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Speech and language impairments are common pediatric conditions, with as many as 10% of children experiencing one or both at some point during development. Expressive language disorders in particular often go undiagnosed, underscoring the immediate need for assessments of expressive language that can be administered and scored reliably and objectively. In this paper, we present a set of highly accurate computational models for automatically scoring several common expressive language tasks. In our assessment framework, instructions and stimuli are presented to the child on a tablet computer, which records the child's responses in real time, while a clinician controls the pace and presentation of the tasks using a second tablet. The recorded responses for four distinct expressive language tasks (expressive vocabulary, word structure, recalling sentences, and formulated sentences) are then scored using traditional paper-and-pencil scoring and using machine learning methods relying on a deep neural network-based language representation model. All four tasks can be scored automatically from both clean and verbatim speech transcripts with very high accuracy at the item level (83-99%). In addition, these automated scores correlate strongly and significantly (ρ = 0.76-0.99, p < 0.001) with manual item-level, raw, and scaled scores. These results point to the utility and potential of automated computationally-driven methods of both administering and scoring expressive language tasks for pediatric developmental language evaluation.
Individuals with amnestic mild cognitive impairment (aMCI), especially for those with multidomain cognitive deficits, should be clinically examined for determining risk of developing Alzheimer's disease. English-speakers with aMCI exhibit language impairments mostly at the lexical-semantic level. Given that the language processing of Mandarin Chinese is different from that of alphabetic languages, whether previous findings for English-speakers with aMCI can be generalized to Mandarin Chinese speakers with aMCI remains unclear.
Accurate aphasia diagnosis is important in stroke care. A wide range of language tests are available and include informal assessments, tests developed by healthcare institutions and commercially published tests available for purchase in pre-packaged kits. The psychometrics of these tests are often reported online or within the purchased test manuals, not the peer-reviewed literature, therefore the diagnostic capabilities of these measures have not been systematically evaluated. This review aimed to identify both commercial and non-commercial language tests and tests used in stroke care and to examine the diagnostic capabilities of all identified measures in diagnosing aphasia in stroke populations.
Language has been extensively investigated by functional neuroimaging studies. However, only a limited number of structural neuroimaging studies have examined the relationship between language performance and brain structure in healthy adults, and the number is even less in older adults. The present study sought to investigate correlations between grey matter volumes and three standardized language tests in late life. The participants were 344 non-demented, community-dwelling adults aged 70-90 years, who were drawn from the population-based Sydney Memory and Ageing Study. The three language tests included the Controlled Oral Word Association Task (COWAT), Category Fluency (CF), and Boston Naming Test (BNT). Correlation analyses between voxel-wise GM volumes and language tests showed distinctive GM correlation patterns for each language test. The GM correlates were located in the right frontal and left temporal lobes for COWAT, in the left frontal and temporal lobes for CF, and in bilateral temporal lobes for BNT. Our findings largely corresponded to the neural substrates of language tasks revealed in fMRI studies, and we also observed a less hemispheric asymmetry in the GM correlates of the language tests. Furthermore, we divided the participants into two age groups (70-79 and 80-90 years old), and then examined the correlations between structural laterality indices and language performance for each group. A trend toward significant difference in the correlations was found between the two age groups, with stronger correlations in the group of 70-79 years old than those in the group of 80-90 years old. This difference might suggest a further decline of language lateralization in different stages of late life.
Background. The Psychology Experimental Building Language (PEBL) test battery (http://pebl.sourceforge.net/) is a popular application for neurobehavioral investigations. This study evaluated the correspondence between the PEBL and the non-PEBL versions of four executive function tests. Methods. In one cohort, young-adults (N = 44) completed both the Conner's Continuous Performance Test (CCPT) and the PEBL CPT (PCPT) with the order counter-balanced. In a second cohort, participants (N = 47) completed a non-computerized (Wechsler) and a computerized (PEBL) Digit Span (WDS or PDS) both Forward and Backward. Participants also completed the Psychological Assessment Resources or the PEBL versions of the Iowa Gambling Task (PARIGT or PEBLIGT). Results. The between-test correlations were moderately high (reaction time r = 0.78, omission errors r = 0.65, commission errors r = 0.66) on the CPT. DS Forward was significantly greater than DS Backward on the WDS (p < .0005) and the PDS (p < .0005). The total WDS score was moderately correlated with the PDS (r = 0.56). The PARIGT and the PEBLIGTs showed a very similar pattern for response times across blocks, development of preference for Advantageous over Disadvantageous Decks, and Deck selections. However, the amount of money earned (score-loan) was significantly higher in the PEBLIGT during the last Block. Conclusions. These findings are broadly supportive of the criterion validity of the PEBL measures of sustained attention, short-term memory, and decision making. Select differences between workalike versions of the same test highlight how detailed aspects of implementation may have more important consequences for computerized testing than has been previously acknowledged.
Standardized psychometric tests are sophisticated, well-developed, and consequential instruments; test outcomes are taken as facts about people that impact their lives in important ways. As part of an initial demonstration that human brain mapping techniques can add converging neural-level evidence to understanding standardized tests, our participants completed items from standardized tests during an fMRI scan. We compared tests for diagnosing posttraumatic stress disorder (PTSD) and the correlated measures of Neuroticism, Attachment, and Centrality of Event to a general-knowledge baseline test. Twenty-three trauma-exposed participants answered 20 items for each of our five tests in each of the three runs for a total of 60 items per test. The tests engaged different neural processes; which test a participant was taking was accurately predicted from other participants' brain activity. The novelty of the application precluded specific anatomical predictions; however, the interpretation of activated regions using meta-analyses produced encouraging results. For instance, items on the Attachment test engaged regions shown to be more active for tasks involving judgments of others than judgments of the self. The results are an initial demonstration of a theoretically and practically important test-taking neuroimaging paradigm and suggest specific neural processes in answering PTSD-related tests. Hum Brain Mapp 38:5706-5725, 2017. © 2017 Wiley Periodicals, Inc.
The effect of language context on bilingual language control has been widely studied, but research examining how these contexts affect executive control is relatively limited. In the present study, we used EEG to examine how language context in production influences executive control in bilinguals. A single group of unbalanced Chinese-English bilinguals completed a modified Flanker task interleaved with a picture-naming task, such that executive control performance was measured in three contexts: Chinese, English, and mixed-language. Event-related potentials (ERPs) revealed larger N2 amplitudes and smaller P3 and LPC (late positive component) amplitudes for the mixed-language context than the single-language context across both congruent and incongruent trials. Moreover, during the language production task, LPC amplitudes in mixed-language context were smaller than in the single-language contexts. These findings suggest that language contexts modulate both bilingual language control and domain-general executive control.
Much of the world's population is bilingual, hence, language selection is a core component of language processing in a significant proportion of individuals. Though language selection has been investigated using artificial cues to language choice such as color, little is known about more ecologically valid cues. We examined with MEG the neurophysiological and behavioral effects of two natural cues: script and cultural context, hypothesizing the former to trigger more automatic language selection. Twenty Arabic-English bilinguals performed a number-naming task with a Match condition, where the cue and target language of response matched, and a Mismatch condition, with opposite instruction. The latter addressed the mechanisms responsible for overriding natural cue-language associations. Early visual responses patterned according to predictions from prior object recognition literature, while at 150-300 ms, the anterior cingulate cortex showed robust sensitivity to cue-type, with enhanced amplitudes to culture trials. In contrast, a mismatch effect for both cue-types was observed at 300-400 ms in the left inferior prefrontal cortex. Our findings provide the first characterization of the spatio-temporal profile of naturally cued language selection and demonstrate that natural but less automatic language-choice, elicited by cultural cues, does not engage the same mechanisms as the clearly unnatural language-choice of our mismatch tasks.
Until now, several branches of research have fundamentally contributed to a better understanding of the ramifications of bilingualism, multilingualism, and language expertise on psycholinguistic-, cognitive-, and neural implications. In this context, it is noteworthy to mention that from a cognitive perspective, there is a strong convergence of data pointing to an influence of multilingual speech competence on a variety of cognitive functions, including attention, short-term- and working memory, set shifting, switching, and inhibition. In addition, complementary neuroimaging findings have highlighted a specific set of cortical and subcortical brain regions which fundamentally contribute to administrate cognitive control in the multilingual brain, namely Broca's area, the middle-anterior cingulate cortex, the inferior parietal lobe, and the basal ganglia. However, a disadvantage of focusing on group analyses is that this procedure only enables an approximation of the neural networks shared within a population while at the same time smoothing inter-individual differences. In order to address both commonalities (i.e., within group analyses) and inter-individual variability (i.e., single-subject analyses) in language control mechanisms, here I measured five professional simultaneous interpreters while the participants overtly translated or repeated sentences with a simple subject-verb-object structure. Results demonstrated that pars triangularis was commonly activated across participants during backward translation (i.e., from L2 to L1), whereas the other brain regions of the "control network" showed a strong inter-individual variability during both backward and forward (i.e., from L1 to L2) translation. Thus, I propose that pars triangularis plays a crucial role within the language-control network and behaves as a fundamental processing entity supporting simultaneous language translation.
The impact of previous surgery on the assessment of language dominance with preoperative fMRI remains inconclusive in patients with recurrent brain tumors. Samples in this retrospective study included 17 patients with prior brain surgery and 21 patients without prior surgery (38 patients total; mean age 43.2, SD = 11.9; 18 females; seven left-handed). All the patients were left language dominant, as determined clinically. The two samples were matched on 10 known confounds, including, for example, tumor laterality and location (all tumors affected Brodmann areas 44/45/47). We calculated fMRI language dominance with laterality indices using a whole-brain and region of interest approach (ROI; Broca's and Wernicke's area). Patients with prior surgery had decreased fMRI language dominance (p = 0.03) with more activity in the right hemisphere (p = 0.03) than patients without surgery. Patients with prior brain surgery did not display less language activity in the left hemisphere than patients without surgery. These results were replicated using an ROI approach in the affected Broca's area. Further, we observed no differences between our samples in the unaffected Wernicke's area. In sum, prior brain surgery affecting Broca's area could be a confounding factor that needs to be considered when evaluating fMRI language dominance.
Permutation-based gene set tests are standard approaches for testing relationships between collections of related genes and an outcome of interest in high throughput expression analyses. Using M random permutations, one can attain p-values as small as 1/(M+1). When many gene sets are tested, we need smaller p-values, hence larger M, to achieve significance while accounting for the number of simultaneous tests being made. As a result, the number of permutations to be done rises along with the cost per permutation. To reduce this cost, we seek parametric approximations to the permutation distributions for gene set tests.
Disruption to language lateralisation has been proposed as a cause of developmental language impairments. In this study, we tested the idea that consistency of lateralisation across different language functions is associated with language ability. A large sample of adults with variable language abilities (N = 67 with a developmental disorder affecting language and N = 37 controls) were recruited. Lateralisation was measured using functional transcranial Doppler sonography (fTCD) for three language tasks that engage different language subprocesses (phonological decision, semantic decision and sentence generation). The whole sample was divided into those with consistent versus inconsistent lateralisation across the three tasks. Language ability (using a battery of standardised tests) was compared between the consistent and inconsistent groups. The results did not show a significant effect of lateralisation consistency on language skills. However, of the 31 individuals showing inconsistent lateralisation, the vast majority (84%) were in the disorder group with only five controls showing such a pattern, a difference that was higher than would be expected by chance. The developmental disorder group also demonstrated weaker correlations between laterality indices across pairs of tasks. In summary, although the data did not support the hypothesis that inconsistent language lateralisation is a major cause of poor language skills, the results suggested that some subtypes of language disorder are associated with inefficient distribution of language functions between hemispheres. Inconsistent lateralisation could be a causal factor in the aetiology of language disorder or may arise in some cases as the consequence of developmental disorder, possibly reflective of compensatory reorganisation.
Generative Pre-trained Transformers (GPT) are powerful language models that have great potential to transform biomedical research. However, they are known to suffer from artificial hallucinations and provide false answers that are seemingly correct in some situations. We developed GeneTuring, a comprehensive QA database with 600 questions in genomics, and manually scored 10,800 answers returned by six GPT models, including GPT-3, ChatGPT, and New Bing. New Bing has the best overall performance and significantly reduces the level of AI hallucination compared to other models, thanks to its ability to recognize its incapacity in answering questions. We argue that improving incapacity awareness is equally important as improving model accuracy to address AI hallucination.
Neuroimaging studies often either look at functional activation in response to an explicit task, or functional connectivity (i.e., interregional correlations) during resting-state. Few studies have looked at the intensity of brain activity or its relationship with age, behavior, and language. The current study investigated both intensity (i.e., the Amplitude of Low-Frequency Fluctuations, ALFF) and the functional connectivity of spontaneous brain activity during rest and their relationship with age and language. A life-span sample of individuals (N = 152) completed a battery of neuropsychological tests to assess basic cognitive functions and resting-state functional MRI data to assess spontaneous brain activity. Focusing on an extend language network, the mean ALFF and total degree were calculated for this network. We found that increased age was associated with more intense activity (i.e., higher ALFF) but lower within-network connectivity. Additionally, these increases in activity within the language network during resting-state were related to worse language ability, particularly in younger adults, supporting a dedifferentiation account of cognition. Our results support the utility of using resting-state data as an indicator of cognition and support the role of ALFF as a potential biomarker in characterizing the relationships between resting-state brain activity, age, and cognition.
As screening tests are tools to quantify communication-interactive abilities of speech and language; therefore, to evaluate, screen, diagnose and treat various aspects of one's abilities, they are necessary. The purpose of this study is to review the existing autism screening tools, their subtests, administration, scoring, and application in clinical and research contexts in children and adults. This study was a review of autism screening tools; hence, an electronic search through databases such as PubMed, Scopus, Medline, SID, and Magiran was performed from 2000 to 2021. The tests were examined in terms of year of publication, duration, age range, assessment method, subtests, and psychometric properties and furthermore, they were reviewed in details. In this study, 19 autism screening tests were evaluated and The Autism Spectrum Quotient was found to have the shortest administration time while The Gilliam Autism Rating Scale had the longest, and the only test that varied in duration was the Autism Screening Instrument for educational planning. Autism screening is a complex issue. Reviewing these articles reveals that some tests have been used more in recent years due to their specialized subtests or easy and fast administration. Prompt testing is extremely crucial especially in emergency situations like the current COVID-19 pandemic the world is struggling with today. A review of speech tone tests shows that the CARS-2 is one of the most widely validated autism assessments.
A progressive speech/language disorder, such as the non fluent/agrammatic variant of primary progressive aphasia and progressive apraxia of speech, can be due to neuropathologically verified Progressive Supranuclear Palsy (PSP). The prevalence of linguistic deficits and the linguistic profile in PSP patients who present primarily with a movement disorder is unknown. In the present study, we investigated speech and language performance in a sample of clinically diagnosed PSP patients using a comprehensive language battery, including, besides traditional language tests, a detailed analysis of connected speech (picture description task assessing 26 linguistic features). The aim was to identify the most affected linguistic levels in seventeen PSP with a movement disorder presentation, compared to 21 patients with Parkinson's disease and 27 healthy controls. Machine learning methods were used to detect the most relevant language tests and linguistic features characterizing the language profile of PSP patients. Our results indicate that even non-clinically aphasic PSP patients have subtle language deficits, in particular involving the lexical-semantic and discourse levels. Patients with the Richardson's syndrome showed a lower performance in the word comprehension task with respect to the other PSP phenotypes with predominant frontal presentation, parkinsonism and progressive gait freezing. The present findings support the usefulness of a detailed language assessment in all patients in the PSP spectrum.
Adopting highly sensitive multivariate electroencephalography (EEG) and alpha-band decoding analyses, the present study investigated proactive and reactive language control during bilingual language production. In a language-switching task, Chinese-English bilinguals were asked to name pictures based on visually presented cues. EEG and alpha-band decoding accuracy associated with switch and non-switch trials were used as indicators for inhibition over the non-target language. Multivariate EEG decoding analyses showed that the decoding accuracy in L1 but not in L2, was above chance level shortly after cue onset. In addition, alpha-band decoding results showed that the decoding accuracy in L1 rose above chance level in an early time window and a late time window locked to the stimulus. Together, these asymmetric patterns of decoding accuracy indicate that both proactive and reactive attentional control over the dominant L1 are exerted during bilingual word production, with a possibility of overlap between two control mechanisms. We addressed theoretical implications based on these findings for bilingual language control models.
The diagnosis of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection relies on the detection of viral RNA by real-time reverse transcription polymerase chain reaction (rRT-PCR) performed with respiratory specimens, especially nasopharyngeal swabs. However, this procedure requires specialized medical personnel, centralized laboratory facilities, and time to provide results (from several hours up to 1 d). In addition, there is a non-negligible risk of viral transmission for the operator who performs the procedure. For these reasons, several studies have suggested the use of other body fluids, including saliva, for the detection of SARS-CoV-2. The use of saliva as a diagnostic specimen has numerous advantages: it is easily self-collected by the patient with almost no discomfort, it does not require specialized health care personnel for its management, and it reduces the risks for the operator. In the past few months, several scientific papers, media, and companies have announced the development of new salivary tests to detect SARS-CoV-2 infection. Posterior oropharyngeal saliva should be distinguished from oral saliva, since the former is a part of respiratory secretions, while the latter is produced by the salivary glands, which are outside the respiratory tract. Saliva can be analyzed through standard (rRT-PCR) or rapid molecular biology tests (direct rRT-PCR without extraction), although, in a hospital setting, these procedures may be performed only in addition to nasopharyngeal swabs to minimize the incidence of false-negative results. Conversely, the promising role of saliva in the diagnosis of SARS-CoV-2 infection is highlighted by the emergence of point-of-care technologies and, most important, point-of-need devices. Indeed, these devices can be directly used in workplaces, airports, schools, cinemas, and shopping centers. An example is the recently described Rapid Salivary Test, an antigen test based on the lateral flow assay, which detects the presence of the virus by identifying the spike protein in the saliva within a few minutes.
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