was to address these issues in a prospective four-year follow-up study of patients with severe traumatic brain injury (TBI) (PariS-TBI study). One hundred and forty seven patients were included. The DEX (self-version) showed a good internal consistency. The total DEX score was significantly inversely correlated with years of education, but did not significantly correlate with any initial injury severity measure. The DEX was significantly and positively related to cognitive deficits, as assessed with the Neurobehavioral Rating Scale–Revised (NRS-R); with mood disorders, as assessed with the Hospital Anxiety and Depression Scale (HADS); with dependency in elementary and extended activities of daily living; and with non-return to work. In multivariate analyses, cognitive and mood impairments were significantly and independently related to the total DEX score. These results suggest that the DEX is a multidetermined sensitive questionnaire to detect everyday life difficulties in patients with severe TBI at a chronic stage.