A group of 317 healthy participants between 54 and 99 years of age performed a verbal fluency task. The participants included Chinese, Hispanic, and Vietnamese immigrants, as well as White and African American English speakers. They were given 1 min to name as many animals as possible in their native language. The results showed that more animal names were produced by younger people and those with more education. Language background was also an important factor: The Vietnamese produced the most animal names and the Spanish speakers produced the fewest. The exaggerated difference between these two groups is attributed to the fact that Vietnamese animal names are short (predominantly 1 syllable) while the Spanish animal names are longer than any other language in this study (2 and 3 syllables per word). Finally, although the ethnic groups named different animals, and appeared to vary in the variety of animal names they used, these factors did not affect overall verbal fluency performance. (JINS, 1998, 4, 531–538.)

Verbal fluency tasks are frequently used in clinical neuropsychology. Clustering (the production of words within semantic subcategories) and switching (the ability to shift between clusters) have been described as 2 components underlying fluency performance. We compared the use of clustering and switching in schizophrenic patients and healthy subjects. Seventy-eight schizophrenic subjects (DSM–IV criteria) and 64 control participants matched for age and educational level were recruited. Negative, disorganized, and productive clinical dimensions were evaluated using the SANS and SAPS scales. The number of words generated per semantic–phonemic cluster and the number of switches were evaluated during 2 verbal fluency tasks (phonemic and semantic). In the healthy controls switching and clustering were closely related to the total number of words generated in the verbal fluency tests. The role of the 2 components was partly dependent on the specific task. Switching was prevalent in formal fluency, while both switching and clustering contributed to semantic fluency. In comparison to the healthy controls, the overall group of schizophrenic patients showed a significant impairment of switching in the formal fluency task and of both switching and clustering in the semantic fluency task, and both the negative and disorganized dimensions correlated with verbal fluency performance, the number of switches during the phonemic fluency task, and the clustering during semantic fluency task. (JINS, 1998, 4, 539–546.)

Ninety-two mixed etiology neurological patients and 216 control participants were assessed on a range of neuropsychological tests, including 10 neuropsychological measures of executive function derived from 6 different tests. People who knew the patients well (relatives or carers) completed a questionnaire about the patient's dysexecutive problems in everyday life, and this paper reports the extent to which the tests predicted the patients' everyday life problems. All of the tests were significantly predictive of at least some of the behavioral and cognitive deficits reported by patients' carers. However, factor analysis of the patients' dysexecutive symptoms suggested a fractionation of the dysexecutive syndrome, with neuropsychological tests loading differentially on 3 underlying cognitive factors (Inhibition, Intentionality, and Executive Memory), supporting the conclusions that different tests measure different cognitive processes, and that there may be limits to the fractionation of the executive system. (JINS, 1998, 4, 547–558.)

Studies of Alzheimer's disease patients show that individuals with larger premorbid brains have a later onset of disease, or a lessened severity of cognitive impairment, or both. This may be due to a “functional reserve” associated with the greater number of neurons and synapses available in larger brains. We used magnetic resonance imaging and the MicroCog Assessment of Cognitive Functioning to examine the association between intracranial volume (premorbid brain size) and neuropsychological function in abstinent crack-cocaine and crack-cocaine–alcohol dependent individuals. There were no significant differences between the crack-only and the crack–alcohol dependent participants in neuropsychological performance or in intracranial volume. The abstinent cocaine-dependent individuals (both crack-only and crack–alcohol) were significantly impaired in many neuropsychological domains. Intracranial volume accounted for a significant proportion of the variance in neuropsychological performance. This result is consistent with the finding in the Alzheimer's literature that larger brains can maintain function to a greater degree, or for a longer period of time, in the face of cerebral disease or insult. Functional reserve may be a heretofore little recognized protective mechanism of the brain that has consequences for the severity of expression of cerebral disease or insult throughout life. (JINS, 1998, 4, 559–565.)

The Landau-Kleffner Syndrome (LKS) is characterized by acquired receptive aphasia and EEG abnormality with onset between the ages of 3 and 8 years. This study presents neuropsychological assessments in 5 children with LKS. The aims were (1) to specify the neuropsychological deficits characteristic of these children; and (2) to clarify the nature of the receptive aphasia by comparing nonverbal and verbal auditory discrimination. Receptive aphasia was present in all children. Retardation, poor motor coordination, hyperkinesia, and conduct problems were frequent but variable. All children exhibited a dissociation between the discrimination of environmental sounds and phonological auditory discrimination, the latter being more impaired than the former. This suggests that the primary deficit of the receptive aphasia is an impairment of auditory phonological discrimination rather than a generalized auditory agnosia. (JINS, 1998, 4, 566–575.)

This study examined the effect of varying the number of potential target words on amnesic patients' category exemplar production performance. In Experiment 1, 4 words from each of 6 categories were presented to amnesic patients and normal control participants. This was followed by an indirect task in which each participant produced the first 8 words that came to mind when presented with a category cue. On this task the amnesic patients were impaired. This outcome stands in sharp contrast to most other category exemplar production tasks that have been reported. However, these other paradigms tend to restrict participants' processing during target item presentation while our procedure allowed them to analyze the target words as they chose. Our procedure may have allowed the control participant more opportunity to “cluster” target words from the same category during list presentation and this, in turn, may have given them an advantage at the time of category exemplar production. Therefore, in Experiment 2, only 1 word per category was presented in the target list and only 2 words per category were requested during category exemplar production. Surprisingly, the amnesic patients still exhibited impaired performance. Therefore, it was suggested that perhaps amnesic patients' known inability to perform semantic levels of processing during individual target word presentation may have resulted in impaired priming for categorical features for these patients. (JINS, 1998, 4, 576–583.)

Studies of speed of cognitive processing in Parkinson's disease (PD) have yielded mixed results. This may relate in part to a differential effect on cognitive speed by the type of information to be processed. In the present study, we compared medication fasted, nondemented individuals with mild idiopathic PD (N = 26) with age-matched controls (N = 12) on a test requiring easy and hard same–different discriminations for verbal, quantitative, and spatial information, as well as on a traditional memory scanning paradigm. A voice-activated relay rather than a key press was used to eliminate the need for limb and finger movements. Simple reaction time and movement time were also measured in a task requiring subjects to move a hand held stylus to a designated target. The PD group performed as fast as the control group across all tasks except movement time. Thus, in our paradigm, the presence of PD alone does not predict cognitive slowing in the presence of motor slowing. (JINS, 1998, 4, 584–592.)

Cognitive deficits associated with neurologic disease or damage are quite common and they are known to negatively impact the lives of patients, caregivers and society at large. Unfortunately, documented effective rehabilitation of cognitive deficits is extremely scarce. In addition the concept of cognitive rehabilitation is usually viewed with tremendous skepticism. This pessimism is manifested in so many ways: It is found in the reluctance of skeptical physicians to refer patients to rehabilitation clinicians, it is seen in the reluctance of service payers to fund clinical efforts, it gets reflected in the graduate training programs which place cognitive rehabilitation in the lower echelons of curricular priorities, it underlies the dearth of funded programs in cognitive rehabilitation research, and it even permeates professional organizations and journals where “treatment studies” represent an extreme minority of presentations and articles. The most salient explanation for this therapeutic nihilism is the implicit belief that “everyone knows it doesn't work.”

We report the results of a letter naming treatment designed to facilitate letter-by-letter reading in an aphasic patient with no reading ability. Patient M.R.'s anomia for written letters reflected two loci of impairment within visual naming: impaired letter activation from print (a deficit commonly seen in pure alexic patients who read letter by letter) and impaired access to phonology via semantics (documented in a severe multimodality anomia). Remarkably, M.R. retained an excellent ability to pronounce orally spelled words, demonstrating that abstract letter identities could be activated normally via spoken letter names, and also that lexical phonological representations were intact when accessed via spoken letter names. M.R.'s training in oral naming of written letters resulted in significant improvement in her oral naming of trained letters. Importantly, as M.R.'s letter naming improved, she became able to employ letter-by-letter reading as a compensatory strategy for oral word reading. M.R.'s success in letter naming and letter-by-letter reading suggests that other patients with a similar pattern of spared and impaired cognitive abilities may benefit from a similar treatment. Moreover, this study highlights the value of testing the pronunciation of orally spelled words in localizing the source of prelexical reading impairment and in predicting the functional outcome of treatment for impaired letter activation in reading. (JINS, 1998, 4, 595–607.)

Phonological alexia and agraphia are acquired disorders characterized by an impaired ability to convert graphemes to phonemes (alexia) or phonemes to graphemes (agraphia). These disorders result in phonological errors typified by adding, omitting, shifting, or repeating phonemes in words during reading or graphemes when spelling. In developmental dyslexia, similar phonological errors are believed to result from deficient phonological awareness, an oral language skill that manifests itself in the ability to notice, think about, or manipulate the individual sounds in words. The Auditory Discrimination in Depth (ADD) program has been reported to train phonological awareness in developmental dyslexia and dysgraphia. We used a multiple-probe design to evaluate the ADD program's effectiveness with a patient with a mild phonological alexia and mixed agraphia following a left hemisphere infarction. Large gains in phonological awareness, reading and spelling nonwords, and reading and spelling real words were demonstrated. A follow-up reassessment, 2 months posttreatment, found the patient had maintained treatment gains in phonological awareness and reading, and attained additional improvement in real word reading. (JINS, 1998, 4, 608–620.)

Two individuals with anomic aphasia and acquired alexia were each provided treatment for their reading impairment. Although reading of single words in isolation was fairly accurate, their text reading was slow and effortful, including functor substitutions and semantic errors. Prior to treatment, reading reaction times for single words showed grammatical class and word-length effects. Both patients responded positively to a treatment protocol that included two phases: (1) multiple oral rereading of text, and (2) reading phrase-formatted text that had increased spacing between phrasal clauses. Their reading rates for text improved while maintaining good comprehension. Following treatment, reading reaction times for single words showed the elimination of grammatical class and word-length effects, suggesting improved access to word forms, particularly functors. (JINS, 1998, 4, 621–635.)

We present a case study of a 43-year-old woman with chronic and stable pure alexia. Using a multiple baseline design we report the results of two different interventions to improve reading. First, a restitutive treatment approach using an implicit semantic access strategy was attempted. This approach was designed to exploit privileged access to lexical–semantic representations and met with little success. Treatment was then switched to a substitutive treatment strategy, which involved using the patient's finger to pretend to copy the letters in words and sentences. Reading using this motor cross-cuing strategy was 100% accurate and doubled in speed after 4 weeks of intervention. We propose that this patient's inability to benefit from the implicit semantic access treatment approach may be in part related to her inability to suppress the segmental letter identification process of word recognition. (JINS, 1998, 4, 636–647.)

I report a series of single case studies involving an aphasic patient, H.G., which illustrates both the usefulness and the limitations of cognitive neuropsychological models and methods in aphasia rehabilitation. The first set of experiments analyze H.G.'s pattern of performance across lexical tasks in order to identify the loci of her damage to the cognitive mechanisms underlying the tasks of naming, comprehension, repetition, reading, and spelling. The second set of studies evaluates her response to two different types of treatment and identifies a few of the variables that influence the effectiveness of treatment. (JINS, 1998, 4, 648–660.)

This study examined the postulate that training production of syntactically complex sentences results in generalization to less complex sentences that have processes in common with treated structures. Three agrammatic aphasic patients were trained to produce wh-movement structures, object clefts and/or object extracted who-questions, while generalization between these structures was tested. One NP-movement structure, passive sentences, also was tested for control purposes. Wh-movement occurs from the direct object position to specifier position in the complementizer phrase [SPEC, CP] for both wh-movement structures. In who-questions movement occurs in the matrix sentence, whereas, in object clefts movement occurs within an embedded relative clause, rendering them the most complex. Results showed robust generalization effects from object clefts to matrix who-question for 1 participant (D.L.); however, no generalization was noted from who-questions to object clefts for another (F.P.), and 1 participant (C.H.) showed acquisition of who-questions, but not object clefts, during the baseline condition without direct treatment. As expected, none of the participants showed improved production of passives. These findings supported those derived from our previous studies, indicating that generalization is enhanced not only when target structures are related along dimensions articulated by linguistic theory, but also when the direction of treatment is from more to less complex structures. The present findings also support proposals that projections of higher levels in the syntactic treatment are dependent on successful projection of lower levels. For our participants, training movement within CP in a lower (embedded) clause resulted in their ability to project to CP at higher levels. (JINS, 1998, 4, 661–674.)

This article is a single-case investigation of phonological naming therapy. The individual involved had fluent jargon speech, with neologisms, verbal paraphasias, and paragrammatisms. The jargon was underpinned by a severe anomia. Content words were rarely accessed either in spontaneous speech or naming. Single word investigations highlighted some preserved skills. Auditory comprehension, at least for concrete words, was relatively intact and although nonwords could not be repeated, words could, and at a level which was far superior to naming. The patient also had some ability to respond to phonological cues. These results suggested that phonological representations were preserved and that there were some intact semantic abilities. It seemed that the naming disorder was primarily due to an inability to access phonology from semantics. Therapy took a phonological approach. The patient was encouraged to reflect upon the syllabic structure and first phoneme of pictured targets. Subsequently, she was required to use this partial phonological knowledge as a self-cue. It was hypothesized that this therapy might equip the subject with a self-cuing naming strategy. Posttherapy investigations of naming demonstrated dramatic improvements, which generalized to untreated items. However, there was little evidence that these were due to a self cuing strategy. Performance on phonological judgment and discrimination assessments, which required conscious phonological reflection, was unchanged, and there were no signs that the patient was self-cuing during naming. Reasons for these paradoxical results are discussed. (JINS, 1998, 4, 675–686.)

An acquaintance of mine once said that “scientists are like cattle. They graze the surface and move on to greener pastures.” The author of this jaded verdict is himself a successful scientist and a master grazer, so he should know. Hemispheric specialization used to be among the more inviting pastures, but no longer is. Most young researchers tend to search for other pastures.

Far too few books exist on the subject of neuropsychological rehabilitation beyond the cognitive rehabilitative approach. However, certain signs seem to suggest that this situation is about to change, such as the publication of this book.

This small (15.5 × 23.5 cm) book summarizes in a clear, well-organized format almost all of the most common conditions, features, and concerns of neurological practice. A chapter on the neurological examination precedes the next 14 chapters which cover (2) “Headache and Facial Pain”; (3) “Loss of Consciousness and Coma” (beginning with epilepsy and ending with sleep apnea, and coma); (4) “Cranial Nerve Dysfunction” (1 through 12 with special emphasis on oculomotor disorders); (5) “Vertigo, Dizziness and Ataxia” (including a brief discussion of psychiatric issues); (6) “Disorders of Higher Cortical Function” (just about all of them); (7) “Cerebrovascular Disease” (with largest sections on infarction, small vessel disease, and subarachnoid hemorrhage); (8) “Parkinson's Disease and Other Extrapyramidal Disorders”; (9) “Cerebral Tumour and Hydrocephalus”; (10) “Multiple Sclerosis” (more pages—12—on MS than any other condition); (11) “Central Nervous System Infection” (HIV is covered under the “Retrovirus” subsection); (12) “Motor Neuron Disease and Peripheral Nerve Disorders”; (13) “Spinal Cord Disorders”; (14) “Myasthenia Gravis and Muscle Disease”; and (15) “The Neurology of Cancer, Systemic Disease and Psychiatry.”

Imaging of the structure and function of the human brain has grown to an area with increasing impact on neuropsychological research as well as on the routine clinical evaluation of brain damaged patients. The scientific and popular literature is now flooded by increasingly more spectacular pictures of the brain. The images no longer only illustrate what is well known from earlier research but they do also sometimes provide information of importance for the further development of neuropsychological theories. The two volumes edited by Erin D. Bigler, Neuroimaging I and II, offer a possibility for neuropsychologists and other interested readers to get acquainted with the more recent developments in measurement technology and applications in basic science (Volume I) as well as in the clinic (Volume II). The authors of the 24 chapters are generally outstanding researchers, with impressive expertise within their fields of specialization.

This book gives a comprehensive account of the functional neuroanatomy of the brain. The first edition, Neuropsychology, Neuropsychiatry, and Behavioral Neurology (1990), consisted of topics traditional for this subject matter, such as “The Cerebral Hemispheres,” “The Limbic System,” and “Neuroanatomy and Pathophysiology of Head Injury, Stroke, Neoplasm, and Abnormal Development.” With the addition of eleven new chapters, the second edition is impressive and unique in its range of topics. The new chapters cover evolution and ontogeny of the brain, social–emotional intelligence, and such unusual topics as the neurophysiology of repression and religious experiences, and the origins of life. One section is titled “The Birth of God and Limbic Hyperactivation.” The writing style is clear and compelling. Most topics are well referenced with scientific literature and include informative illustrations. More theoretical topics are presented with logical arguments.