Individuals with mild cognitive impairment (MCI) show variable impairment in autobiographical memory function, source memory function and reduced integrity in the brain’s default mode network (DMN). There is overlap between the DMN, such as the medial posterior cortical hub, and brain regions that are active when participants recall autobiographical memories. To assess the association between autobiographical memory and the DMN, 14 MCI and eleven age and education-matched healthy control participants were assessed using the autobiographical memory interview (AMI) and underwent resting state fMRI scans. The same participants underwent a test of source memory which assessed both recognition and source memory. The MCI group showed significantly increased semantic as well episodic memory impairments using the AMI, evident across the lifespan for episodic memory but not for childhood semantic memory. Significantly poorer DMN connectivity, using a goodness of fit index (GOF) of the DMN template, was evident in the MCI group. MCI participants showed poorer performance on both recognition and source memory relative to HC participants. A modest association between AMI semantic memory (r=0.4) scores, but not episodic memory scores (r=0.09), and DMN connectivity was found in these participants. For future study the predictive value of MR imaging in the DMN of MCI participants should be explored.

Aims: Verb morphology, arguably, is identified as an area of exceptional challenge for the language development of both young typically-developing children, and children with language difficulties (Leonard, 2014a; Rice & Wexler, 2001). The developmental patterns of verb acquisition are found to be strongly governed by the typological properties of the ambient language; often language errors found in fusional languages (e.g. English and German) are significantly different from those found in agglutinative languages (e.g. Turkish and Tamil) (cf. Phillips, 2010). Therefore, the purpose of the study was to explore the developmental trends in the acquisition of verb morphology in Bangla, a language with agglutinative features. The first objective was to examine the morphosyntactic development of typically-developing (TD) Bangla-speaking children with regard to three verb forms, namely the Present Simple, the Present Progressive and the Past Progressive. A second objective was to examine the development of the three verb forms among a group of children with language impairment (LI). Rationale: Since Bangla is spoken by a large population, the acquisition data of Bangla represents a significant number of people, and the findings from the acquisition studies, when considered for intervention purposes, serve a considerably large population. Also, given that the normative data of language acquisition is unavailable for Bangla which leads to the absence of a language-specific assessment and intervention for LI children, the present study is expected to have importance for Bangla-speaking contexts. Method: Before the main study commenced, a pilot study was conducted with 19 Bangla-speaking TD children aged between two and four (years) in order to explore the developmental characteristics of the verb forms and to evaluate the research instruments identified for the actual study. The main study included 70 TD children between 1;11 and 4;3 years who were recruited from six daycare centres of Dhaka, Bangladesh. The children participated in three elicitation tasks, each to elicit one verb form, and a 20-minute play session that yielded a spontaneous language sample from each child. The researcher scored children’s performances on the three tasks, and transcribed the language samples using transcription software (Systematic Analysis of Language Transcripts). The elicitation tasks were used to determine children’s mastery of the forms, whereas the language samples were used to calculate a set of language measures associated with morphological development. The study also included a group of nine children with LI between 3;11 and 9;4 years who participated in the same set of tasks as the TD children. These children were recruited from a special school in Dhaka. Findings: The results revealed that, for both TD and LI children, the Present Simple form was acquired with highest accuracy which was followed by the scores in the Present Progressive and the Past Progressive forms respectively. The error patterns indicated a qualitative progress even in children’s errors, which was consistent with the accuracy rates of the target forms. Based on the TD children’s performance on the three tasks, a developmental sequence for the three Bangla verb forms was proposed. Results also identified that Mean length of Utterance (MLU) did not have stronger associations with the tasks scores than did Age. Among the determinants tested, Bound Morpheme Type (BMT) was identified to have the strongest associations with the task scores. Analyses of the data from the LI children revealed a significant difference between the TD and the LI children on all three tasks and the other language measures. When compared against the proposed developmental stages, the children within the LI group were found to different in terms of their morphosyntactic capacities. A sub-group of LI children also did not conform to any stages of typical development. Conclusions: Results of the present study offer directions for future investigations in a wide range of areas of Bangla morphosyntax that need to be examined with both TD and LI children. Moreover, factors associated with language development that the present study did not examine (e.g. the role of input) also need to be addressed in future studies. Above all, there is a strong need for ongoing investigations in order to identify a comprehensive picture of morphosyntactic development of Bangla-speaking TD children, which can then lead to the assessment of a range of language impairments in Bangla.

Perceptual and motor functions and self-care ability after stroke were assessed within two weeks (n:109; mean age 69±10) and 4-6 years (n:75;70±9) after admission to a non-intensive care stroke unit. Sixty-two of the long-term stroke survivors reported on their life satisfaction (7 items) as experienced (in retrospect) before the stroke and at the time of the investigation. Perceptual functions and actual levels of life satisfaction were registered in 60 clinically healthy subjects aged about 60 or about 80 years. Both early on and late after stroke the 16 items of perceptual function were clearly grouped into two factors, which neatly fitted an ecological perceptual concept. One factor characterized low-order and the other higher-order perception. Impairments of low-order perception occurred for about 10% of the patients, whether investigated early or late after stroke. No one among the reference populations had such impairments. Higher-order perceptual impairments prevailed in 60% early on and in 57% late after stroke and were often more pronounced than those occurring in the reference populations, among whom 35% of the 60 year olds and significantly more - 77% - of the 80 year olds had such impairments. Hence, perceptual impairments are common after stroke, but slight age-dependent reductions should be considered when higher-order perceptual function is assessed and treated after stroke. Together with motor function, which was impaired in 52% of the early and 36% of the late stroke samples, higher-order perceptual function and to a limited extent low-order perception could predict the level of self-care ability in 70% and 62% of the early and late samples, respectively. Whereas levels of global and of domain specific variables of life satisfaction were similar in the two reference populations, the stroke had lead to a reduction in life satisfaction for 61% of the long-term survivors. Reductions were particularly pronounced for global life satisfaction and for satisfaction with leisure and sexuality. Although significantly associated with motor impairment and self-care disability, these reductions could not be attributed only to impairments and disability. The findings are discussed with particular reference to assessment and treatment in occupational therapy. / <p>S. 1-58: sammanfattning, s. 59-139: Härtill 5 uppsatser</p> / digitalisering@umu

The studies presented in this work were completed with the goal ofgaining greater insight into the roles of protein oxidation in brain aging and age-relatedcognitive impairment. Aging is associated with the impairment of physiological systemssuch as the central nervous system (CNS), homeostatic system, immune system, etc.Functional impairments of the CNS is associated with increased susceptibility to developmany neurodegenerative diseases such as Alzheimer's diseases (AD), Parkinson's disease(PD), and amyotrophic lateral sclerosis (ALS). One of the most noticeable functionalimpairments of the CNS is manifested by cognitive decline. In the past three decades, thefree radical theory of aging has gained relatively strong support in this area. Excessiveproduction reactive oxygen species (ROS) was demonstrated as a contributing factor inage-related memory and synaptic plasticity dysfunction. This dissertation use proteomicsto identify the proteins that are oxidatively modified and post-translationally altered inaged brain with cognitive impairment and normal aging brain.Ongoing research is being pursued for development of regime to preventoxidative damage by age-related oxidative stress. Among which are those that scavengefree radicals by antioxidants, i.e. ??-lipoic acid (LA), and protecting the brains byreducing production of neurotoxic substance, i.e. reducing production of amyloid ??(A??).Therefore, proteomics were also used to identify the alteration of specific proteins in agedbrain treated with LA and antisense oligonucleotides again amyloid protein precursor.This dissertation provides evidences that certain proteins are less oxidatively modifiedand post-translationally altered in cognitively impaired aged brain treated with LA andantisense oligonucleotides against the A?? region of amyloid precursor protein (APP)(AO).Together, the studies in this dissertation demonstrated that increased oxidativestress in brain play a significant role in age-related cognitive impairment. Moreover, suchincreased oxidative stress leads to specific protein oxidation in the brain of cognitiveimpaired subject, thereby leading to cognitive function impairment. Moreover, thefunctional alterations of the proteins identified by proteomics in this dissertation mayleads to impaired metabolism, decline antioxidant system, and damaged synapticcommunication. Ultimately, impairment of these processes lead to neuronal damages andcognitive decline. This dissertation also show that several of the up-regulated andoxidized proteins in the brains of normal aging mice identified are known to be oxidizedin neurodegenerative diseases as well, suggesting that the expression levels of certainproteins may increase as a compensatory response to oxidative stress. This compensationwould allow for the maintenance of proper molecular functions in normal aging brainsand protection against neurodegeneration.

Aim: To evaluate an audiologic rehabilitation program previously piloted in the U.S. (Kelly-Campbell, in review) for unaided hearing-impaired working adults that was also modified to include their significant others. <p> <p> Method: In this quasi-randomised repeated measures waitlist design, forty-eight participants (24 hearing-impaired adults and their 24 normal hearing significant others) aged 50-64 years were randomised into either a non-waitlist group (immediate treatment), or a waitlist group (treatment after 12-weeks). In these groups, participant couples attended three weekly 2-hour group sessions and completed health-related quality of life (HRQOL) assessments. Treatment outcomes for hearing-impaired adults (HIAs) were measured from self and significant other (SO) proxy reports of the Communication Profile for the Hearing Impaired (CPHI; Demorest & Erdman, 1986; 1987). Treatment outcomes for SOs were measured from self-reports of the Significant Other Scale for Hearing Disability (SOS-HEAR; Scarinci, Worrall & Hickson, 2009b). An investigation of the effect of treatment on the congruence of SO-proxy versus HIA HRQOL measures was also undertaken. <p> Results: A series of analyses of variance and repeated-measures t-tests examined HRQOL outcomes for HIAs and their SOs between pre-treatment, post-treatment, and at 12-weeks follow-up. Results suggest a significant effect of time for all HRQOL assessments, with gender effects found for CPHI measures, but not for SOS-HEAR measures. Medium to large effect sizes were revealed for both HIAs and their SOs. <p> Conclusions: Group AR appears to be a beneficial treatment approach for reducing the consequences of hearing impairment for HIAs and for their normal hearing SOs.

This research introduces, develops and applies the concept of using student perceptions to measure opportunity-to-learn, in order to evaluate regular and special educational provision. A qualitative investigation into services for the education of learners with vision impairment identified the common aim of giving students equal access to the curriculum as their sighted peers. It also elicited potential determinants of need that affect caseload allocation decisions. Opportunity-to-learn was identified as a concept in the research literature, which has evolved from a measure of content coverage into a potential indicator of school effectiveness, measured almost exclusively from the teachers' perception. This research drew on the growing body of research that asks the students, to shift the focus from the teacher to the students themselves. An instrument was developed, based on the Essential Skills of the New Zealand curriculum, that measures opportunity-to-learn from the perspective of the students. This was used to collect baseline data on 1300 students, with no identified special needs, from twenty secondary schools throughout New Zealand. Analysis of the baseline data demonstrated the validity of the approach, and its potential to aid in research on the educational process, using this set of intermediate indicators. Results showed differences between schools and between girls and boys. The mean index scores for the schools were not strongly related to the socio-economic background of the schools, but did reflect independent measures of school quality. The instrument was then used to measure opportunity-to-learn for fifty learners with vision impairment in regular high schools. Comprehensive data on these learners was gathered from regular and specialist teachers, parents, schools and the individuals themselves. This data was analysed to evaluate the services and the opportunity-to-learn for the learners with vision impairment. Results showed that on average these students had opportunity-to-learn at least as good as for their sighted peers. Areas of weakness and strength within the service were identified. The instrument proved effective in the evaluation process.

The 2002 Supreme Court decision (Atkins vs. Virginia, 536 U. S. 304), prohibiting the execution of mentally retarded persons, may potentially increase malingering of mental retardation (MR). There is limited research addressing the detection of feigned MR. The present study compared results from tests of intelligence, adaptive functioning, legal/courtroom knowledge, and psychiatric and neurocognitive feigning to determine how effectively these instruments discriminate between MR participants and community volunteers asked to either approach the test honestly (CVH group) or feign, or malinger, MR (CVM group). CVMs suppressed their IQ scores sufficiently to appear MR. CVMs overestimated deficits on individuals with genuine MR on tests of adaptive functioning and courtroom knowledge. Psychiatric feigning instruments did not discriminate between MR and CVM groups. Neurocognitive feigning instruments discriminated between groups, however specificity and Positive Predictive Power were unacceptably low. Revising cutting scores to hold specificity at .95 improved PPP significantly, suggesting the potential utility of these instruments to detect feigned mental retardation. Results from this study suggest that applying published decision rules to MR populations on tests commonly used in forensic neuropsychological evaluations will likely result in a high rate of false positive errors. Given the high stakes associated with classification errors in capital cases involving MR defendants, alternative cutting scores appropriate for this population should be determined.

<p>[1] s., s. 4-70: sammanfattning, s. 73-153: 4 uppsatser</p> / digitalisering@umu

Objective: The purpose of this dissertation was to determine whether measures of reaction time inconsistency (RTI) can be applied clinically to detect cognitive impairment in older adults. Methods: Data were obtained from the Victoria Longitudinal Study (VLS), a longitudinal study of healthy aging, and PREVENT, a multivariate study of risk factors for Alzheimer’s disease. Study 1 examined effects of task complexity and computational approach on the association between RTI and physical and cognitive functioning in participants of the VLS. Study 2 assembled normative data from the VLS and standardized RTI data from an independent VLS cohort against these normative data. Significant Study 1 findings were replicated in Study 2 using the obtained RTI T-Scores, and the clinical utility of results were evaluated using stratum specific likelihood ratios (SSLRs). Study 3 replicated Study 2 analyses in data from PREVENT. Results: Results of Study 1 identified four operationalizations of RTI from a choice reaction task that yielded consistent significant associations with cross-sectional cognitive performance. Consistent associations were not observed between these scores and cognitive change or performance on measures of physical functioning. Study 2 replicated Study 1 findings in an independent sample using RTI T-Scores. SSLRs supported the clinical utility of measures of RTI for detecting prevalent cognitive impairment. Study 3 replicated findings from Study 2, but SSLRs indicated that only low RTI scores yielded associations of sufficient reliability for clinical interpretation. Consistent with Study 1 and Study 2, associations between RTI T-Scores and measures of physical function were nonsignificant. Conclusions: Low RTI T-Scores were shown across two samples to be associated with a clinically meaningful reduction in the odds of cognitive impairment. Further research is needed in order to clarify the utility of high RTI scores for positive prediction of cognitive impairment. / Graduate

Being hearing impaired does not only affect a child’s academic performance, but can also influence a child’s overall development and ability to succeed academically. Evidence suggests that the outlay in early childhood has a large impact on a child’s readiness to learn. Neurodevelopmental movement programmes are generally not accepted as evidenced-based practice and their effect on academic performance is often underrated. Movement, however, is regarded by many as essential to learning and there seems to be a positive interchange between the brain and the body. This study reports on the influence of a neurodevelopmental movement programme on the development, behaviour and performance on a neurodevelopmental evaluation scale of four to eight year-old children with hearing impairment children. The study furthermore provides a report of the results of the psychometric assessment in the form of a neurodevelopmental profile for this specific sample. Children were selected from a special needs school in the rural QwaQwa Free State area of South Africa. Two groups of children (an experimental and comparison group) were used in this study, with both groups undergoing a pretest and posttest phase using three test batteries (Griffiths Mental Developmental Scales- Extended Revised, Child Behaviour Checklist, and a neurodevelopmental evaluation scale). The experimental group was subjected to a fourteen-week neurodevelopmental movement programme. The comparison group underwent a placebo intervention. The results indicate that the children in the experimental group showed an improvement in some aspects of specific development following the intervention (locomotor functioning, performance related abilities, and practical reasoning skills). General developmental age showed significant improvement in both the experimental group and the comparison group. No behavioural aspects showed significant improvements following the intervention, whereas some neurodevelopmental aspects, such as the vestibular system (Tandem Walk and One Leg Stand) and the reflex system (TLR – reflex) showed significant improvements. The results of this empirical investigation aid in understanding the impact of movement programmes on a child with hearing disability’s general development and neurodevelopmental development. / Thesis (PhD (Psychology))--North-West University, Potchefstroom Campus, 2013.