Made by DATEXIS (Data Science and Text-based Information Systems) at Beuth University of Applied Sciences Berlin
Deep Learning Technology: Sebastian Arnold, Betty van Aken, Paul Grundmann, Felix A. Gers and Alexander Löser. Learning Contextualized Document Representations for Healthcare Answer Retrieval. The Web Conference 2020 (WWW'20)
Funded by The Federal Ministry for Economic Affairs and Energy; Grant: 01MD19013D, Smart-MD Project, Digital Technologies
Although often termed a "neurological condition," synesthesia is not listed in either the DSM-IV or the ICD since it most often does not interfere with normal daily functioning. Indeed, most synesthetes report that their experiences are neutral or even pleasant. Like perfect pitch, synesthesia is simply a difference in perceptual experience.
The simplest approach is test-retest reliability over long periods of time, using stimuli of color names, color chips, or a computer-screen color picker providing 16.7 million choices. Synesthetes consistently score around 90% on reliability of associations, even with years between tests. In contrast, non-synesthetes score just 30–40%, even with only a few weeks between tests and a warning that they would be retested.
Grapheme-color synesthetes, as a group, share significant preferences for the color of each letter (e.g. A tends to be red; O tends to be white or black; S tends to be yellow etc.) Nonetheless, there is a great variety in types of synesthesia, and within each type, individuals report differing triggers for their sensations and differing intensities of experiences. This variety means that defining synesthesia in an individual is difficult, and the majority of synesthetes are completely unaware that their experiences have a name.
Neurologist Richard Cytowic identifies the following diagnostic criteria for synesthesia in his "first" edition book. However, the criteria are different in the second book:
1. Synesthesia is involuntary and automatic.
2. Synesthetic perceptions are spatially extended, meaning they often have a sense of "location." For example, synesthetes speak of "looking at" or "going to" a particular place to attend to the experience.
3. Synesthetic percepts are consistent and generic (i.e. simple rather than pictorial).
4. Synesthesia is highly memorable.
5. Synesthesia is laden with affect.
Cytowic's early cases mainly included individuals whose synesthesia was frankly projected outside the body (e.g. on a "screen" in front of one's face). Later research showed that such stark externalization occurs in a minority of synesthetes. Refining this concept, Cytowic and Eagleman differentiated between "localizers" and "non-localizers" to distinguish those synesthetes whose perceptions have a definite sense of spatial quality from those whose perceptions do not.
Synesthesia is found in at least 4.4% of the population, as a high estimate, which is equivalent to 1 in 23 people. This study had also concluded that one common form of synesthesia—grapheme-color synesthesia (colored letters and numbers) – is found in more than one percent of the population, and this latter prevalence of graphemes-color synesthesia has now been independently verified in a yet larger sample. Earlier estimates of the prevalence of synesthesia were based on "best-guess" estimations only ("e.g." 1 in 250,000) or had limitations in their methodologies because they required synesthetes to refer themselves for study ("e.g." 1 in 2000) and for this reason the authors of those studies had been moderate in their claims. Also, some individuals will not self-classify as synesthetes because they do not realize that their perceptions are different from those of everyone else.
The most common forms of synesthesia are those that trigger colors, and the most prevalent of all is day-color. Also relatively common is grapheme-color synesthesia. We can think of "prevalence" both in terms of how common is synesthesia (or different forms of synesthesia) within the population, or how common are different forms of synesthesia within synesthetes. So within synesthetes, forms of synesthesia that trigger color also appear to be the most common forms of synesthesia with a prevalence rate of 86% within synesthetes. In another study, music-color is also prevalent at 18–41%. Some of the rarest are reported to be auditory-tactile, mirror-touch, and lexical-gustatory.
There is research to suggest that the likelihood of having synesthesia is greater in people with autism.
Ordinal-linguistic personification (OLP, or personification for short) is a form of synesthesia in which ordered sequences, such as ordinal numbers, days, months and letters are associated with personalities and/or genders (). Although this form of synesthesia was documented as early as the 1890s (; ) researchers have, until recently, paid little attention to this form (see History of synesthesia research).
Mme L. reports that “1, 2, 3 are children without fixed personalities; they play together. 4 is a good peaceful woman, absorbed by down-to-earth occupations and who takes pleasure in them. 5 is a young man, ordinary and common in his tastes and appearance, but extravagant and self-centered. 6 is a young man of 16 or 17, very well brought up, polite, gentle, agreeable in appearance, and with upstanding tastes; average intelligence; orphan. 7 is a bad sort, although brought up well; spiritual, extravagant, gay, likeable; capable of very good actions on occasion; very generous. 8 is a very dignified lady, who acts appropriately, and who is linked with 7 and has much influence on him. She is the wife of 9. 9 is the husband of 8. He is self-centred, maniacal, selfish, thinks only about himself, is grumpy, endlessly reproaching his wife for one thing or another; telling her, for example, that he would have been better to have married a 9, since between them they would have made 18 – as opposed to only 17 with her… 10, and the other remaining numerals, have no personifications”.
Cakins (1893) describes a case for whom “T’s are generally crabbed, ungenerous creatures. U is a soulless sort of thing. 4 is honest, but… 3 I cannot trust… 9 is dark, a gentleman, tall and graceful, but politic under his suavity” .
For synesthete MT “I [is] a bit of a worrier at times, although easy-going; J [is] male; appearing jocular, but with strength of character; K [is] female; quiet, responsible…” .
More recently AP has reported that February is “an introverted female”, while F is a “[male] dodgy geezer”. Similarly, May is reported to be “soft-spoken” and “girly” while M is an “old lady [who] natter[s] a lot”, and while August is “a boy among girls”, A is a female “mother type” (; ).
Piblokto, also known as pibloktoq and Arctic hysteria, is a condition most commonly appearing in Inughuit (Greenlandic Inuit) societies living within the Arctic Circle. Piblokto is a culture-specific hysterical reaction in Inuit, especially women, who may perform irrational or dangerous acts, followed by amnesia for the event. Piblokto may be linked to repression of the personality of Inuit women. The condition appears most commonly in winter. It is considered to be a form of a culture-bound syndrome, although more recent studies (see "Skepticism" section) question whether it exists at all. Piblokto is also part of the glossary of cultural bound syndromes found in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV).
Communication deviance (CD) occurs when a speaker fails to effectively communicate meaning to their listener with confusing speech patterns or illogical patterns. These disturbances can range from vague linguistic references, contradictory statements to more encompassing non-verbal problems at the level of turn-taking. The term was originally introduced by Wynne and Singer in 1963 to describe a communication style found among parents who had children with schizophrenia. A recent meta-analysis reported that communication deviance is highly prevalent in parents of patients diagnosed with schizophrenia and adoption studies have reported significant associations between CD in the parent and thought disorder in the offspring, however, the mechanisms by which CD impacts on the offspring's cognition are still unknown.
The research of psychiatrists and psychoanalysts Lyman Wynne and Theodore Lidz on communication deviance and roles (e.g., pseudo-mutuality, pseudo-hostility, schism and skew) in families of people with schizophrenia also became influential with "systems-communications"-oriented theorists and therapists.
Although there is no known cause for piblokto, Western scientists have attributed the disorder to the lack of sun, the extreme cold, and the desolate state of most villages in the region. A reason for this disorder present in this culture may be due to the isolation of their cultural group.
This culture-bound syndrome is possibly linked to vitamin A toxicity (hypervitaminosis A). The native Inughuit diet or Eskimo nutrition provides rich sources of vitamin A through the ingestion of livers, kidneys, and fat of arctic fish and mammals and is possibly the cause or a causative factor. This causative factor is through the disturbance that has been reported for males, females, adults, children, and dogs. The ingestion of organ meats, particularly the livers of some Arctic mammals, such as the polar bear and bearded seal, where the vitamin is stored in toxic quantities, can be fatal to most people.
Inughuit tradition states that it is caused by evil spirits possessing the living. Shamanism and animism are dominant themes in Inughuit traditional beliefs with the angakkuq (healer) acting as a mediator with the supernatural forces. Angakkuit use trance states to communicate with spirits and carry out faith healing. There is a view among the Inughuit that individuals entering trance states should be treated with respect given the possibility of a new "revelation" emerging as a result. Treatment in piblokto cases usually involves allowing the episode to run its course without interference. While piblokto can often be confused with other conditions, (including epilepsy) in which failure to intervene can lead to the victim coming to harm, most cases tend to be more typical.
Among preschoolers, the prognosis for recovery is good. Based on research, about 65% of preschoolers who stutter recover spontaneously in the first two years of stuttering, and about 74% recover by their early teens. In particular, girls seem to recover well. For others, early intervention is effective in helping the child overcome disfluency.
Once stuttering has become established, and the child has developed secondary behaviors, the prognosis is more guarded, and only 18% of children who stutter after five years recover spontaneously. However, with treatment young children may be left with little evidence of stuttering.
With adult people who stutter, there is no known cure, though they may make partial recovery or even complete recovery with intervention. People who stutter often learn to stutter less severely, though others may make no progress with therapy.
Emotional sequelae associated with stuttering primarily relates to state-dependent anxiety related to the speech disorder itself. However, this is typically isolated to social contexts that require speaking, is not a trait anxiety, and this anxiety does not persist if stuttering remits spontaneously. Research attempting to correlate stuttering with generalized or state anxiety, personality profiles, trauma history, or decreased IQ have failed to find adequate empirical support for any of these claims.
Several treatment initiatives, for example the McGuire programme, and the Starfish Project advocate diaphragmatic breathing (or "costal breathing") as a means by which stuttering can be controlled.
Culture shock is a subcategory of a more universal construct called transition shock. Transition shock is a state of loss and disorientation predicated by a change in one's familiar environment that requires adjustment. There are many symptoms of transition shock, including:
- Anger
- Boredom
- Compulsive eating/drinking/weight gain
- Desire for home and old friends
- Excessive concern over cleanliness
- Excessive sleep
- Feelings of helplessness and withdrawal
- Getting "stuck" on one thing
- Glazed stare
- Homesickness
- Hostility towards host nationals
- Impulsivity
- Irritability
- Mood swings
- Physiological stress reactions
- Stereotyping host nationals
- Suicidal or fatalistic thoughts
- Withdrawal
Since this syndrome is very rare, it takes a multidisciplinary team to evaluate the syndrome and diagnose it, including speech-language pathologists, neurolinguists, neurologists, neuropsychologists, and psychologists. In 2010, Verhoeven and Mariën identified several subtypes of Foreign Accent Syndrome. They described a neurogenic, developmental, psychogenic and mixed variant. Neurogenic FAS is the term used when FAS occurs after central nervous system damage. Developmental FAS is used when the accent is perceptible as of an early age, e.g. children who have always spoken with an accent. Psychogenic FAS is used when FAS is psychologically induced, associated with psychiatric disorder or clear psychiatric traits. The term mixed FAS is used when patients develop the disorder after neurological damage, but the accent change has such a profound impact on the self-perception and identity that they will modify or enhance the accent to make it fit with the new persona. Hence, there is a psychological component.
Diagnosis, up until today, is generally purely perceptually based. However, in order to find out what subtype the patient is suffering from, complementary investigations are necessary. This differentiation is necessary for the clinician to allow for correct therapeutic guidance. Psychological evaluations may be performed in order to rule out any psychiatric condition that may be causing the change in speech, as well as tests to assess reading, writing, and language comprehension in order to identify comorbid disorders often co-occurring with the disorder. One of the symptoms of this syndrome is that the patient moves their tongue or jaw differently while speaking, which creates a different sound, so a recording is done of the speech pattern in order to analyze it. Often images of the brain are taken with either MRI, CT, SPECT or PET scans. This is done in order to see if there is structural and or functional damage in the areas of the brain that control speech and/or rhythm and melody of speech. EEG is sometimes performed to investigate whether there are disturbances at the electrophysiological level.
Assessment will usually include an interview with the child’s caregiver, observation of the child in an unstructured setting, a hearing test, and standardized tests of language. There is a wide range of language assessments in English. Some are restricted for use by experts in speech-language pathology: speech and language therapists (SaLTs/SLTs) in the UK, speech-language pathologists (SLPs) in the US and Australia. A commonly used test battery for diagnosis of DLD is the Clinical Evaluation of Language Fundamentals (CELF).
Assessments that can be completed by a parent or teacher can be useful to identify children who may require more in-depth evaluation. The Children’s Communication Checklist (CCC–2) is a parent questionnaire suitable for assessing everyday use of language in children aged 4 years and above who can speak in sentences.
Informal assessments, such as language samples, are often used by speech-language therapists/pathologists to complement formal testing and give an indication of the child's language in a more naturalistic context. A language sample may be of a conversation or narrative retell. In a narrative language sample, an adult may tell the child a story using a wordless picture book (e.g. Frog Where Are You?, Mayer, 1969), then ask the child to use the pictures and tell the story back. Language samples can be transcribed using computer software such as the Systematic Analysis of Language Software, and then analyzed for a range of features: e.g., the grammatical complexity of the child's utterances, whether the child introduces characters to their story or jumps right in, whether the events follow a logical order, and whether the narrative includes a main idea or theme and supporting details.
Another method implemented to test for aprosodia involves having questionnaires filled out by those close to the patient. The doctors and nurses taking care of a patient are also requested to fill out a questionnaire if aprosodia is suspected. This diagnosis method occurs more as an indicator that the aprosodia battery should be administered rather than being used as a singular diagnosis tool. Implementation of the questionnaire is expected to become more widespread as aprosodia is revealed to be a side-effect of more diseases.
Although MCS patients are able to demonstrate cognitively mediated behaviors, they occur inconsistently. They are, however, reproducible or can be sustained long enough to be differentiated from reflexive behavior. Because of this inconsistency, extended assessment may be required to determine if a simple response (e.g. a finger movement or a blink) occurred because of a specific environmental event (e.g. a command to move the finger or to blink) or was merely a coincidental behavior. Distinguishing between VS and MCS is often difficult because the diagnosis is dependent on observation of behavior that show self or environmental awareness and because those behavioral responses are markedly reduced. One of the more common diagnostic errors involving disorders of consciousness is mistaking MCS for VS which may lead to serious repercussions related to clinical management.
Giacino et al. have suggested demonstration of the following behaviors in order to make the diagnosis of MCS.
- Following simple commands.
- Gestural or verbal yes/no responses (regardless of accuracy).
- Intelligible verbalization.
- Purposeful behavior such as those that are contingent due to appropriate environmental stimuli and are not reflexive. Some examples of purposeful behavior include:
- appropriate smiling or crying in response to the linguistic or visual content of emotional but not to neutral topics or stimuli.
- vocalizations or gestures that occur in direct response to the linguistic content of questions.
- reaching for objects that demonstrates a clear relationship between object location and direction of reach.
- touching or holding objects in a manner that accommodates the size and shape of the object.
- pursuit eye movement or sustained fixation that occurs in direct response to moving or salient stimuli.
There are three basic outcomes of the Adjustment Phase:
- Some people find it impossible to accept the foreign culture and to integrate. They isolate themselves from the host country's environment, which they come to perceive as hostile, withdraw into an (often mental) "ghetto" and see return to their own culture as the only way out. These "Rejectors" also have the greatest problems re-integrating back home after return.
- Some people integrate fully and take on all parts of the host culture while losing their original identity. This is called cultural assimilation. They normally remain in the host country forever. This group is sometimes known as "Adopters" and describes approximately 10% of expatriates.
- Some people manage to adapt to the aspects of the host culture they see as positive, while keeping some of their own and creating their unique blend. They have no major problems returning home or relocating elsewhere. This group can be thought to be cosmopolitan. Approximately 30% of expats belong to this group.
Culture shock has many different effects, time spans, and degrees of severity. Many people are handicapped by its presence and do not recognize what is bothering them.
Assessment will usually include an interview with the child’s caregiver, observation of the child in an unstructured setting, a hearing test, and standardized tests of language and nonverbal ability. There is a wide range of language assessments in English. Some are restricted for use by speech and language professionals (therapists or SALTs in the UK, speech-language pathologists, SLPs, in the US and Australia).
A commonly used test battery for diagnosis of SLI is the Clinical Evaluation of Language Fundamentals (CELF).
Assessments that can be completed by a parent or teacher can be useful to identify children who may require more in-depth evaluation.
The Grammar and Phonology Screening (GAPS) test is a quick (ten minute) simple and accurate screening test developed and standardized in the UK. It is suitable for children from 3;4 to 6;8 years;months and can be administered by professionals and non-professionals (including parents) alike, and has been demonstrated to be highly accurate (98% accuracy) in identifying impaired children who need specialist help vs non-impaired children. This makes it potentially a feasible test for widespread screening.
The Children’s Communication Checklist (CCC–2) is a parent questionnaire suitable for testing language skills in school-aged children.
Informal assessments, such as language samples, may also be used. This procedure is useful when the normative sample of a given test is inappropriate for a given child, for instance, if the child is bilingual and the sample was of monolingual children. It is also an ecologically valid measure of all aspects of language (e.g. semantics, syntax, pragmatics, etc.).
To complete a language sample, the SLP will spend about 15 minutes talking with the child. The sample may be of a conversation (Hadley, 1998), or narrative retell. In a narrative language sample, the SLP will tell the child a story using a wordless picture book (e.g. "Frog Where Are You?", Mayer, 1969), then ask the child to use the pictures and tell the story back.
Language samples are typically transcribed using computer software such as the Systematic Analysis of Language Software (SALT, Miller et al. 2012), and then analyzed. For example, the SLP might look for whether the child introduces characters to their story or jumps right in, whether the events follow a logical order, and whether the narrative includes a main idea or theme and supporting details.
The nature of the alleged mental representations that underlie the act of pointing to target body parts have been a controversial issue. Originally, it was diagnosed as the effects of general mental deterioration or of aphasia on the task of pointing to body parts on verbal command. However, contemporary neuropsychological therapy seeks to establish the independence of autotopagnosia from other disorders. With such a general definition, a patient that presents with a dysfunction of or failure in accessing one of four mental representation systems suffers from autotopagnosia. Through observational testing, the type of mental misrepresentation of the body can be deduced: whether "semantic", "visuospatial", "somatosensory", or "motor misrepresentations". Neuropsychological tests can provide a proper diagnosis in regards to the specificity of patient’s agnosic condition.
1) Test 1: Body Part Localization: Free vision and no vision conditions
2) Test 2: On-line positioning of body vis-à-vis objects
3) Test 3: Localization of objects on the body surface
4) Test 4: Body part semantic knowledge
5) Test 5: Matching body parts: Effect of viewing angle
One of the defining characteristics of minimally conscious state is the more continuous improvement and significantly more favorable outcomes post injury when compared with vegetative state. One study looked at 100 patients with severe brain injury. At the beginning of the study, all the patients were unable to follow commands consistently or communicate reliably. These patients were diagnosed with either MCS or vegetative state based on performance on the JFK Coma Recovery Scale and the diagnostic criteria for MCS as recommended by the Aspen Consensus Conference Work-group. Both patient groups were further separated into those that suffered from traumatic brain injury and those that suffered from non-traumatic brain injures (anoxia, tumor, hydrocephalus, infection). The patients were assessed multiple times over a period of 12 months post injury using the Disability Rating Scale (DRS) which ranges from a score of 30=dead to 0=no disabilities. The results show that the DRS scores for the MCS subgroups showed the most improvement and predicted the most favorable outcomes 12 months post injury. Amongst those diagnosed with MCS, DRS scores were significantly lower for those with non-traumatic brain injuries in comparison to the vegetative state patients with traumatic brain injury. DRS scores were also significantly lower for the MCS non-traumatic brain injury group compared to the MCS traumatic brain injury group. Pairwise comparisons showed that DRS scores were significantly higher for those that suffered from non-tramuatic brain injuries than those with traumatic brain injuries. For the patients in vegetative states there were no significant differences between patients with non-traumatic brain injury and those with traumatic brain injuries. Out of the 100 patients studied, 3 patients fully recovered (had a DRS score of 0). These 3 patients were diagnosed with MCS and had suffered from traumatic brain injuries.
In summary, those with minimally conscious state and non-traumatic brain injuries will not progress as well as those with traumatic brain injuries while those in vegetative states have an all around lower to minimal chance of recovery.
Because of the major differences in prognosis described in this study, this makes it crucial that MCS be diagnosed correctly. Incorrectly diagnosing MCS as vegetative state may lead to serious repercussions related to clinical management.
Before the development of the current tests for the assessment of post-traumatic amnesia (PTA), a retrospective method was used to determine the patient's condition, consisting of one or more interviews with the patient after the episode of PTA was judged to be over. The retrospective method, however, fails to account for the apparent lucidity of patients who are still experiencing substantial disorientation, or the finding that the recovery from post-traumatic amnesia is often characterized by the presence of "islands of memory" (short periods of clarity). A failure to take these facts into consideration may have biased retrospective methods towards underestimating the length and severity of an episode of PTA. Also, the retrospective method relies on retrospective memory, one's memory for past events, which is not very reliable in healthy individuals, and even less so in patients who have recently experienced a traumatic brain injury (TBI). Patients may also unconsciously or consciously bias their answers because they want to appear more healthy or more ill than they truly were, or because of poor insight. The retrospective method is also flawed because there is no standard measurement procedure. Although the retrospective method may provide useful subjective data, it is not a useful tool for measurement or categorization.
Sigmund Freud has footnoted the possibility that this fear may be derived from a lack of ingenuity allowing one to ornamentally distance the copulatory organs from the excretory organs. Such a condition can affect both men and women. For others, symptoms include what characterizes a panic attack. It does not necessarily have to be induced by an uncovered penis, but may also result from seeing the manbulging outline or curvature of the penis, perhaps through clothes consisting of thin fabric. In more extreme cases it has been likened to the fight or flight response ingrained within the human body wherein an individual ceases to be intimate with their male partner and is unable to visit mixed gender establishments where people are likely to wear more revealing clothing, such as a gym, beach, cinema or livingrooms with a switched on monitor. The fear can recur through any of the senses including accidental touch, sight, hearing the word penis or thinking about an erection. The phobia may have developed from a condition such as dyspareunia, a trauma (usually sexual) that occurred during childhood, but can also have a fortuitous origin. In literature covering human sexuality, it is used as an adjective only to negatively allude to penetrative sex acts. Men who have the phobia may try to avoid wearing jeans and other light fabrics, especially in public. Some analysts have purported that the condition may be inherited or may be a combination of genetic inheritance and life experiences. For men with the condition, one of the byproducts is difficulty consummating with a partner due to a sense of vulnerability. This vulnerability may have developed during childhood because they grew up being told by their parents that sex and its physiological functions were evil, sinful and dirty, but were subsequently unable to detach such shameful feelings nor reverse it upon reaching adulthood, even when romantic initiatives were subsequently approved of or encouraged by their parents.
Although the GOAT has proved useful in acute care, recent research has called attention to some of its drawbacks. The GOAT's assessment of orientation may put too much of a focus on memory as the main mechanism behind orientation. The range of cognitive and behavioral symptoms associated with PTA seems to indicate that the patient's disorientation is more than just a memory deficit. Consequently, it may be beneficial to incorporate tests of other cognitive functions, such as attention, which relate to both memory and orientation.
Another recent study compared the success of the GOAT and the Orientation Log (O-Log) in predicting rehabilitation outcomes, and found that, while the O-Log and the GOAT perform similarly as measures of PTA severity and duration, the O-Log provides a more accurate picture of rehabilitation.
While the GOAT is a useful tool, these results suggest that using alternative methods of assessing PTA may increase the amount of information available to physicians and may help in predicting rehabilitative success. The international cognitive (INCOG) expert panel has recommended the use of a validated PTA scale such as the GOAT or WPTAS for assessing PTA duration in patients with moderate-to-severe traumatic brain injury on a daily basis.
Phallophobia in its narrower sense is a fear of the erect penis and in a broader sense an excessive aversion to masculinity.
Many normed assessments can be used in evaluating skills in the primary academic domains: reading, including word recognition, fluency, and comprehension; mathematics, including computation and problem solving; and written expression, including handwriting, spelling and composition.
The most commonly used comprehensive achievement tests include the Woodcock-Johnson IV (WJ IV), Wechsler Individual Achievement Test II (WIAT II), the Wide Range Achievement Test III (WRAT III), and the Stanford Achievement Test–10th edition. These tests include measures of many academic domains that are reliable in identifying areas of difficulty.
In the reading domain, there are also specialized tests that can be used to obtain details about specific reading deficits. Assessments that measure multiple domains of reading include Gray's Diagnostic Reading Tests–2nd edition (GDRT II) and the Stanford Diagnostic Reading Assessment. Assessments that measure reading subskills include the Gray Oral Reading Test IV – Fourth Edition (GORT IV), Gray Silent Reading Test, Comprehensive Test of Phonological Processing (CTOPP), Tests of Oral Reading and Comprehension Skills (TORCS), Test of Reading Comprehension 3 (TORC-3), Test of Word Reading Efficiency (TOWRE), and the Test of Reading Fluency. A more comprehensive list of reading assessments may be obtained from the Southwest Educational Development Laboratory.
The purpose of assessment is to determine what is needed for intervention, which also requires consideration of contextual variables and whether there are comorbid disorders that must also be identified and treated, such as behavioral issues or language delays. These contextual variables are often assessed using parent and teacher questionnaire forms that rate the students' behaviors and compares them to standardized norms.
However, caution should be made when suspecting the person with a learning disability may also have dementia, especially as people with Down's syndrome may have the neuroanatomical profile but not the associated clinical signs and symptoms. Examination can be carried out of executive functioning as well as social and cognitive abilities but may need adaptation of standardized tests to take account of special needs.
Epidemiological surveys, in the US and Canada, estimated the prevalence of SLI in 5-year-olds at around 7 percent. However, neither study adopted the stringent 'discrepancy' criteria of the Diagnostic and Statistical Manual of Mental Disorders or ICD-10; SLI was diagnosed if the child scored below cut-off on standardized language tests, but had a nonverbal IQ of 90 or above and no other exclusionary criteria.
As autotopagnosia is not a life-threatening condition it is not on the forefront of medical research. Rather, more research is conducted regarding treatments and therapies to alleviate the lesions and traumas that can cause autotopagnosia. Of all the agnosias, visual agnosia is the most common subject of investigation because it is easiest to assess and has the most promise for potential treatments. Most autotopagnosia studies are centered on a few test subjects as part of a group of unaffected or “controlled” participants, or a simple case study. Case studies surrounding a single patient are most common due to the vague nature of the disease.