Oral fluency and narrative production in children with Turner's syndrome.

Despite good verbal skills, children with Turner's syndrome (TS) have been found to perform poorly on oral fluency tasks. Explanations for this impairment were explored in a study of 9-12-year-old children with TS. The children with TS were found, as expected, to have impaired levels of retrieval on initial letter fluency tasks, in comparison to their peers. Children with TS were also found to have receptive vocabularies which were significantly better than controls, indicating that the weak performance on oral fluency cannot be attributed to lower vocabulary levels. Naming skills were normal for children with TS, indicating that oral fluency scores cannot be attributed to generalised problems with lexical access. Analysis of the content of fluency performance indicated clusters of words within sub-categories which were of normal size but there were fewer switches between clusters than for controls and fewer returns to previously successful clusters. Additionally, a significantly larger proportion of the words generated were of low frequency (e.g. Assyrian, antediluvian) and the children with TS did not thereby show a normal frequency effect in word retrieval. One explanation is that these reflect abnormal action of executive language retrieval processes. Within narrative production, picture description was normal. However, in relation to narrative tasks, hypothesised to place greater executive demands, there was impairment which was significantly greater for narratives of yesterday than narratives of organising a party. This impairment within the narrative generation tasks could be attributable to a selective impairment within executive retrieval skills, or could represent an impairment in episodic memory or the executive processes involved in its retrieval.