Gérard Deloche

From one to 1: An analysis of a transcoding process by means of neuropsychological data

Abstract This study investigates how aphasic patients handle quantities in numeral and digital codes. The task consisted of transcoding numbers written in alphabetic code into their digital form. Errors were analyzed with reference to: (i) general structural quantitative parameters (numeral and number lengths…); (ii) general behavioral disturbances (perseveration, serial ordering disorders…); (iii) specific cognitive processes implied in this particular transcoding task. The third approach proved the most powerful; it indicated that systematic errors were produced resulting from the partial and/or inappropriate use of transcoding strategies such as the transcription of each numeral element into its lexical value or the systematic coding of ‘MILLE’ (thousand) and ‘CENT’ (hundred) into one digit, irrespective of their particular lexical/ multiplicand role in the syntactical structure underlying the word order in numerals. The results are relevant to the study of cognitive processes in normal subjects.

Cognitive approaches in neuropsychological rehabilitation

Presenting a new perspective on cognitive therapy in neuropsychology, these papers examine a cognitively-oriented, single-case methodology in neuropsychological rehabilitation. The recommended strategy is in-depth analysis of the precise nature of the impaired as well as the preserved processing components in the individual patient. The objective is to design a therapeutic course based on individual patient needs that is justified by the theoretical interpretation of the location of the deficit in his or her cognitive architecture.

Surface dyslexia: A case report and some theoretical implications to reading models

Abstract This paper reports on the psycholinguistic investigation of a surface dyslexic aphasic patients abilities to handle written material. The analysis of paralexic errors produced in reading aloud single words and nonwords classically suggested that the patient was using an analytical strategy parsing the letter string stimulus, from left to right, into graphemes, and assigning phonemic values to graphemes. The patients results were found to be sensitive to irregularities in correspondence between graphemes and phonemes not only in reading aloud but in lexical decisions, writing on dictation, rhyming, and written-word comprehension. Moreover, the patients linguistic behavior brought out the reverse pattern observed in deep-dyslexic performances within word/nonword and content/function word dimensions. It was found that some semantic information about written words could be retrieved from both phonological and nonphonological processes presumably operating concurrently and both providing converging or conflicting pieces of meaning to the understanding of written words. Some considerations derived from the observation of this pathological reading behavior are discussed, contributing to a psycholinguistic model of normal reading.

Calculation and number processing : assessment battery; role of demographic factors

This paper describes the structure and contents of EC301, a standardized testing battery for the evaluation of brain-damaged adults in the area of calculation and number processing. The battery was administered to 180 normal subjects stratified by education (3 levels), age (3) and gender. EC301 is composed of a large variety of tasks dealing with basic arithmetic skills, and their linguistic, spatial, and mnesic dimensions. The three main notational systems for numbers--Arabic digits, written verbal, and spoken verbal number forms--are explored. Analysis of error rates indicated the effect of some demographic factors (principally, education; incidentally, gender) on normal performance in some tasks.

Patterns of attentional impairment following closed head injury: a collaborative European study.

A comprehensive assessment of both selective (focused attention, divided attention) and intensive (alertness and vigilance) attentional processes was performed on 106 patients with closed head injury using a computerised battery for the evaluation of attention. All patients were tested at least five months after their accident. A high percentage of patients were pathological in tests mapping the selective components of attention while only a minority were impaired on tests mapping the intensive components of attention. Three different subgroups of patients with consistent performance patterns were evidenced. The psychometric characteristics of the battery and its possible clinical usefulness are discussed.

Calculation and number processing in mild Alzheimer's disease

Calculation and number processing abilities in 17 patients suffering from a mild form of dementia of Alzheimers type (DAT) were studied by means of a standardized multitask assessment battery, the EC301 (Deloche et al., 1994). Patients were selected from a larger sample by using a specific visuo-perceptive task to control the confounding effects of deficits in analysing digit serial order. Language and memory skills were evaluated by means of standardized testing procedures. The EC301 overall score showed impaired performance in 12 cases. Calculation and number processing scores were highly correlated with Mini-Mental State Examination and language performance. However, multiple single-case analyses indicated heterogeneous patterns of preserved/impaired abilities with respect to the three cognitive areas under investigation (calculation, memory, and language) and to the different components of the calculation and number processing system.

Cognitive consequences of early phase of literacy

The effect of the degree of illiteracy (complete or incomplete) on phonological skills, verbal and visual memory and visuospatial skills is examined in 97 normal Brazilian adults who considered themselves illiterate, and 41 Brazilian school children aged 7 to 8 years, either nonreaders or beginning readers. Similar literacy effects were observed in children and in adults. Tasks involving phonological awareness and visual recognition memory of nonsense figures distinguish the best nonreaders and beginning readers. Children performed better than adults at oral repetition of short items and figure recall, and adults better than children at semantic verbal fluency, digit span, and word list recall. A principal component analysis of the correlations between tasks showed that phonological awareness/reading, phonological memory/oral repetition, and semantic verbal memory/fluency tasks, generated different components. The respective role of culturally based preschool activities and literacy on the cognitive functions that are explored in this study is discussed.

A calculation and number processing battery for clinical application in illiterates and semi-literates.

Ten simple tasks assessing counting, number processing, elementary calculation and quantity estimation were proposed to 122 normal Brazilian adults aged between 18 and 58 years with 0, 1, 2, 3 or 4 years of education. Tasks such as counting the number of elements in small sets were almost perfectly mastered by these illiterate or semi-literate normal subjects; however in other tasks (e.g. those assessing knowledge of the correspondence between numbers and banknotes) a sizeable proportion of the sample showed errors. The pattern of errors was analysed to identify difficulty factors. A strong gender effect with better performance in men than women was observed, which was even greater than the expected effect of educational level. Results in normals allowed to propose cut-off scores for neuropsychological assessment in brain-damaged patients with very low levels of education, which were tested in a small sample of illiterate or semi-literate patients with cerebrovascular accident. It is argued that the relatively neglected area of neuropsychological assessment in illiterates is of great practical and theoretical interest.

Rehabilitation of confrontation naming in aphasia: Relations between oral and written modalities

Abstract This study presents a microcomputer-assisted rehabilitation programme for picture confrontation naming impairments. The results reported concern two aphasic patients with inverse pretherapeutic dependencies between oral and written naming mechanisms. The surface dysgraphics written naming responses were often mediated by access to phonological word forms, whereas the conduction aphasics oral responses often relied on covert finding of orthographic word forms. The rehabilitation technique focused exclusively on written naming from the keyboard, without oral training. Improvements were obtained in both cases, with various generalizations to non-drilled items, untrained (oral) modality and handwriting. These beneficial effects were still present 1 year post-therapy. Microcomputer-delivered cues thus seem to be a promising technique for the rehabilitation of oral and written naming difficulties in some aphasic patients.

Rehabilitation of Unilateral Neglect: A Controlled Multiple-Baseline-Across-Subjects Trial Using Computerised Training Procedures

Seven stroke patients showing left spatial neglect received recreational computing during baseline and computerised rehabilitation tasks with moving targets during treatment, according to a multiple-baseline-across subjects design. Results indicated no specific effects of treatment on static paper and pencil or computerised tests. However, some trends suggested specificity of treatment on computerised tests. Besides the question of the efficacy of computerised training of neglect, some methodological issues are considered. It is suggested that the statistical procedure used allows the researcher to capture the nature of changes in performance on the computerised tests.