Congenital Cytomegalovirus and Human Immunodeficiency Virus: Effects on Hearing, Speech and Language Development, and Clinical Outcomes in Children

Prenatal infections can have adverse effects on an infant's hearing, speech, and language development. Congenital cytomegalovirus (CMV) and human immunodeficiency virus (HIV) are two such infections that may lead to these complications, especially when left untreated. CMV is commonly associated with sensorineural hearing loss in children, and it can also be associated with anatomical abnormalities in the central nervous system responsible for speech, language, and intellectual acquisition. In terms of speech, language, and hearing, HIV is most associated with conductive and/or sensorineural hearing loss and expressive language deficits. Children born with these infections may benefit from cochlear implantation for severe to profound sensorineural hearing losses and/or speech therapy for speech/language deficits. CMV and HIV simultaneously present in infants has not been thoroughly studied, but one may hypothesize these speech, language, and hearing deficits to be present with potentially higher severity. Early identification of the infection in combination with early intervention strategies yields better results for these children than no identification or intervention. The purpose of this review was to investigate how congenital CMV and/or HIV may affect hearing, speech, and language development in children, and the importance of early identification for these populations.

Language and Cognitive Functions in a Neurological Tumour Population: A Long-Term Follow-Up Study

<p>Complex cognitive capacities such as language and “executive function” are difficult to evaluate in neuropsychological populations due to their multifactorial nature. The current study takes a cognitively-motivated core-skills approach to their assessment. Across four investigations, these various capacities are decomposed into simpler core skills based on current cognitive theory. An undifferentiated sample of 28 neurological tumour patients is then assessed on these skills. In the first study, we assessed the “core skills” underpinning language function at three time points: pre-operative (one day prior to surgery), post-operative (within three days of surgery), and at long-term follow-up (at least three months post-surgery). This approach was sensitive at detecting impairment; indeed, almost half of the patients showed persistent long-term language deficits even at long-term follow-up. The decompositional approach also proved effective at predicting long-term outcomes. Overall, these results suggest that the subtle language deficits may be more common and more persistent than previously estimated in tumour populations. The second study examined the relationship between “core” language skills and sentence-level language processing at long-term follow up. Whilst there were few significant correlations, the results nonetheless suggest that “core skills” measures may be useful predictors of some aspects of sentence-level processing. The third study isolated and identified “core” skills that are essential for complex cognitive control more generally, and assessed these in our patient sample at long-term follow-up. Results were broadly supportive of this decompositional approach, and again, our assessments proved highly sensitive at detecting deficits in this patient sample. The fourth study examined the relationship between language processing and complex cognitive control. Specifically, we examined whether there are systems specially dedicated to the control of language, or whether control functions operate across all domains. Overall, our results were broadly consistent with the domain-specific view - that there may be functionally distinct control systems operating on verbal and nonverbal material. The results, taken together suggest that a core skills approach to neuropsychological assessment has considerable promise, and is worth exploring further in a large patient sample. This approach may also help extend our understanding of the functional organisation of language, and the broader cognitive skills necessary for linguistic operations.</p>

Language and Cognitive Functions in a Neurological Tumour Population: A Long-Term Follow-Up Study

<p>Complex cognitive capacities such as language and “executive function” are difficult to evaluate in neuropsychological populations due to their multifactorial nature. The current study takes a cognitively-motivated core-skills approach to their assessment. Across four investigations, these various capacities are decomposed into simpler core skills based on current cognitive theory. An undifferentiated sample of 28 neurological tumour patients is then assessed on these skills. In the first study, we assessed the “core skills” underpinning language function at three time points: pre-operative (one day prior to surgery), post-operative (within three days of surgery), and at long-term follow-up (at least three months post-surgery). This approach was sensitive at detecting impairment; indeed, almost half of the patients showed persistent long-term language deficits even at long-term follow-up. The decompositional approach also proved effective at predicting long-term outcomes. Overall, these results suggest that the subtle language deficits may be more common and more persistent than previously estimated in tumour populations. The second study examined the relationship between “core” language skills and sentence-level language processing at long-term follow up. Whilst there were few significant correlations, the results nonetheless suggest that “core skills” measures may be useful predictors of some aspects of sentence-level processing. The third study isolated and identified “core” skills that are essential for complex cognitive control more generally, and assessed these in our patient sample at long-term follow-up. Results were broadly supportive of this decompositional approach, and again, our assessments proved highly sensitive at detecting deficits in this patient sample. The fourth study examined the relationship between language processing and complex cognitive control. Specifically, we examined whether there are systems specially dedicated to the control of language, or whether control functions operate across all domains. Overall, our results were broadly consistent with the domain-specific view - that there may be functionally distinct control systems operating on verbal and nonverbal material. The results, taken together suggest that a core skills approach to neuropsychological assessment has considerable promise, and is worth exploring further in a large patient sample. This approach may also help extend our understanding of the functional organisation of language, and the broader cognitive skills necessary for linguistic operations.</p>

The Unfolding of Cognitive Effort During Sentence Processing: Pupillometric Evidence From People With and Without Aphasia

Purpose: Arousal and cognitive effort are relevant yet often overlooked components of attention during language processing. Pupillometry can be used to provide a psychophysiological index of arousal and cognitive effort. Given that much is unknown regarding the relationship between cognition and language deficits seen in people with aphasia (PWA), pupillometry may be uniquely suited to explore those relationships. The purpose of this study was to examine arousal and the time course of the allocation of cognitive effort related to sentence processing in people with and without aphasia. Method: Nineteen PWA and age- and education-matched control participants listened to relatively easy (subject-relative) and relatively difficult (object-relative) sentences and were required to answer occasional comprehension questions. Tonic and phasic pupillary responses were used to index arousal and the unfolding of cognitive effort, respectively, while sentences were processed. Group differences in tonic and phasic responses were examined. Results: Group differences were observed for both tonic and phasic responses. PWA exhibited greater overall arousal throughout the task compared with controls, as evidenced by larger tonic pupil responses. Controls exhibited more effort (greater phasic responses) for difficult compared with easy sentences; PWA did not. Group differences in phasic responses were apparent during end-of-sentence and postsentence time windows. Conclusions: Results indicate that the attentional state of PWA in this study was not consistently supportive of adequate task engagement. PWA in our sample may have relatively limited attentional capacity or may have challenges with allocating existing capacity in ways that support adequate task engagement and performance. This work adds to the body of evidence supporting the validity of pupillometric tasks for the study of aphasia and contributes to a better understanding of the nature of language deficits in aphasia. Supplemental Material https://doi.org/10.23641/asha.16959376

Language in Behavioral Variant Frontotemporal Dementia: Another Stone to Be Turned in Latin America

Beyond canonical deficits in social cognition and interpersonal conduct, behavioral variant frontotemporal dementia (bvFTD) involves language difficulties in a substantial proportion of cases. However, since most evidence comes from high-income countries, the scope and relevance of language deficits in Latin American bvFTD samples remain poorly understood. As a first step toward reversing this scenario, we review studies reporting language measures in Latin American bvFTD cohorts relative to other groups. We identified 24 papers meeting systematic criteria, mainly targeting phonemic and semantic fluency, naming, semantic processing, and comprehension skills. The evidence shows widespread impairments in these domains, often related to overall cognitive disturbances. Some of these deficits may be as severe as in other diseases where they are more widely acknowledged, such as Alzheimer's disease. Considering the prevalence and informativeness of language deficits in bvFTD patients from other world regions, the need arises for more systematic research in Latin America, ideally spanning multiple domains, in diverse languages and dialects, with validated batteries. We outline key challenges and pathways of progress in this direction, laying the ground for a new regional research agenda on the disorder.

Speech and language impairments in behavioral variant frontotemporal dementia: A systematic review

Although behavioral variant frontotemporal dementia (bvFTD) is classically defined by behavioral and socio-emotional changes, impairments often extend to other cognitive functions. These include early speech and language deficits related to the disease's core neural disruptions. Yet, their scope and clinical relevance remains poorly understood. This systematic review characterizes such disturbances in bvFTD, considering clinically, neuroanatomically, genetically, and neuropathologically defined subgroups. We included 181 experimental studies, with at least 5 bvFTD patients diagnosed using accepted criteria, comparing speech and language outcomes between bvFTD patients and healthy controls or between bvFTD subgroups. Results reveal extensive and heterogeneous deficits across cohorts, with (a) consistent lexico-semantic, orthographic, and prosodic impairments; (b) inconsistent deficits in motor speech and grammar; and (c) relative preservation of phonological skills. Also, preliminary findings suggest that the severity of speech and language deficits might be associated with global cognitive impairment, predominantly temporal or fronto-temporal atrophy and MAPT mutations (vs C9orf72). Although under-recognized, these impairments contribute to patient characterization and phenotyping, while potentially informing diagnosis and prognosis.

Revisiting the case for ‘feral’ humans under the light of the human self-domestication hypothesis

Historically, some cases of ‘feral’ children have been reported. Contemporary descriptions generally preclude any insightful inference about the nature and the extent of the language deficits exhibited by these children, as well as the ultimate causes of their problems with language. However, they have been regularly used to support the view that language acquisition requires a proper social environment in order to occur. In this paper, we revisit the case for ‘feral’ children with the viewpoint that human evolution entailed a process of self-domestication that parallels what we find in domesticated animals. Because feralization commonly occurs in nature and because it entails a partial reversion of features of domestication, this self-domestication approach to the evolution of language reassesses the case for ‘feral’ children, particularly when compared with present-day conditions involving abnormal patterns of socialization, whether they are genetically-triggered as in autism spectrum disorder, or environmentally-triggered, as in reactive attachment disorder. Overall, the structural and functional language deficits observed in these human groups emerge as useful proxies for previous stages in the evolution of language(s) under the influence of human self-domestication.