Giulia Gilardone

This study explores syntactic processing in ten Italian-speaking individuals with agrammatism, testing predictions from two competing linguistic accounts: the Trace Deletion Hypothesis and Generalized Minimality. We examined subject, object and passive relatives in comprehension (sentence-to-picture matching task) and production (sentence priming task), manipulating number mismatch as a possible facilitation factor. According to Generalized Minimality, mismatch should reduce intervention effects in object relatives, while the Trace Deletion Hypothesis predicts uniform impairment of derived structures. Comprehension results showed an overall subject advantage, with mismatch-related facilitation observed in a subset of participants. However, high interindividual variability challenged strong generalisations. No clear performance pattern emerged in production, possibly due to concurring deficits and task-related limitations. Passive relatives, expected to be easier in line with studies on language acquisition, were as impaired as object relatives, supporting a specific deficit with passives in agrammatism. Linguistic theory played a central role in accounting for the variability observed, with Generalized Minimality emerging as the most explanatory, yet not unchallenged account.

Introduction RiComprendo was designed as a comprehensive tool to evaluate comprehension of various syntactic structures with a sentence-to-picture matching-task. The study sets normative data and investigates the influence of demographic characteristics and sentence types. Methods Two-hundred-ten right-handed healthy Italian native speakers were included. RiComprendo was administered via E-Prime, collecting both accuracy and response time (RTs) data. Adjusted scores for age and education and equivalent scores for each sentence type (i.e., simple active sentences, passives, peripheral and center-embedded subject and object relatives, and coordination) were computed. The effect of sentence type, age and education on accuracy and RTs was investigated through generalized linear mixed models. Item difficulty was tested with an Item Response Theory (IRT) model. Results Normative data and a spreadsheet for scores automatic computation are provided. The mixed models identified a significant impact of sentence type both on accuracy and RTs. Simple sentences presented high accuracy, while the worst performance was found with center-embedded object relatives. Higher education was significantly associated with better accuracy, while older age was associated with longer RTs and with a marginally negative effect on accuracy. Discussion Sentence comprehension is influenced by structural complexity and demographic characteristics (age and education). Providing normative data for different sentence types, RiComprendo enables the evaluation of effects of specific syntactic properties (i.e., canonicity, number of clauses, filler-gap dependencies, intervention, center-embedding). Conclusion RiComprendo could serve as a valuable tool for testing the comprehension of complex sentences in research and clinical settings, informing in-depth functional assessment and tailored intervention.

The role of either short-term memory (STM) or working memory (WM) in sentence comprehension is a matter of debate. Although it is commonly accepted that memory resources are necessary for sentence comprehension, there is no agreement regarding the nature of their role. The aim of this review is to investigate and synthesize assessment tools and correlation data between STM or WM and sentence comprehension in probable Alzheimer's disease (AD). To this aim, a systematic review and meta-analysis of the literature was conducted according to the PRISMA guidelines. PubMed, Web of Science, Scopus, PsycInfo, and LLBA databases were searched. Two independent authors selected peer-reviewed articles published in English and focused on the relationship between STM or WM and sentence comprehension in probable AD. A total of 11 case–control studies were included at the end of the selection process. Most studies adopted offline tasks to evaluate sentence comprehension, while a small number of authors applied online experimental tasks. The digit span forward and backward were the most employed standardized tests to evaluate phonological STM and WM, respectively. The meta-analysis results supported the association between performance on STM and WM and comprehension tasks. However, moderate heterogeneity was found, mainly due to the small number of included studies, especially for STM, and the substantial variability of the adopted tasks. Therefore, in order to clarify the specific source of language comprehension deficits, new and sophisticated experiments should be conducted using adequate material.

The Mini-Balance Evaluation Systems Test (Mini-BESTest), a 14-item scale, has high content validity for balance assessment. This study further examines the construct validity of the Mini-BESTest with an emphasis on its measurement invariance. The Mini-BESTest was administered to 292 neurological patients in two sessions (before and after rehabilitation) and evaluated with the Rasch analysis (Many-Facet Rating Scale Model: persons, items, sessions). Categories’ order and fit to the model were assessed. Next, maps, dimensionality, and differential item functioning (DIF) were examined for construct validity evaluation. DIF was inspected for several clinically important variables, including session, diagnosis, and assistive devices. Mini-BESTest items had ordered categories and fitted the Rasch model. The item map did not flag severe construct underrepresentation. The dimensionality analysis showed that another variable extraneous to balance affected the score of a few items. However, this multidimensionality had only a modest impact on measures. Session did not cause DIF. DIF for assistive devices affected six items and caused a severe measurement artefact. The measurement artefact caused by DIF for diagnosis was negligible. The Mini-BESTest returns interval measures with robust construct validity and measurement invariance. However, caution should be used when comparing Mini-BESTest measures obtained with and without assistive devices.

Background: The comprehension profile of people with agrammatism is a debated topic. Syntactic complexity and cognitive resources, in particular phonological short‐term memory (pSTM), are considered as crucial components by different interpretative accounts.Aim: To investigate the interaction of syntactic complexity and of pSTM in sentence comprehension in a group of persons with aphasia with and without agrammatism.Methods & Procedures: A cohort of 30 participants presenting with aphasia was assessed for syntactic comprehension and for pSTM. A total of 15 presented with agrammatism and 15 had fluent aphasia.Outcomes & Results: Linear nested mixed‐model analyses revealed a significant interaction between sentence type and pSTM. In particular, participants with lower pSTM scores showed a reduced comprehension of centre‐embedded object relatives and long coordinated sentences. Moreover, a significant interaction was found between sentence type and agrammatism, with a lower performance for passives within the agrammatic group.Conclusions & Implications: These results confirm that pSTM is involved in the comprehension of complex structures with an important computational load, in particular coordinated sentences, and long‐distance filler gap dependencies. On the contrary, the specific deficit of the agrammatic group with passives is a pure syntactic deficit, with no involvement of pSTM.

Aphasia has a great impact on children’s lives, with stroke being its most common and studied etiology. However, our knowledge about this disorder is limited, the studies on this topic are sparse, and a consensus regarding its definition is lacking. In particular, the interpretation of this condition varied over time: from the rigid description of the so-called “standard doctrine” to the adoption of adult models for post-stroke aphasia. Therefore, this review provides a critical overview of childhood aphasia after stroke, focusing on its epidemiology, definition, diagnosis, and clinical manifestation. The scoping review approach was adopted, following PRISMA-ScR guidelines. PubMed, Web of Science, and PsycInfo databases were searched for related peer-review papers in English. Forty-six records were identified; the majority were single cases and case series, only a few were reviews and observational studies. Epidemiologic data are scarce; a few studies report that aphasia affects about one-third of children post-stroke. Despite terminological differences, there is an overall agreement on the definition of post-stroke aphasia in children as a language disorder acquired after the age of two. Approaches for the diagnosis and evaluation vary widely, including both assessments for developmental language disorders and tests for aphasia in adults. The clinical manifestations described in children are numerous and varied, similar to those found in adults, in contrast with the “standard doctrine.” This review highlights the need for further studies to improve the knowledge of this condition, develop validated and specific assessment tools, and standardize clinical management.

The early identification of the discharge setting from Inpatient Rehabilitation Facilities is a primary goal in stroke-related research because of its clinical and socio-economic relevance. Several features have been identified as significant predictors of the discharge setting. Within cognitive deficits, aphasia is known to be a common and disabling condition that could influence rehabilitation outcome. However, it is often set as an exclusion criterion in stroke research. This study aims to investigate the predictive power of clinical variables, in particular specific language disturbances and nonlinguistic cognitive deficits, for discharge setting in post-acute stroke patients with aphasia after intensive multidisciplinary rehabilitation. In a sample of 158 patients, demographic, motor, language, and nonverbal cognitive data were retrospectively considered for the prediction of the discharge to home vs. another institutional setting. Univariate analysis identified relevant differences between groups and the significant variables were included in a logistic regression model. The results showed that better functional motor status, absence of dysphagia and unimpaired nonlinguistic cognitive profile independently predict the discharge to home. In particular, nonverbal cognitive functioning seemed to be specifically relevant within the aphasic population. The findings could be helpful for setting up the rehabilitation priorities and an adequate discharge arrangement.

Background : According to surveys conducted in several countries, public awareness and knowledge of aphasia are inadequately low. Persons with aphasia appoint this fact as a relevant environmental barrier. Aims: The present inquiry aims at analyzing the status of awareness and knowledge about aphasia in Italy. Methods & Procedures: An original questionnaire was distributed online through a snowball sampling method on the Italian adult population. Respondents were asked if they had heard of the term “aphasia” and subsequently tested on its definition and clinical characteristics. Similar questions regarding “celiac disease” and “Down syndrome” were asked for comparison. Demographic data and information about the source of knowledge were also recorded. Outcomes & Results : Considering 2172 respondents, 62.4% had heard of aphasia, 58.2% showed definition knowledge while 4.6% complete general knowledge. These rates were lower than those for the other medical conditions. Older age, female gender, higher education, and being a health professional were significantly associated with awareness. The questionnaire highlighted poor knowledge about the social and functional consequences of aphasia. Conclusions : Overall, the rates of aphasia awareness and knowledge were low. Despite health professionals performed better, the level of general knowledge was also poor among these respondents. These preliminary data set the need for further inquiries, undertaking appropriate methodological ameliorations.

PURPOSE: There is a general lack of evidence on the efficacy of rehabilitation training methods after childhood stroke. The aim of the current paper is to provide an example of a multidisciplinary assessment and intensive patient-centered rehabilitation program that was devised following the Clinical Guidelines for Childhood Stroke Diagnosis, Management and Rehabilitation, based on the International Classification of Functioning, Disability and Health. METHOD: The case of a 13-year-old teenager with physical, linguistic, cognitive and emotional impairments after acute ischemic stroke (AIS) in left middle cerebral artery territories is presented and his neurorehabilitation program is described. RESULTS: After an intensive and comprehensive rehabilitation period, the patient showed significant improvement involving language abilities, cognitive flexibility, logical reasoning and motor independence. A 6-month post-stroke follow-up evaluation showed further gains in spontaneous language, improved motivation and collaboration, reduction of impulsiveness and better general motor stability. CONCLUSION: This case highlights how an intensive, patient-centered, interdisciplinary rehabilitation approach can lead to good improvement across different domains, maximizing the spontaneous recovery in children and adolescents after AIS.