Semantic interference on a phonological task in illiterate subjects

Identifying Appropriate Neuropsychological Tests for Uneducated/Illiterate Older Individuals

OBJECTIVES

We investigated the utility of traditional neuropsychological tests in older uneducated/illiterate individuals without dementia to determine the possibility that they are likely not appropriate for this group.

METHODS

We assessed the neuropsychological performance of 1122 older adults [≥65 years old; mean age: 74.03 (SD = 5.46); mean education: 4.76 (SD = 2.5) years; women: n = 714], in the context of the Hellenic Longitudinal Investigation of Aging and Diet (HELIAD), a population-based study conducted in Greece.

RESULTS

We based our analyses on three groups: high-functioning/cognitively healthy (i.e., without dementia) uneducated/illiterate individuals (n = 80), high-functioning/cognitively healthy educated/literate individuals (n = 932), and low-functioning/cognitively impaired educated/literate individuals (presumably with dementia; n = 110). We used binary regression analyses with Bonferroni correction to investigate whether test performance differentiated uneducated/illiterate from educated/literate individuals. Models were adjusted for age and sex; raw test scores were the predictor variables. The uneducated/illiterate cohort was at a disadvantage relative to the healthy educated/literate group on all variables but verbal memory recognition and consolidation, congruent motor responses, and phonological fluency clustering (p > .002). Moreover, only word list learning immediate and delayed free recall and delayed cued recall differentiated the high-functioning/cognitively healthy uneducated/illiterate from the low-functioning/cognitively impaired educated/literate group, favoring the former (p's < .002).

CONCLUSIONS

Our findings suggest that only particular verbal memory test variables are fair in determining whether older uneducated/illiterate individuals have functional/cognitive impairment suggestive of a neurodegenerative process. On all other neuropsychological variables, this cohort was at a disadvantage. Therefore, we highlight the need for identifying appropriate methods of assessment for older uneducated/illiterate individuals.

Literacy versus formal schooling: influence on working memory

Previous work has demonstrated that illiterate individuals exhibit reduced performance on measures of working memory, relative to a literate cohort. Given the relationship of working memory to phonological processing, which is enhanced by literacy, we sought to examine working memory in illiterate individuals and whether differences can be attributed to artifacts of the test typically used. To the extent that differences actually exist, we also examined whether they can be attributed to the effects of literacy per se or whether they reflect the effects of formal schooling. To accomplish this, we explored the performance of four groups of participants (illiterate, functionally illiterate, self-educated literate, school-educated literate), on five tests of working memory. Illiterate groups performed more poorly than the literate groups on all measures except the "Spatial Span" forward condition and "Remembering a New Route." Our results suggest that differences in working memory performance among literate and illiterate individuals can be attributed to literacy per se. Formal schooling, however, appears to enhance working memory skills. Finally, we stress the need to use tools that are not influenced by literacy and schooling effects in the clinical assessment of illiterate individuals.

Linguistic and cognitive skills in readers and nonreaders

BACKGROUND

investigation of linguistic and cognitive skills in readers and nonreaders.

AIM

to evaluate the performance of readers and nonreaders in tasks related to several linguistic and cognitive skills and to determine the implication of the results to the clinical practice and to eduaction.

METHOD

participants of the study were 35 children in the process of alphabetization. The children were given tasks designed to assess their cognitive and linguistic abilities. The group of nonreaders was composed by 20 children who did not read any of the words presented on a list of 24 items. The group of readers included 15 children who read nearly every word presented on the same list.

RESULTS

the group of readers presented a better performance on the following tasks: language development assessment; alphanumeric rapid automatized naming and working memory. There was a great variability in the performance of readers and nonreaders in the phonological awareness tasks. For the group of readers, syllabic judgment and segmentation tasks were considered easy or very easy; syllabic transposition and phonemic subtraction presented medium difficulty and phoneme identification was considered a difficult task. For the group of nonreaders, syllabic segmentation was considered an easy task; syllabic judgment presented medium difficulty, and syllabic transposition, phonemic subtraction and phoneme identification were considered very difficult.

CONCLUSION

the experience with reading influences the performance of children in linguistic and cognitive tasks. The performance of readers and nonreaders in the phonological awareness assessments indicates the importance of taking into account not only the required level of linguistic segmentation but also the cognitive level required by the nature of the task.