Table 1 summarises a series of cases of exceptional language development appeared
in the literature.
The conclusion to the above studies is straightforward. Formal language problems
are not inherent in MR/Down syndrome (DS) qua MR/DS. I suggest that the problems
of MR/DS persons in the semantic aspects of language, on the one hand, and in the
phonological and morphosyntactic aspects, on the other, do not have the same roots.
The semantic problems of MR/DS subjects with language originate in their cognitive
difficulties. These problems are unavoidable given that major cognitive limitations
define the MR condition. On the contrary, the difficulties of typical MR/DS subjects
with the formal aspects of language (at least the advanced ones) do not originate
in general cognition, as demonstrated by the exceptional cases. My opinion is that
they result from specific impairments in language organisation. This runs contrary
to the view that all language difficulties in MR are a direct consequence of their
cognitive deficit.
I will undertake this risky exercise relying particularly on the Françoise case,
because this is the case for which I have the most complete record. I will quote
from other exceptional cases whenever relevant information is available. Four explanatory
possibilities will be examined. They are listed in Table 4.
Table 4. Explanatory factors for the MR/DS exceptional language cases.
- Particular educational factors: no
- Left-hemispheric cerebral dominance: probably necessary.
- Cognitive functioning (general): no
- Working memory (phonological loop): possible contributing role.
- Brain architectural characteristics: likely
2.1 Particular educational factors (unusual language training procedures by parents,
educators, teachers, etc.).
Could such influences have determined the state of affairs exemplified in the MR/DS
exceptional language cases? The answer is 'no'. I am not implying that a
good quality language input is not of utility in language acquisition (see Rondal, 1985, for a favourable outcome). However,
there is no indication in the cases reviewed that a particular remedial procedure
was responsible for the advanced abilities. Additionally, educational intervention
is not known to be particularly effective in compensating for the difficulties of
typical MR/DS children with the phonological and morphosyntactic dimensions of language.
Moreover, parent-child verbal interactions with MR/DS children have been proven
to be basically normal (Rondal,
1978), when by 'normal' it is meant the type of linguistic input
and feedback received by NR children at corresponding language levels. Maternal
speech addressed to MR/DS language-learning children is adapted to the children's
language levels in the same ways (i.e., prosody, articulation, lexicon, semantic
structures and contents, morphosyntax, and pragmatics) and to the same extent as
mothers' speech to NR children with similar linguistic levels. If adaptations
of that sort were the key factor in determining exceptional language abilities in
MR/DS subjects, one should observe many more such cases.
2.2 Cerebral hemispheric specialisation for language functions
Dichotic-listening studies have reported a left ear/right hemisphere advantage for
speech sound reception in DS individuals (not found in control groups of NR subjects
and MR subjects of other etiologies). DS subjects, however, exhibit the expected
right ear/left-hemisphere superiority in speech production.
Elliott, Weeks, and Elliott (1987) have suggested that the language problems
of DS persons may be related to a dissociation between the cerebral areas responsible
for speech perception and production causing difficulties of communication between
organic systems that normally overlap, and leaving speech reception in control of
the right hemisphere that may not be best equipped to handle this function.
The MR language exceptional subjects for whom relevant data are available (i.e.,
Françoise, and Curtiss and Yamada's Laura - see Table 1,
case no. 2, are both left-hemisphere dominant for language functions (receptive
as well as expressive). I have reported (Rondal,
1995) corresponding data for 24 DS adults with typical language abilities
for DS (15 males and 9 females, aged 21 to 36 years) in a dichotic-listening study
(10 males were right-handed; 5 left-handed; the females were all right-handed) and
19 of the same DS adult subjects (all right-handed) in a dual-task study. A large
number of these subjects demonstrated interference between verbalisation and right-hand
movements compatible with the hypothesis of a left-hemisphere dominance for speech
production. In the dichotic-listening task, three females exhibited a right-ear
advantage - from 30 to 70% - (suggesting left-hemisphere dominance). Six males exhibited
a right-ear advantage (from 10 to 63%). Retaining those individuals for whom the
right-ear advantage was equal to or in excess of 50%, one had two female and one
male individuals. These three subjects all demonstrated a positive relative amount
of interference in the dual task (suggesting left-hemisphere dominance for speech
production). They could be considered homogeneous as to cerebral hemispheric dominance
for the speech functions. This is also the case for Françoise (Table
2). However, the language abilities of the above three DS adults were only
average for DS persons. Left-hemisphere dominance may be a necessary condition for
advanced language development, (outside of early focal brain lesions determining
a transfer of the language control to the right hemisphere at little or no functional
cost (Eisele, 1991); a situation
that theoretically does not concern MR/DS individuals as they are not supposed to
present focal brain lesions as a result of their condition). Obviously, however,
left-hemisphere dominance cannot be a sufficient condition for exceptional language
development in MR/DS people.
2.3 Non-linguistic cognitive factors?
Most MR language-exceptional individuals studied have mental ages (MA) around 5
years. It could be argued that they are 'simply' demonstrating language
abilities corresponding to their cognitive level (Moerk,
1994; Bates, 1997, in press).
Elizabeth Bates maintains that basic grammatical development is complete by 4-5
years of age (or even before) in NR children. She states (Bates, in press): 'The
amount and type of cognition required to learn a grammar cannot be more than the
amount and type of cognition that is available to healthy normal children between
1.5 and 3 years of age, for that is the period in which the bulk of grammatical
development takes place' (p. 3). From such a standpoint, one should expect MR/DS
individuals with MAs of 4 or 5 years to exhibit well-developed formal language abilities.
If general cognition at 4-5 years-MA were a sufficient condition for explaining
advanced formal language abilities, typical MR/DS subjects with such MAs (and there
are many) should similarly exhibit well-developed morphosyntactic skills. Unfortunately
for them and for the above claim, typical MR/DS individuals as a rule remain much
below complete grammatical development during their whole lives, despite often receiving
systematic and longstanding language intervention.
Alternatively, if one does not accept the idea that grammatical development is complete
by 4-5 years of age but insists instead that it goes on until 9-10 years for some
complex syntactic structures, then the levels reached by the exceptional MR/DS individuals
become impossible to explain in relying solely on general cognitive variables. Indeed,
these individuals exhibit grammatical levels much beyond what would be considered
normal development around 4-5 years MA in this alternative hypothesis. The general
cognition hypothesis is contradicted by the data either from the typical MR/DS subjects
or from the language-exceptional MR/DS individuals, depending on how one wants to
set the timing for completion of grammatical development in NR children. In my opinion,
the language-exceptional MR/DS individuals have more to rely on than a cognitive
level of 4-5 years MA. They have at their disposal a language specific ability (grammatical)
that has been spared in spite of their pathology. This ability is also available
to young NR children (around 20-24 months) when they start developing grammar. It
is largely lacking in typical MR/DS individuals.
Bates (in press) states 'In order to prove that cognitive abilities are unnecessary
for language, - [my note: it would be better to speak of grammar or even more narrowly
of morphosyntax rather than of language, for there are reasons to believe that cognition
is necessary for the conceptual aspects of language in order to develop and function;
and I do not believe that this point is controversial] - we would have to find a
case in which grammar is acquired in the absence of the specific cognitive abilities
that two-year olds have at their disposal during the language learning process (p.3)'.
It is true that such a demonstration has not been provided. The reverse situation
is currently observed, however. All typical moderately and severely MR individuals
reach and go beyond 2 years MA, but, as said, they fall short of developing full
grammar. Early cognitive development may supply the necessary basis for grammatical
development, but it cannot be a sufficient condition. Needed too is a specific device
responsible for the grammatical operations.
The grammatical ability referred to does not have to be innate in the representational
sense out of any logical or biological necessity. As will be discussed later in
the paper, it does imply, however, the existence of innate architectural constraints
(to employ
Elman et al.'s, terminology, 1996), i.e., the innate organisation of
the processing system that must deal with linguistic, and particularly grammatical,
representations.
Karmiloff-Smith et al. (1995) suggest that there are domain specific predispositions
for analysing language stimuli which with language experience, become increasingly
specialised and interconnected. As normal development proceeds, a process of 'modularization'
(p. 23) gives rise to a modular-like organisation (weaker than the Fodorian view
of modules - Fodor, 1983). These types of modules
can be said to be more made than born (Bates
et al., 1988). But, judging from the vantage point of the MR literature,
fully efficient language modularization, to continue with Karmiloff-Smith's
terminology, does not occur in typical MR/DS subjects despite some cognitive, lexical,
and pragmatic acquisitions. This again suggests that something else is needed to
bring about the modularization process that may be characteristic of advanced language
development and functioning.
As suggested, early cognitive functioning is relevant for early morphosyntactic
development. Supportive evidence can be found in several exceptional MR/DS cases.
Françoise as well as Chritopher,
O'Connor and Hermelin's subject, and FF,
Vallar and Papagno's subject - i.e., those language exceptional
individuals for whom we have developmental histories - were markedly delayed in
language, onset. Françoise was producing only one word (/to/ for couteau, i.e.,
in French) at 4 years CA, even worse than many typical DS children. She developed
her formal language abilities between approximately 5 and 10 years. WS children
are severely delayed in early language development. It is only as adolescents that
they exhibit the advanced formal abilities documented (Singer
et al., in press). Bates (in press)
suggests that it is only when they have a vocabulary size and general cognitive
level comparable to those of NR two-years olds that the grammar of the WS individuals
'gets off the ground'. The above observations suggest that a cognitive-semantic
basis amounting to what is known by the moderately and severely MR child around
5 years-CA and to the NR child around 20-24 months is needed for the grammatical
component to start working when such a component is indeed available.
2.4. What about working memory (Baddeley,
1990) in relation with exceptional language development in MR/DS individuals?
Françoise, Claudine, as well as Vallar and Papagno's FF, have an auditory-verbal
short-term memory (AV-STM) span of 4 or more (FF, in particular). The AV-STM spans
of typical DS persons do not exceed 3 or 4 units. They are impaired in the functioning
in the phonological loop of their working memory system (Jarrold & Baddeley, 1997).
They also exhibit very limited to non-existent private speech and rehearsal abilities
(Comblain, 1996). Françoise,
Claudine, and FF's AV-STM spans certainly were lower at the time of their language
development than recent estimates. As said, Françoise developed her particular language
abilities between 5 and 10 years CA. In NR children, immediate verbal memory span
increases from a mode of 4 items around 5 years CA to 5 items around 7 years, and
5.5 items around 10 years (Mackenzie
& Hulme, 1987). In MR/DS children, Mackenzie and Hulme (1987) observed
little increase in digit span over a 5-year period in their DS group (from about
3 items at 11 years CA to 3.5 items at 16 years) as well as in a group of moderately
and severely MR children of other etiologies (from about 3.5 items at 11 years CA
to 4 items at 16 years). Vallar and Papagno (1993) proposed that FF's better
AV-STM (i.e., 5.75 items) explains her better formal language abilities. Such a
strong suggestion is not convincing. However, a positive contribution of AV-STM,
due to a better functioning of the phonological loop of the AV-STM system, cannot
be ruled out in MR/DS language-exceptional subjects. Françoise, Claudine, as well
as FF, exhibit normal-like processes of working memory when recalling verbal material
(e.g., word-length, phonological similarity, and Brown-Peterson effects). They rely
on rehearsal strategies based on semi-private speech. Their speech rate is normal
or close to normal in contrast to that of typical DS subjects (Rondal,
1995). This is an important indication as Baddeley
(1990) specifies the content of the phonological loop of working memory as 'the
number of items of whatever length that can be uttered in about two seconds'
( p.74).
Correlative data published by Gathercole and associates (e.g.,Gathercole, 1995;
Gathercole & Baddeley, 1993;
Gathercole, Willis, Emslie, & Baddeley, 1992) suggest that phonological
short-term memory may contribute to word learning during normal development at least
until approximately 4 years. By that age, other factors such as the way in which
lexical items are integrated into the existing lexicon and the way the lexicon is
organised, may exert more of an effect than in earlier stages of word learning.
But no model has been proposed specifying exactly how, when, and to what extent,
the phonological loop mediates early lexical or morphosyntactic development.
Grant et al. (in press) attribute the advanced levels of expressive and
receptive vocabulary documented in a group of 17 individuals with WS (aged 8 to
35 years) to their relatively preserved phonological short-term memory. For these
subjects, however, as well as for the language-exceptional MR/DS mentioned above,
and even for the NR subjects of Gathercole and associates, the direction of causality
could be the reverse, i.e., better lexical abilities gradually permitting enhanced
short-term memory functioning; an alternative hypothesis that has not received sufficient
attention in the working memory literature.
Let us consider the Françoise case again to pursue the discussion and set neat limitations
on the possible contribution of AV-STM to exceptional formal language development
in MR/DS subjects. As said, Françoise's STM span is 4. Her sentence span is
14 words. At times, she can repeat correctly sentences containing up to 20 words.
This is normal functioning according to data reported by
Butterworth, Campbell, and Howard (1986). Françoise made few word order
errors on sentences containing more than 14 words. Most of her errors were omissions
and trivial word substitutions. So were also the typical errors of Butterworth et
al's university students when requested to recall sentences 15-20 words long.
Françoise's immediate recall performance is in sharp contrast with that of typical
DS subjects (Rondal, 1995).
The latter individuals cannot repeat correctly sentences containing more than 7
or 8 words at best. They frequently omit major sentence constituents. Additionally,
Françoise had no difficulty in correctly interpreting (center-) embedded subject
and object relatives when the relative pronouns and their co-referring nouns were
separated by several words. Neither did she experience particular problems when
requested to establish pronominal co-reference across sentences in paragraphs with
pronouns and co-referring nouns separated by up to eight words. It seems reasonable
to conclude that the contribution of Françoise's immediate phonological memory
to sentence production and comprehension is sharply limited.
2.5. Variation at brain level
My guess is that the major determinant of the impressive morphosyntactic and phonological
differences observed between typical and exceptional MR/DS subjects operates at
brain level. The macroscopic brain structures devoted to the formal aspects of language
(as opposed to the more semantic ones) are probably spared to a large extent in
those MR/DS individuals with exceptional language abilities. They are damaged and
only poorly operational in regular MR/DS subjects. I will suggest a likely reason
for this state of affairs later in the paper. But let me first consider and reject
an alternative explanatory hypothesis. It can be formulated as follows. Suppose
one assumes something like representational nativism to be true, he could argue
that what is spared in the language-exceptional MR/DS cases is not so much the devoted
brain structures than (unconscious) linguistic notions ascribable to innate properties
of the human mind. One would then be led to suggest that the basic language differences
between exceptional and regular MR/DS subjects lie at the level of the micro-circuitry
of the brain. This is at that level that nativists (e.g., Pinker, 1994) tend to locate innate representational
language knowledge.
Such an hypothesis must be rejected for the following reasons. First, representational
nativism can be challenged on logical and neurobiological grounds (see
Elman et al., 1997, for a detailed exposition). It is becoming clearer that
linguistic representations are constructed on the basis of children's experiences
with language.
Bates et al. (1996) agree that synaptic connections are the likely depository
structures for linguistic representations because that is the only brain level with
the coding power for higher-order cognitive outcomes. The difference between this
view and representational nativism is that the devoted synaptic connections here
are viewed as modifiable and actually modified by linguistic experience. Second,
there is no reason to believe that language exceptional and typical MR/DS subjects
differ at the level of synaptic connectivity as a result of genetic differences.
And, third, if it were the case exceptional language cases could be found only in
genetic syndromes (which does not happen - see Table 1).
As suggested, language-exceptional MR/DS individuals enjoy preserved brain macro-structures
devoted to the treatment of formal aspects of language. This suggestion may be related
to
Elman et al.'s (1996) concept of architectural constraints at the brain
level. This notion refers to the innate structuring of the brain information-processing
system devoted to the acquisition and use of linguistic representations. As
Bates et al. (1996) state 'In neural networks, some forms of knowledge
can only be realised or acquired in a system with the right structure (the right
number of units, number of layers, types of connectivity between layers, etc.)'(p.
3). Specifying further the architectural constraints in real brains,
Elman et al. (1996) distinguish three sub-levels; the basic computing units
(neurons, neurotransmitters, etc.); the local architectures (number and thickness
of neuronal layers, density of different cell types within layers, type of neuronal
circuitry, etc.); and the global architecture (including the afferent and efferent
neural pathways).
Correctly organised brain macro-structures owe much to the interplay of what
Elman et al. (1996) label 'chronotopic constraints'. This includes
constraints on the number of cell divisions taking place in neurogenesis, relative
differences in timing between brain subsystems, differences in synaptic growth according
to brain areas and functions, etc.
My suggestion is that language-exceptional and typical MR/DS subjects markedly differ
as to the architectural and chronotopic characteristics of brain development. Results
of pathological studies of the brain of DS persons reveal major anomalies, among
which arrested maturation of neurons and synapses some time around birth, reduced
brain weight, reduced neuronal densities, decreased synaptic density and presynaptic
length, hypoplasia of the frontal lobes, narrowed superior temporal gyri, delayed
myelination of nerve fibers affecting long association and intercortical fibers
between frontal and temporal lobes, hypothalamic and hippocampal abnormalities,
and diminished size of brain stem and cerebellum have been reported (Wisnieswky, Kida, &
Brown, 1996; Nadel, 1996).
To date there have been few functional studies of brain function in DS individuals.
Devinsky et
al. (1990) reported normal EEG activity in young DS adults, but
McAlaster (1992) reported abnormal development of EEG profiles in DS
subjects.
Horwitz et al. (1990)'s PET (positron emission tomography) scan study
of cerebral metabolic patterns in young DS adult subjects reveal smaller correlations
for region-pairs within and between frontal and parietal lobes. One brain region
particularly affected is the inferior frontal gyrus including Broca's area.
The thalamus shows smaller correlations with the temporal regions in the DS group
compared to controls. Shapiro,
Haxby, and Grady (1992), also using PET scan, report a corresponding disruption
of neuronal interactions between frontal and parietal lobes, possibly including
Broca's area.
Bates et al. (1996) suggest that left-hemisphere specialisation for language
in humans depends on the architectural constraints specified above. They further
claim that studies of infants with focal brain injury demonstrate that the temporal
(but not the frontal) region of the left hemisphere is specialised at birth. Later
in life, the temporal and the frontal regions of the left hemisphere play a major
role in language production and comprehension in the great majority of NR persons
(a small percentage of NR adults exhibit a right-hemisphere dominance or a mixed
specialisation for the language functions).
The particular brain areas responsible for the expressive and receptive treatment
of the formal language aspects in normal adults are becoming better known. According
to Damasio and Damasio (1989,
1992), they involve the posterior perisylvian sector of the left-cerebral hemisphere,
including the basal ganglia, with respect to the processing of speech sounds, phoneme
assembly into words, and selection of word forms; the anterior perisylvian sector
of the left hemisphere, including the basal ganglia, with respect to receptive and
expressive morphosyntax.
Stowe et al.'s (1994) review of PET scan studies points to the involvement
of the left-cerebral hemisphere extrastriate cortex and superior temporal cortex
in lexical access; Brodmann's areas 41, 42, and mid-Brodmann's 22, in phonological
processing; the superior temporal cortex in syntactic processing; and the inferior
frontal gyrus, the mid and inferior temporal gyri, Brodmann's area 8, and the
temporal poles, in discourse comprehension.
It is reasonable to assume that the brain problems typical of DS individuals seriously
undermine the development and functioning of the language brain structures. Particularly
detrimental is probably the slowing down of synaptic growth around birth (Nadel, 1986). The consequence is that typical
DS subjects do not develop the necessary brain architecture for accommodating language
stimuli in such a way as to build grammatical knowledge. It is likely also that
the plasticity which characterises normal brain development allowing functional
reorganisation in case of early focal brain injury - is not open to DS infants for
reasons of their genetic pathology and the sharp restrictions that it imposes on
brain genesis and epigenesis.
The language-exceptional DS subjects escape the above fate for reasons that may
be related to the phenotypic effects of genetic variation in this syndrome. The
same suggestion is valid for other genetic syndromes as well. Geneticists agree
that there is substantial variation at the genetic level between people within genotypic
categories such DS, WS, Fragile-X syndrome (FXS), and other genetic causes of mental
retardation (Dykens, 1995).
Most genetic influences on phenotypes are not discrete and the inheritance patterns
may be a blend between single gene and polygenic influences (Smith, Pennington,
& DeFries, 1996). Complex traits show a quantitative variation in their presentation.
The major sources of variation number four. There may be, first, a single major
gene involved in a trait and it may show variable penetrance. Penetrance is defined
by the proportion of individuals with the susceptible gene(s) having a given disorder.
Second, there may be variable expression of a single major gene or of a number of
genes involved, due to the modifying influences of other genes or environmental
factors, leading to differences in phenotypes., a major gene may have many possible
mutations (alleles) that may also have different phenotypes. And, fourth, imprinting
effects, i.e., variability of gene expression associated with the parental origin
of the excess genetic material.
Genetic research is yielding more precise gene identification and phenotypic mapping
of chromosome 21, the chromosome involved in Trisomy 21 (T21).
Korenberg et al. (1994) suggest that DS is a contiguous gene syndrome. This
augurs against a single DS chromosomal region responsible for most of the DS phenotypic
features. DS and its phenotypes are accurately thought of as the result of the over-expression
and subsequent interactions of a subset of the estimated 1,000 to 1,700 genes located
on chromosome 21. Korenberg et al. (1994) have constructed a phenotypic map including
25 features considered typical of DS. They assign a region of 2-20 mega-bases between
regions p11.2 and 22.3 on the distal part of the long arm of chromosome 21, as likely
to contain the genes responsible for the DS phenotypes. This conception of the genotype-phenotype
relationship in DS is consistent with central characteristics of T21, such as the
rich variety of phenotypes and the variability in both penetrance and expression
of the phenotypic features. It is conceivable that an important inter-individual
variation exists at brain level in the language areas (as well as in other areas)
of DS persons, consequent on genetic variations. One may imagine a sort of Gaussian
curve of formal language abilities in DS people, or better several Gaussian curves,
one for each formal dimension. The exceptional cases documented (and others to come
may be) would occupy the extreme right portion of such distributions of formal language
abilities.
3. The brain-genes perspective defined above has the advantage of proposing one
single explanation for the range of variations observed in the language of typical
MR/DS people and the extremes of such variations in the language-exceptional cases.
It may also be applied to behavioural and brain differences across syndromes such
as Down syndrome, Williams syndrome, and Fragile-X syndrome; a large number of other
genetic syndrome awaiting systematic phenotypical studies (Dykens, 1995).
Rondal and Edwards (1997) have reviewed a number of research works on
the language abilities of WS and FXS individuals. When the results of these studies
are compared with each other and with what is known of the language of typical DS
subjects, a feature distribution like the one illustrated in Table 5 is revealed.
Table 5. Three MR language syndromic profiles
|
|
Syndromes
|
|
Language aspect
|
Down
|
Williams
|
Fragile-X
(affected males)
|
|
Phonetico-phonological
|
- -
|
+
|
- -
|
|
Lexical
|
-
|
++
|
+
|
|
Thematic semantic
|
+
|
+
|
?
|
|
Morphosyntactic
|
- -
|
|
-
|
|
Pragmatic
|
+
|
- -
|
-
|
|
Discursive
|
- -
|
+
|
-
|
Key.
+(+): relative strength
-(-) : relative weakness
? : insufficient data available
|
WS is a multisystem developmental disorder caused by the deletion of contiguous
genes at locus 7q11.23. Hemizygosity of the elastin (ELN) gene accounts for the
vascular and connective tissue abnormalities observed in WS patients. However, the
genes that contribute to other features of the syndrome, such as infantile hypercalcemia,
dysmorphic facies, and cognitive defects (between mild and moderate mental retardation)
remain to be identified. FXS is an X-linked disorder passed on through generations.
It is caused by a null mutation at the FMR-1 gene in which the levels of protein
in mRNA (messenger ribonucleic acid) are greatly reduced. At the DNA (desoxyribonucleic
acid) level, it is characterised by abnormal repetitions of a trinucleotide sequence
(either cytosine-cytosine-guanine or cytosine-guanine-guanine). Most males with
FXS are moderately to severely mentally retarded. One fifth (considered to be nonpenetrant)
are of average intelligence. Approximately, one third of the FXS females are affected
with a phenotypic variant of the syndrome. They exhibit learning difficulties. Some
are impaired with mild to moderate MR. The rest of the carrier females are unaffected.
Yet they may transmit the disorder to their children. Surveys of MR populations
(Webb et al.,
1986) suggest that FXS accounts for 2 to 7 percent of MR among males. FXS' prevalence
in the general population is between 0.73 and 0.72 per 1000 males.
Pioneering work by Bellugi and associates at the Salk Institute for Biological Studies
suggest that functional differences between WS and DS individuals correspond to
(and are probably caused by) syndromic variation at brain level.
Bellugi et al. (1990) compared the neurological profiles of WS and DS adolescents
matched for CA and IQ. The WS subjects demonstrated generalized hypotonia, tremor,
midline balance problems and oral-motor and motoric abnormalities, suggestive of
cerebellar dysfunction. DS adolescents showed minimal hypotonia, little evidence
of cerebellar signs, and better performance on oromotor functions. Both groups exhibited
equal degrees of microcephaly, cerebral hypoplasia, reduced cerebral volume, and
decreased myelination; but overall brain shapes of each group proved distinct. DS
brains exhibit important degrees of hypofrontality whereas WS individuals have decreased
posterior width with reduction in size of the forebrain posterior to the rolandic
sulcus, i.e., the parietal, posterior temporal, and occipital cortical regions,
and narrowing of the corpus callosum anterior to the splenium. WS individuals show
elongated posterior to anterior length compared to normal brains. Hypofrontality
of neocortex in DS subjects together with reduction in frontal lobe projections
from the corpus callosum was further demonstrated in a magnetic resonance imagery
study by Wanet al. (1992). These authors relate this neuroanatomical indication
to a profile of frontal lobe dysfunction in DS corresponding to poor verbal fluency,
perseverative tendencies, and greater difficulty on tasks requiring flexible problem-solving
strategies. DS subjects, however, seem to have relatively preserved basal ganglia
and diencephalic structures. In contrast, WS subjects have better frontal and temporal
limbic structures (Jernigan
et al, (1993).There is also evidence in WS of a dysregulation of the control
of neuronal and glial numbers, as illustrated by increased cell packing density
at the cytoarchitectonic level (Galaburda
et al., 1994). This may reflect an interference with naturally occurring
cell death and the presence of neurotrophic factors (possibly linked to abnormal
extracellular calcium levels).
The cerebellar volume in DS subjects is approximately 77 per cent of the equivalent
volume in young normal controls, versus 99 per cent in WS subjects. Although cerebellar
size is intact and neocerebellum largely preserved in WS (Wang, 1992), some other neurological findings
are suggestive of cerebellar dysfunction. The posterior fossa structures of the
WS and DS subjects were further examined by
Bellugi et al. (1990), leading to the identification in WS subject of an
anomalous pattern, with neocerebellar vermal lobules showing hyperplasia in the
context of low-normal paleocerebellar vermal development and significantly reduced
forebrain size. Such an aberrant cerebrum/cerebellum volume ratio could serve to
distinguish WS neurologically from other syndromes such as DS or autism (Courchesne
et al. 1988).
Bellugi et al. (1990) speculate (following suggestions by
Leiner, Leiner and Dow, 1986 on the possible role of human neocerebellar
structures in mental and linguistic functions) that the observed hyperplasia of
specific vermal lobules in the context of cerebral maldevelopment may be related
to the language profile of their WS subjects. These subjects demonstrate relatively
preserved syntax and advanced referential lexical abilities, whereas the DS subjects'
language profiles are flatter.
Bellugi et al. (1990) further remark that their WS subjects are behaviourally
grossly similar to unilateral right-hemisphere damaged (normal) adults whereas the
DS individuals are more like left-hemisphere damaged aphasics, demonstrating language
impairment and a marked tendency to a global processing of the information. This
is intriguing from a neuropsychological point of view given that in WS as well as
in DS no focal brain damage is considered to exist. The curtailment of the dorsal
parietal and posterior temporal areas of the brain in WS subjects, together with
the thinning of portions of the corpus callosum, may be directly relevant to their
visuo-spatial deficits (Galaburda
et al., 1994), and indirectly perhaps to the dissociation between auditory-verbal
and visuo-spatial short-term memory systems. WS subjects indeed have better preserved
AV- than VS-STM, whereas the converse is true for many DS subjects (Jarrold & Baddeley, 1997).
Similarly, the relatively preserved size of the frontal and most of the temporal
lobes in WS is consistent with the relative preservation of formal linguistic capacity
in many of these subjects.
According to
Galaburda et al. (1994), several features of cortical architectonic differentiation
in WS (e.g., increased cell packing density, horizontal disposition of neurons and
other anomalous layering of the cortex, excessive number of subcortical neurons,
immature vascular development, weak myelination of fibers) suggest an arrest in
neuronal development between the end of the second trimester and the second year
of life. For Down syndrome, the estimated time of marked slowing down in neuronal
development is around birth. It is tempting to speculate that the 6-month to 1-year
difference in neural epigenesis between DS and WS is in relation with the better
preservation of the formal language organisation in the latter individuals. This
may constitute an indication that brain epigenetic development during the first
six months or the first year of life significantly affects the development of dedicated
architectural structures. Pursuing careful investigations in the separation of higher
cortical functions in well-defined genetically based syndromes will shed interesting
lights on the neural systems subserving the language functions.
4. The preceding analysis encourages the belief that considerable value is to be
gained by the creation of a shared platform for a heuristic and theory-motivated
dialogue across such disciplines as genetics, linguistics, language acquisition,
language disorders, brain imaging and the cognitive sciences in general, with regard
to the genetic dysphasies, among which DS represents an important and historically
primordial category. The research logic is clear. It consists in (1) specifying
the behavioral phenotypes regarding various aspects of language; (2) determining
the specific neuroanatomy and brain functions underlying these phenotypes; and (3)
identifying the specific genotypes responsible for the individual differences and
influencing the language functions involved. A major research avenue opens leading
towards a neurobiological psycholinguistics. Progress along this path will lead
to a better understanding of the intrinsic nature of the language profiles in MR/DS
persons.
Acknowledgements:
I am grateful to Elizabeth Bates for insightful discussions and exchanges on the
theme of this paper as well as for supplying me with several papers still unpublished
or currently in press.
Correspondence
Laboratoire de Psycholinguistique, Boulevard du Rectorat, 5, B-32, 4000, Liege,
Belgium.
E-mail: ja.rondal@ulg.ac.be
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