F. William Black

Unilateral Brain Lesions and MMPI Performance: A Preliminary Study:

Samples of 15 Ss with right- and 20 Ss with left-hemisphere brain lesions secondary to war-related penetrating missile wounds were matched for age, education, and recency of injury and evaluated with the MMPI. Right-hemisphere lesioned Ss produced a composite profile with all scales within normal limits. In contrast, the composite profile of left-hemisphere lesioned Ss showed significant elevations on the Sc, D, and Hs clinical scales, suggesting increased psychopathological responses in such Ss. Although the general configurations of the composite MMPI profiles in the two samples were similar, significant differences in the elevation of both validity and clinical scales were obtained. The results tend to support previous findings of a depressive-catastrophic reaction in patients with lesions in the dominant hemisphere, while not supporting the euphoric-indifference response in nondominant-hemisphere lesioned Ss.

MEMORY AND PAIRED-ASSOCIATE LEARNING OF PATIENTS WITH UNILATERAL BRAIN LESIONS

Wechsler Memory Scale scores and paired-associate learning performance were compared in matched samples of Ss with right- and left-hemisphere brain lesions secondary to penetrating missile wounds and normal controls. Wechsler Memory Quotient, easy paired-associate learning scores, and difficult paired-associate learning scores for left-hemisphere Ss were significantly lower than those for normal controls; while the mean scores for right-hemisphere and normal control Ss did not differ significantly. For the latter Ss the Wechsler Memory Quotient and the difficult paired-associate learning task differed significantly with lower mean scores for left-hemisphere Ss. Significant relationships were obtained between Wechsler Memory Quotient and all paired-associate learning scores and between WAIS IQ and Wechsler Memory Quotient, total and easy paired-associate learning scores.

Cognitive Effects of Unilateral Brain Lesions Secondary to Penetrating Missile Wounds

The WAIS verbal and nonverbal subtest performance of Ss with unilateral brain lesions secondary to penetrating missile wounds was examined and compared with that of normal controls. The performance of matched right- and left-hemisphere lesion Ss differed significantly on only two verbal and one nonverbal measures, however, all performance differences were in the direction hypothesized. The performance of right-hemisphere lesioned and control Ss differed significantly on all measures, with consistently lower scores by brain-injured Ss, while the performance of left-hemisphere and control Ss differed significantly on the three verbal measures and WAIS Full Scale IQ. These results are in general agreement with previous reports using a similar research design and tend to support the hypothesis of differential impairment of verbal and nonverbal test performance in Ss with unilateral brain lesions.

Achievement Test Performance of High and Low Perceiving Learning Disabled Children

The achievement test performance of low and high perceiving learning disabled children was compared, and the relationship of visual-perceptual and achievement variables in a sample of learning disabled children was investigated. With the effects of intelligence controlled, the reading test performance of the low perceivers was significantly higher than that of the high perceivers. No significant differences existed between the two samples in spelling or arithmetic. Only two of a possible 18 correlations between perceptual and achievement variables were found to be significant. The implications of the use of perceptual tests in the evaluation and remediation of a learning disability are discussed.

Neurological Dysfunction and Reading Disorders

Intellectual functioning, visual perception, and academic achievement were investigated in two samples of children with significant reading disorders. One sample also showed demonstrable neurological abnormalities, while the second sample demonstrated no such abnormalities. The two samples differed significantly only on the visual-perceptual variable, suggesting more cognitive similarity than dissimilarity between the two groups. When the neurologically impaired sample was differentiated as to right- or left-side impairment, the right-sided sample performed significantly less adequately on the variables of WlSC Performance Scale IQ and Frostig PQ, while the left-sided sample performed significantly less adequately on the WISC Verbal Scale IQ, WRAT Reading, and WRA T Spelling. The implications of labeling a child as neurologically impaired are discussed.

Cognitive, Academic, and Behavioral Findings in Children with Suspected and Documented Neurological Dysfunction

Intellectual, perceptual, academic, and behavioral comparisons were made for matched samples of elementary school children with suspected and documented neurological dysfunction. Significant differences were obtained between samples on most intellectual (WISC) variables, with all comparisons favoring the suspected neurological dysfunction sample. The samples did not differ appreciably on perceptual, academic, and two of three behavioral variables, suggesting that the pattern of performance for the two samples in areas highly relevant for education wus similar. WISC Verbal-Performance discrepancies exceeding 15 points were relatively good predictors of documented neurological dysfunction.

Patterns of cognitive impairment in children with suspected and documented neurological dysfunction.

WISC Verbal-Performance discrepancy, Vocabulary-Block Design discrepancy, and Similarities-Object Assembly discrepancy were investigated in matched samples of 25 normal, suspected neurological dysfunction, and documented neurological dysfunction children. The results suggest a continuum of deficit in these samples ranging from normal performance by normal controls to moderate impairment in Ss with documented neurological dysfunction. The suspected neurological dysfunction sample occupied a median position in the continuum as predicted. An analysis of WISC IQ and subtest scores in the three samples also supported the predicted continuum of deficit. Specific WISC subtest comparisons may be of some research and clinical utility in the prediction of neurological dysfunction in pediatric patients.

NEUROANATOMIC AND NEUROPSYCHOLOGIC CORRELATES OF DIGIT SPAN PERFORMANCE BY BRAIN-DAMAGED ADULTS

Digit repetition performance was examined in samples of adult brain-injured patients having confirmed unilateral lesions. The primary purposes of the study were to investigate the sensitivity of forward and backward repetition to the effects of lateralized brain lesions and to assess the differential neuroanatomic and neuropsychologic substrates of the two forms of digit repetition. Digit repetition, especially digits backward and particularly by patients with left-hemisphere lesions, was significantly lower than would be predicted on the basis of intelligence. However, impaired repetition was not invariably a consequence of brain damage. Correlational data suggested but could not confirm hypotheses about either the functional or the neuroanatomic substrate in differential performance on digits forward and backward. Problems implicit in using measures having a high intellectual loading in clinical studies are discussed, as are suggestions for further research.

Reversal and rotation errors by normal and retarded readers.

The incidence of and relationships among word and letter reversals in writing and Bender-Gestalt rotation errors were investigated in matched samples of 100 normal and 100 retarded readers. No significant differences in the incidence of reversal and rotation errors were found in the two groups. Word reversal was an isolated finding with low frequency, while letter reversal and Bender rotation were less isolated and more frequent. The significance of examining for such errors by elementary school children to predict reading retardation is discussed in the light of the research findings.

Some Psychological Correlates of Developmental Dyslexia

This study compares psychological test performance of 24 dyslexic boys and 24 normal readers using four age levels (7, 9, 11, and 13 years). Screening of all boys and matching techniques were used to eliminate the possibility that reading differences were due to social or educational deprivation, gross sensory-motor handicaps, specific neurologic deficiencies, intellectual impairment, or primary emotional disorders. All children were administered a psychological battery composed of measures of perceptual and perceptual-motor abilities (WISC Performance IQ, Bender-Gestalt, and an auditory-visual integration test) and of verbal-cognitive skills (WISC Verbal IQ, two dichotic listening tasks, and a test of word fluency). Significant developmental differences between dyslexics and controls were found only for the overall measure of perceptual-motor and verbal-cognitive ability. The results of this study do not support a hypothesis of a single etiology, either deficit or developmental delay, for dyslexia. In a final section, the educational implications of this study are discussed with particular consideration of programs for reading remediation.