Joyce L. Harris

Rey-Auditory Verbal Learning and Rey-Osterrieth Complex Figure Design performance in Alzheimer's disease and closed head injury

Performance on the Rey-Auditory Verbal Learning (R-AVL) and Rey-Osterrieth Complex Figure Design (R-O CFD) tests was examined in patients (N = 94) with dementia of the Alzheimers type (DAT) and closed head injury (CHI). On the R-AVL, DAT patients demonstrated considerably greater impairment than CHI patients, along with a flat learning/retention curve that showed negligible improvement with repeated trials, recency effects only, and an excessive number of word intrusions (confabulation) on the recognition trial. CHI patients demonstrated both a recency and primacy effect along with improvement over repeated trials (positive slope learning curve). Both groups demonstrated impairment R-O CFD recall; the DAT group again displayed substantially greater copying and recall deficits. Clinical guidelines are given for the use of the R-AVL and R-O CFD for these two patient populations.

Complex discourse production in mild cognitive impairment: Detecting subtle changes

Background: Mild cognitive impairment (MCI) is characterised by memory impairment that is greater than would be expected for an individuals age and educational background. Differentiating MCI from normal cognition in ageing is a compelling social, clinical, and scientific concern. Of those with MCI, 50% progress to Alzheimers dementia within 5 years, while many individuals remain stable or return to normal functioning. Importantly, early identification of MCI has important implications for speech‐language pathology intervention. Aims: The purpose of this study was to investigate whether performance on a complex elicited discourse production task differentiated individuals with MCI from those with normal cognition. The variables of interest were discourse length, complexity, and quality. Methods & Procedures: Eight individuals with MCI and eight age‐ and gender‐matched controls were tested with the Mini‐Mental State Exam (MMSE), Logical Memory Subtest (LMS) of the Weschsler Memory Scale, and the Boston Naming Test (BNT). For the experimental task, each participant provided a complex, elicited discourse sample that was unconstrained in terms of discourse genre, in response to verbal instructions. Outcomes & Results: The MMSE and LMS scores differentiated the groups in the expected direction, with the control group outperforming the MCI group. The groups performed comparably on the BNT. Performance on the experimental discourse production task distinguished the groups on measures of length and quality, but not in syntactic complexity. Conclusions: These findings suggest that performance on a complex elicited discourse production task uncovers subtle differences in the abilities of individuals with MCI, such that measures of length and quality differentiated them from individuals with normal cognition.

Communication Wellness Check‐Up©: Age‐related changes in communicative abilities

Background: Subtle changes in communicative function may be an early sign of an underlying neurological condition. Although early detection is encouraged to prevent illness, decrease morbidity, and reduce disability, early detection does not typically include periodic cognitive‐communicative assessment. Aim: The goal of this research was to determine whether subtle linguistic markers in discourse production would differentiate groups of participants with and without cognitive impairment. Additionally, the relationships among participant variables, performance on standardised cognitive and linguistic measures, and performance on an experimental discourse production task were examined. Methods & Procedures: A total of 30 neurologically healthy younger adults, 22 neurologically healthy older adults, 10 adults with mild cognitive impairment (MCI), and 10 persons with neurological damage (PWND) participated in the study. A discourse production task, “Trip to New York”, and several standardised measures including the BNT, MMSE, and WMS were administered to each participant. The discourse task was analysed in terms of 13 thematic core concepts. For each participant, a proportion score was calculated. The narrative sample also was analysed for several linguistic variables. Outcomes & Results: Results revealed that the typically functioning groups provided more thematic information than the MCI and PWND groups. Multivariate ANOVA of linguistic variables (e.g., proportion of pronouns, modifiers, nouns, verbs) revealed differences in the proportion of pronouns and modifiers for the four groups. Conclusions: The study found subtle markers in the complex elicited discourse of individuals with MCI and PWND that may further our understanding of cognitive‐communicative changes in typically functioning older adults.

The association of elaborative or maintenance rehearsal with age, reading comprehension, and verbal working memory performance

Elaborative or maintenance rehearsal strategy-use during a verbal working memory task was the grouping variable for a study that tested whether group membership distinguished 53 healthy adults by age, education, or performance on reading comprehension and verbal working memory tasks. No significant differences in age or reading comprehension emerged as a function of strategy-use. However, the elaborative strategy group had significantly better performance on one measure of verbal working memory. Several within age-group differences as a function of strategy-use were also significant. Younger adults who used elaborative rehearsal had superior working memory measures, and older adults who used elaborative rehearsal had superior reading comprehension measures, suggesting elaborative rehearsals memory-enhancing function in verbal working memory and reading comprehension tasks.

Toward model-driven interventions for African Americans with cognitive-communicative disorders.

African American adults have a disproportionately high incidence and prevalence of cognitive-communicative disorders, yet their use of speech-language pathology services does not reflect their need for clinical intervention. The purpose of this article is to issue a call to action aimed at moving toward the development of model-informed interventions for African American adults with cognitive-communicative disorders. We propose the development of model-driven interventions that are designed to reflect the values and preferences of many African American adults in terms of culturally distinctive opportunities for activities and participation within their communities. Examples of culturally distinctive activities and participatory roles are offered as a starting point for establishing social validity and empirical support for underlying assumptions. Constructs from the INTERNATIONAL CLASSIFICATION OF FUNCTIONING, DISABILITY, AND HEALTH and evidence-based practice are juxtaposed to suggest their mutual relevance to developing clinical services that resonate with the values and preferences of many African Americans.

Test–retest discourse performance of individuals with mild cognitive impairment

Background: Mild cognitive impairment (MCI) is an evolving, intermediate diagnostic category between normal cognitive ageing and dementia in which individuals demonstrate cognitive performance that is impaired beyond that expected in normal cognitive ageing or among those with similar educational backgrounds. MCI may convert to dementia; however, the time‐course to conversion is unknown. Aims: The purpose of the current research was to investigate whether, in a group of previously tested individuals with MCI, decrements in complex discourse production would be evident as early as 6 months following initial assessment. Methods & Procedures: Eight individuals with MCI were reassessed at a 6‐month follow‐up using a complex discourse production task previously shown to differentiate these individuals with MCI from normal controls. Outcomes & Results: The hypothesis that performance scores at 6‐month follow‐up would be lower than initial scores in individuals with MCI was not supported. No evidence emerged of precipitous decline in complex ideation, planning, organisation, and abstract reasoning, as measured in number of words, T‐units, and core elements, leading to additional hypotheses with scientific and practical implications that warrant investigation. Conclusions: Extended serial reassessment is indicated in order to more fully characterise discourse production performance in MCI over time.

Semantic and phonological retrieval in traumatic brain injury

ABSTRACT Background: Identifying associations or links between encoded stimuli can influence whether those stimuli are successfully retrieved at a later time. Aims: The purpose of this study was to investigate the influence of semantic and phonological lexical targets on recall in individuals with mild to moderate traumatic brain injury (TBI) and to identify if individuals with TBI form associations when recalling related information. Methods & Procedures: Forty-seven individuals, 14 with TBI, completed the Deese–Roediger–McDermott (DRM) word retrieval paradigm in which six digitally recorded word lists were presented auditorily. Three of the lists contained semantically related words and three contained phonologically related words. Outcomes & Results: Non-brain-injured (NBI) participants recalled significantly more phonological and semantic stimuli than participants with TBI. Phonologically related stimuli resulted in increased intrusions for both TBI and NBI participants. For participants with TBI, age and time post injury were not significantly correlated with performance on the DRM paradigm, though the number of semantically related items recalled was moderately correlated with performance on standardised assessments. Though TBI participants recalled fewer words, they appeared to utilise recall strategies in a manner similar to NBI peers with intrusion data suggesting that both groups were forming associations between words. Conclusions: Individuals with mild to moderate TBI successfully identify associations between encoded stimuli and used those associations when recalling target information.