This study involved the effects of a perceptual motor enrichment program upon the motor skills of a six year old boy with cerebellar brain damage, who, with a control group of ten normal six year olds, was given a pre-test of motor skills. He and a child from the control group participated in a perceptual-motor enrichment program. The motor skills of both subjects were tested halfway through the program. Following the program, the experimental child, the control child, and the control group were post-tested on their motor skills. The testings showed that the greatest gains in motor skills were obtained by the experimental child, followed by the control child. The control group displayed little increase in motor skill performance.

The purpose of this study was to determine significant differences in test scores between LLD and MBI Special Education students. The records of thirty-seven LLD and fifty-six MBI students between the ages of six through eleven were obtained from a small Texas school district. The results indicated no significant differences between groups on WISC Full Scale, Performance and Verbal scales or on WISC subtests scores. No significant differences were found on WRAT scores. Significant differences were found on the Bender-Gestalt Test for Children and the Visual Aural Digit Span Test at the nine- through eleven-year level. No differences were found at the six- through eight-year level.

Förmågan att benämna verb och substantiv kan skilja sig åt hos såväl friska vuxna (Strauss Hough, 2007) som personer med afasi (Mätzig, Druks, Masterson & Vigliocco, 2009). Hos personer med afasi har skillnader mellan förmågan att benämna substantiv och verb relaterats till skadelokalisation (Damasio & Tranel, 1993). Vid afasiutredningar används ofta benämningstest för att bedöma framplockningen av ord (Herbert, Hickin, Howard, Osborne & Best, 2008). Action Naming Test (ANT) är ett verbbenämningstest som normerats på svenska (Lindahl & Oskarsson, 2011; Stenberg & Wik, 2013), men inte studerats hos personer med afasi. Syftet med föreliggande studie är att undersöka hur verbbenämningsförmågan ser ut hos personer med afasi och expressiva svårigheter, i relation till den svenska normeringen för ANT. Några av orden i normeringen var problematiska, varför en reanalys av data genomfördes av Stenberg och Wik (2013). Resultaten för ANT har i föreliggande studie därför jämförts med normdata framtagen före och efter reanalysen. Deltagarna bedömdes även med Boston Naming Test (BNT), eftersom studien även syftade till att undersöka om det fanns skillnader i förmåga att benämna verb och substantiv. Förutom testning med ANT och BNT besvarade deltagarna även hälsoenkäten Short Form-36 (SF–36), för att undersöka eventuella samband mellan hälsotillstånd och benämningsförmåga. I studien deltog 19 personer (41–83 år, medianålder 68 år) med kronisk afasi och expressiva svårigheter. Deltagarna presterade signifikant bättre vid benämning av verb (ANT) än av substantiv (BNT), både före (p=.007) och efter (p<.001) exkludering av de problematiska orden. De presterade under normvärdet för ANT, både före och efter ordexkluderingen, men majoriteten erhöll ett högre testresultat efter reanalysen. Inga signifikanta skillnader i benämningsförmåga relaterat till kön, ålder, utbildningsnivå eller skadelokalisation återfanns. ANT kan användas vid utredning av benämningssvårigheter vid afasi. Vid jämförelse med normdata bör värden framtagna efter reanalysen användas eftersom deltagarna i förevarande studie presterade signifikant bättre efter exkludering. Deltagarna uppvisade en signifikant skillnad i prestation på ANT och BNT, vilket motiverar att verbbenämningstest bör genomföras. / The ability to name verbs and nouns can differ in healthy adults (Strauss Hough, 2007) and in people with aphasia (Mätzig, Druks, Masterson & Vigliocco, 2009). In individuals with aphasia, differences in ability to name nouns and verbs have been related to location of brain damage (Damasio & Tranel, 1993). Confrontation naming tests are frequently used in aphasia assessments to evaluate the ability to retrieve words (Herbert, Hickin, Howard, Osborne & Best, 2008). Action Naming Test (ANT) is a verb naming test that has been standardized in Swedish (Lindahl & Oskarsson, 2011; Stenberg & Wik, 2013), but no studies have been done on verb naming with ANT in Swedish individuals with aphasia, which is the aim of the present study. Some of the words in the Swedish standardization were problematic and consequently a re-analysis of the data was conducted by Stenberg and Wik (2013). The results of the ANT in the present study were compared with collected standardized data before and after the re-analysis. To investigate whether there were differences in the ability to name verbs and nouns, participants were also assessed with the Boston Naming Test (BNT). Participants were also asked to answer the health survey Short Form-36 (SF‑36), to investigate possible links between health and verb naming ability. The study enrolled 19 subjects (41–83 years, median age 68 years) with chronic aphasia and expressive difficulties. Participants performed significantly better in verb naming (ANT) than noun naming (BNT), both before (p=.007) and after (p<.001) the problematic words were excluded. The sample performed below norm levels on ANT, both before and after the exclusion, but the majority achieved a higher test result after the re-analysis. No significant differences were found in verb naming ability related to sex, age, educational level or location of brain damage. ANT can be used to assess naming ability in people with aphasia. However, when compared with standardized data, values ​​developed after the re-analysis should be used since the participants of this study performed significantly better after exclusion. The participants showed a significantly better performance on ANT than BNT, which supports the view that verb naming tests are of value.

The single subject alternating treatment design experiment reported here compared the effectiveness of pencil-and-paper versus computerized communication treatment for neurologically impaired adults. Five stroke patients receiving outpatient speech/language treatment (ages 51-72) served as subjects. One subject completed the experiment as designed and clearly supported the hypothesis that a higher number of correct responses would be produced using the computer generated exercises than the pencil-and-paper version. Two subjects were unable to demonstrate improvement using the experimental treatment program and the other two subjects were unable to master keyboarding skills necessary to use the computer effectively. However, four out of five subjects preferred using the computer even though it did not result in improved performance. Details of specific subjects' performance, and benefits and cautions regarding computer use are discussed. Results suggest that adequate receptive language skills favor effective computer use while impulsivity and visual spatial deficits may be expected to interfere. Careful matching of treatment task to the individual is important; if the task is too easy or too difficult potential benefit of computer use may be masked. The study also supports the finding that computer use is a highly motivating treatment technique for some patients and may be of benefit even if improved task performance does not result. Suggestions for further research include comparison of computerized versus non-computerized treatment for a greater variety of tasks, careful task analysis of currently available software, examination of techniques for training the mechanics of computer use, examination of specific subject characteristics which correlate with successful use of the computer, and determination of which aspect of computer use, specific feedback or improved motivation, is responsible for improved performance. / Graduation date: 1992

Early cortical injury has been attributed to the consequential effects of various factors, such as alcohol, drug addiction, smoking, and inadequate nutrient intakes during periods of pregnancy and lactation, or delivery of infants by forceps, and premature deliveries. These are only a few examples of circumstances, or "injury", that may result in disorders ranging from mild learning difficulties to aggressive behaviour. Injury to the cortex during the early years of development has been know to result in poor behavioural outcome into adulthood. Presently, the most common form of treatment includes a pharmacological agent, which may be accompanied with behavioral modification therapies supported by families. As an alternative form of therapy towards the treatment of early cortical injury, choline and a vitamin and mineral supplement (EM Power+) were used to determine the possibilities of nutrition intervention in an animal model. The injuries were incurred by aspiration lesion at days three, (Exp.1) and four, (Exp.2) and lesions were localized to the midline medial frontal cortex in some rats, while a different group of rats received lesions in the posterior parietal cortex. The pre-and postnatal choline treated animals showed favorable results for the medial frontal lesions, and the postnatal vitamin supplement treated animals showed favorable results for treatment in both medial frontal and posterior parietal lesions. All animals were tested in adulthood indicating that nutrition intervention is very beneficial for alleviating some of the functional deficits commonly seen from early cortical injury. / xiv, 191 leaves : ill. ; 28 cm.

While the focus of rehabilitation following traumatic brain injury (TBI) is often on management of physical and cognitive impairments, emotional and behavioural changes in the person with the injury may represent major hurdles in adjustment following injury. Mood, anxiety and adjustment disorders are common following TBI. A manualised cognitive behavioural therapy (CBT) treatment programme was developed that incorporated provision of education on consequences of TBI, used cognitive and behavioural strategies to recognise and manage emotional reactions to injury, and promoted achievement of personal goals. Participants were nine people with TBI referred to Massey University Psychology Clinic Wellington, for psychotherapy to assist in managing symptoms of psychological distress or adjustment difficulties following injury. Measures used included the Hospital Anxiety and Depression Scale (HADS) to monitor progress in reduction of symptoms of Anxiety and Depression; the Patient Competency Rating Scale (PCRS) to assess competency across areas of day-to-day living; and the Homework Rating Scale Second Edition (HRS-II) to assess the value of homework assignments for participants. Results were presented graphically in group format and in the form of individual case studies outlining progress in achieving individual goals. There was considerable variation in the responses of participants to treatment. When anxiety and depression were secondary to other referral issues such as fatigue and pain that remained high over treatment sessions, there was limited movement on HADS Anxiety and Depression scores. The small number of participants impacted on the ability to detect differences between Patient and Informant ratings on the PCRS or to demonstrate increased levels of awareness over treatment sessions. Consistent completion of Homework assignments proved difficult for participants. Factors that impacted on achievement of personal goals included ongoing levels of fatigue and pain, levels of personal expectation, interpersonal and organisational skills, insight into emotional reactions, and good family and social support. There is a part for a CBT approach in adjusting to changes following TBI, particularly in assisting with reassessing expectations following injury.

Diffusion tensor imaging (DTI) is a specialist MRI modality that can identify microstructural changes or abnormalities in the brain. It can also be used to show fibre tract pathways. Both of these features were used in this thesis. Firstly, standard imaging analysis techniques were used to study the effects of mild, repetitive closed head injury on a group of professional boxers. Such data is extremely rare, so the findings of regions of brain abnormalities in the boxers are important, adding to the body of knowledge about more severe traumatic brain injury. The author developed a novel multivariate analysis technique which was used on the same data. This new technique proved to be more sensitive than the standard univariate methods commonly used. An important part of diagnosing and monitoring brain damage involves the use of biomarkers. A novel investigation of whether diffusion parameters obtained from DTI data could serve as bio-markers of cognitive impairment in Parkinson's disease was conducted. This also involved developing a multivariate approach, which displayed increased sensitivity compared with any of the component parameters used singly, and suggested these diffusion measures could be robust bio-markers of cognitive impairment. Fibre tract connectivity between regions of the brain is also a potentially valuable measure for diagnosis and monitoring brain integrity. The feasibility of this was investigated in a multi-modal MRI study. Functional MRI (fMRI) identifies regions of activation associated with a particular task. DTI can then find the pathway of the fibre bundles connecting these regions. The feasibility of using regional connectivity to interrogate brain integrity was investigated using a single healthy volunteer. Fibre pathways between regions activated and deactivated by a working memory paradigm were determined. Though the results are only preliminary, they suggest that this line of research should be continued.

[Truncated abstract] Controlled and automatic processing are broad categories, and how best to measure these constructs and their impact on functioning after mild traumatic brain injury (TBI) remains uncertain. The purpose of this thesis was to examine automatic and controlled processing aspects of attention after mild TBI using the Paced Auditory Serial Addition Task (PASAT) and event-related potentials (ERPs). The PASAT is one of the most frequently used tests to evaluate attentional functioning. It has been demonstrated to be a measure sensitive to both acute and longer-term effects of mild TBI, presumably due to demands for rapid processing and executive attentional control. ERPs provide a noninvasive neurophysiological index of sensory processing and cognitive functions and have demonstrated sensitivity to even minor cognitive dysfunction. The parameters provided by this functional technique may be those most likely to distinguish individuals with mild TBI from controls. Initially, it was hypothesized that successful novice PASAT performance requires the engagement of executive attention to establish novel controlled information processing strategies. Ten individuals who had suffered a mild TBI an average of 15.20 months previously were therefore expected to demonstrate processing abnormalities on the PASAT, relative to 10 healthy matched controls. Although the mild TBI group reported significant intensification of subjective symptoms since their injury, compared to controls, the mild TBI group provided a similar amount of correct PASAT responses. ... In the first experiment a visual search task consisting of an automatic detection and a controlled search condition was developed. In the second experiment the search task was performed concurrently with the PASAT task in a dual-task paradigm. In the mild TBI group, prior failure to establish more efficient forms of information processing with practice was found to significantly interfere with simultaneous performance of the PASAT task and the attention demanding condition of the search task. The pattern of impaired performance was considered to reflect a reduction in processing resources rather than a deficit in resource allocation. Dual-task performance in the control group was not associated with a large interference effect. In general, the results of this thesis suggest that individuals with mild TBI are impaired in their ability to progress from the stage of effortful controlled information processing to a stage of more efficient, automatic processing, and thus suffer a subtle attentional deficit. Following mild TBI, performance levels equivalent to controls may only be achieved with an abnormal expenditure of cognitive effort. As a result of the neuropathologic consequences of injury, individuals who have sustained a mild TBI are less able to benefit from practice, experience difficulty coping with simultaneous performance of secondary task, and are susceptible to distressing subjective symptomatology.

Several studies have focused on the contribution of the right hemisphere brain to the emotional aspects of communication, raising evidence that it is specialized in the emotional processing of faces. Right hemisphere brain damage (RHBD) may cause disturbances in the function mentioned, affecting social interactions since they depend on facial emotion recognition. This research aimed to contribute to the study of the possible impairment in the ability to identify facial expressions in 4 RHBD patients in order to elucidate whether those interfere with the performance of two emotion recognition instruments expressed by faces images. From a comparison between the RHBD group, 4 patients with left hemisphere brain damage (LHBD) and 8 subjects in the control group, we found 22 statistically significant or borderline statistical associations results (p≅0,05) only to the stimuli of the instrument Facial Expression Brazilian Task (FERBT), including the analysis of the emotional valences between LHBD and RHBD groups. Of these, 13 showed superiority of the control group in relation to clinical groups, and 9 showed superiority the LHBD group compared to the RHBD group. From this study, we can infer that FERBT is more congruent in relation to Emotion Recognition Index (ERI) concerning the hypothesis of brain asymmetry in facial expression recognition. The results of FERBT partially agrees with the hypothesis of emotional valence, since significant differences between clinical groups were found, favoring the LHBD group to the sum of emotion scores of negative valence at 500 milliseconds (ms), 1 second (s) and overall score of FERBT, adding up all the emotions in different times. However, it should be noted that borderline statistical associations differences favoring the LHBD group were found only for the emotion of fear (200ms and the total time) and anger (total time) with no significant differences for emotions of positive valence. This study helped to assess neuropsychological deficits after right hemisphere brain damage, since there is a significant gap in this diagnostic area. Through research, we can improve our knowledge about impairments caused by right hemisphere lesion by increasingly developing accurate assessment techniques and rehabilitation methods. / Vários estudos têm enfocado a contribuição do hemisfério cerebral direito para os aspectos emocionais da comunicação, levantando evidências de que o mesmo é especializado no processamento emocional de faces. Lesões de hemisfério direito (LHD) podem acarretar perturbações na função descrita anteriormente, prejudicando as interações sociais, uma vez que estas dependem do reconhecimento de emoções na modalidade facial. A presente pesquisa teve como finalidade contribuir para o estudo dos possíveis comprometimentos na capacidade de identificar expressões faciais em 4 pacientes LHD, buscando elucidar se àqueles acabam interferindo no desempenho de 2 instrumentos de reconhecimento de emoções expressas por imagens de faces. A partir de um comparativo entre o grupo LHD, 4 indivíduos com lesão de hemisfério esquerdo (LHE) e 8 sujeitos controle, foram encontrados 22 resultados com significância estatística ou associações estatísticas limítrofes (p≅0,05) somente para os estímulos do instrumento Facial Expression Brazilian Task (FERBT), incluindo análise da valência emocional entre grupos LHE e LHD. Destes, 13 mostraram superioridade do grupo controle em relação aos grupos clínicos e 9 mostraram superioridade de grupo LHE em relação ao grupo LHD. Infere-se a partir do presente estudo que o FERBT apresenta maior congruência, em relação ao Emotion Recognition Index (ERI), com a hipótese da assimetria cerebral no reconhecimento de expressões faciais. Os resultados do FERBT concordam parcialmente com a hipótese da valência emocional, uma vez que foram encontradas diferenças relevantes entre grupos clínicos, favorecendo o grupo LHE, para o somatório das pontuações de emoções de valência negativa nos tempos de 500 milissegundos (ms), 1 segundo (s) e pontuação geral do FERBT somando-se todas as emoções dos diferentes tempos. Contudo, deve-se ressaltar que associações estatísticas limítrofes, favorecendo o grupo LHE, foram encontradas apenas para a emoção de medo (200ms e total dos tempos) e raiva (total dos tempos), não havendo diferenças significativas para emoções de valência positiva. O presente estudo contribuiu para a avaliação de déficits neuropsicológicos após lesão direita, visto que há importante lacuna nessa área de diagnóstico neuropsicológico. Através da pesquisa, poderemos aprimorar nosso conhecimento sobre as disfunções ocasionadas pela lesão de hemisfério direito, desenvolvendo técnicas cada vez mais precisas de avaliação e métodos de reabilitação.

6 Abstract The rehabilitation of patients with brain damage is an interprofessional, complex, intensive, long-lasting and individually oriented process. One frequent consequence of brain damage is hemiparesis, which also causes a disorder of the upper extremity movement pattern. The movement ability of the upper extremity is essential for an individual's self-sufficiency, the performance of common daily activities, and thus for an independent life in a family setting. Special therapeutic rehabilitation approaches should involve the training of new activities, including the motor learning mechanism that activates brain plasticity. A functional reorganization of the motor cortex occurs along with the activation of reserve neurons and the replacement of damaged synapses. One of the aims of this work was to demonstrate, using objective function methods, the possibility of influencing the movement patterns of a paretic upper extremity by means of intensive interprofessional rehabilitation even several years after the brain damage. The second aim was to demonstrate that the monitoring of motor functions in patients after brain damage leads to improved motivation, thereby improving motor functions. A study was conducted among 55 selected patients after brain damage with central hemiparesis who participated in the...