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Shorland J, Douglas J, O'Halloran R. Insights into social communication following traumatic brain injury sustained in older adulthood. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2024; 59:449-462. [PMID: 36583452 DOI: 10.1111/1460-6984.12837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 12/02/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND There is a lack of evidence relating to cognitive-communication difficulties following traumatic brain injury (TBI) sustained in older adulthood. A prominent area in which post-TBI cognitive-communication difficulties manifest is at the level of social communication. An investigation of social communication focusing on comparison of those injured in older and younger adulthood is a practical starting point for age-related cognitive-communication outcome comparison. AIMS The overall objective of this study was to explore the social communication of individuals who sustained severe TBI in an early period of older adulthood (50-70 years) compared to younger adulthood (18-40 years), as informed by self and close other reports. METHODS & PROCEDURES This exploratory controlled group comparison study involved analysis of self-reported and close other reported La Trobe Communication Questionnaire data for 22 adults with severe TBI (11 older at injury; 11 younger at injury) and 22 control participants (11 older; 11 younger). TBI participants were matched for injury variables and participant groups were matched for sex, age and education. OUTCOMES & RESULTS The close others of the older and younger adults with TBI reported them to have significantly more frequent difficulty with social communication than the close others of age-matched control groups. Older adults with TBI reported significantly more frequent difficulty with social communication than uninjured older adults. In contrast, younger adults with TBI and uninjured younger adults reported a similar frequency of difficulty with social communication. No age-based difference in the frequency of social communication difficulty was evident when comparing the self or close other reports of older and younger adults with TBI. Awareness of social communication difficulty, as indexed by comparing self and close other perceptions, showed a different pattern across the TBI groups. The older TBI group rated themselves as having significantly less frequent social communication difficulty than was perceived by their close others. In contrast, no statistically significant difference was evident between the self and close other social communication ratings of the younger TBI group. CONCLUSIONS AND IMPLICATIONS Where possible clinicians need to work with close communication partners to understand the nature and degree of social communication difficulty following severe TBI. This may be especially important when working with people who sustain TBI in older adulthood if future research shows that this population have greater difficulty with self-awareness of social communication difficulty. WHAT THIS PAPER ADDS What is already known on the subject Cognitive-communication difficulties are a common consequence of traumatic brain injury (TBI) that can have long-term impact on everyday functioning. These challenges have primarily been investigated in individuals who sustained TBI in younger adulthood. What this paper adds to existing knowledge Individuals who sustain severe TBI in early older adulthood have a higher frequency of reported social communication difficulty to non-injured adults of a similar age, albeit they may underreport such difficulties potentially in the context of reduced self-awareness. What are the potential or actual clinical implications of this work? Social communication difficulty is an issue for people who sustain severe TBI in early older adulthood. However, a poorer overall social communication outcome in comparison to those injured in younger adulthood should not be assumed. Clinical service delivery for these challenges is most optimally delivered in a collaborative manner with the individual and their close others. Future research is required to investigate the identified trends from this study.
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Affiliation(s)
- Joanna Shorland
- Discipline of Speech Pathology, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Jacinta Douglas
- Living with Disability Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
- Summer Foundation, Melbourne, Victoria, Australia
| | - Robyn O'Halloran
- Discipline of Speech Pathology, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
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Ouerchefani R, Ouerchefani N, Ben Rejeb MR, Le Gall D. Pragmatic language comprehension: Role of theory of mind, executive functions, and the prefrontal cortex. Neuropsychologia 2024; 194:108756. [PMID: 38103682 DOI: 10.1016/j.neuropsychologia.2023.108756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 09/23/2023] [Accepted: 12/10/2023] [Indexed: 12/19/2023]
Abstract
The specific contribution of focal damage of the prefrontal cortex and the cognitive mechanisms accounting for communicative-pragmatic disorders remains unclear. The objective of the current study was to investigate the impact of focal prefrontal cortex damage on the ability to understand indirect speech or hints and to identify the prefrontal neural mechanisms involved. We also examined the underlying cognitive mechanisms of disorders of indirect speech understanding particularly theory of mind and executive functions. Thirty patients with focal prefrontal cortex damage and 30 control subjects were compared on their performances on the Hinting task assessing pragmatic language skills, the "Faux-Pas" task and the Reading the Mind in the Eyes task assessing Theory of Mind and a battery of executive tasks. Patients were significantly impaired compared with control subjects on all these abilities. Both deficits of executive functions and theory of mind were able to predict impaired ability of patients in understanding non-literal meanings on the Hinting task. Finally, using voxel-based lesion analysis we identified a partially shared neural prefrontal network involved in all these abilities centered on the dorsomedial and ventral regions of the prefrontal cortex.
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Affiliation(s)
- Riadh Ouerchefani
- University of Tunis El Manar, High Institute of Human Sciences, Department of Psychology, 26 Boulevard Darghouth Pacha, Tunis, Tunisia; Univ Angers, Université de Nantes, LPPL, SFR Confluences, F-49000 Angers, France.
| | - Naoufel Ouerchefani
- Department of Neurosurgery, Foch Hospital, 40 Rue Worth, 92151 Suresnes, Paris, France.
| | - Mohamed Riadh Ben Rejeb
- University of Tunis I, Faculty of Human and Social Science of Tunisia, Department of Psychology, Boulevard 9 Avril, C.P. 1007, Tunis, Tunisia.
| | - Didier Le Gall
- Univ Angers, Université de Nantes, LPPL, SFR Confluences, F-49000 Angers, France.
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Skromanis S, Padgett C, Matthewson M, Honan CA. Social disinhibition in acquired brain injury and neurological disease: a concept analysis. BRAIN IMPAIR 2023; 24:529-547. [PMID: 38167359 DOI: 10.1017/brimp.2022.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Social disinhibition is becoming increasingly recognised in the neuropsychological literature as a complex and debilitating sequalae associated with acquired frontal lobe damage. Despite this, the term has been inconsistently defined and described in both clinical and research contexts. The purpose of this paper was to explore and examine the concept of social disinhibition in the context of brain injury and other organic neurological conditions. METHOD A literature search for articles published in the English language from journal inception to June 2021 was conducted using MEDLINE, PsycInfo, Embase, CINAHL and Web of Science. A 'concept analysis' was conducted on the identified literature using Walker & Avant's (2019) framework. RESULTS The analysis suggested that while several terms are often used interchangeably with social disinhibition, including impulsivity and behavioural dysregulation, these terms may be differentiated and defined separately within the broader domain of 'behaviours of concern'. Attributes, antecedents and consequences of social disinhibition were also identified and discussed. CONCLUSIONS Clarifying the concept of social disinhibition has important implications in both clinical and research contexts, including increased understanding of the behaviours, more accurate estimates of incidence and prevalence, and the development and implementation of targeted rehabilitation programmes.
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Affiliation(s)
- Sarah Skromanis
- School of Psychological Sciences, University of Tasmania, Launceston, Australia
| | - Christine Padgett
- School of Psychological Sciences, University of Tasmania, Hobart, Australia
| | - Mandy Matthewson
- School of Psychological Sciences, University of Tasmania, Hobart, Australia
| | - Cynthia A Honan
- School of Psychological Sciences, University of Tasmania, Launceston, Australia
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Kong APH, Lau DKY, Lai DHY. Measuring pragmatic competence of discourse output among Chinese-speaking individuals with traumatic brain injury. BRAIN IMPAIR 2023; 24:660-678. [PMID: 38167368 DOI: 10.1017/brimp.2022.36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Discourse analysis is one of the clinical methods commonly used to assess the language ability of individuals with traumatic brain injury (TBI). However, the majority of published analytic frameworks are not geared for highlighting the pragmatic aspect of discourse deficits in acquired language disorders, except for those designed for quantifying conversational samples. This study aimed to examine how pragmatic competence is impaired and reflected in spoken monologues in Chinese speakers with TBI. METHODS Discourse samples of five tasks (personal narrative, storytelling, procedural, single- and sequential picture description) were elicited from ten TBI survivors and their controls. Each discourse sample was measured using 16 indices (e.g., number of informative words, percentage of local/global coherence errors, repeated words or phrases) that corresponded to the four Gricean maxims. Twenty-five naïve Chinese speakers were also recruited to perform perceptual rating of the quality of all 50 TBI audio files (five discourse samples per TBI participant), in terms of erroneous/inaccurate information, adequacy of amount of information given, as well as degree of organization and clarity. RESULTS The maxim of quantity best predicted TBI's pragmatic impairments. Naïve listeners' perception of pragmatics deficits correlated to measures on total and informative words, as well as number and length of terminable units. Clinically, personal narrative and storytelling tasks could better elicit violations in pragmatics. CONCLUSION Applying Gricean maxims in monologic oral narratives could capture the hallmark underlying pragmatic problems in TBI. This may help provide an additional approach of clinically assessing social communications in and subsequent management of TBI.
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Affiliation(s)
- Anthony Pak-Hin Kong
- Academic Unit of Human Communication, Development, and Information Sciences, The University of Hong Kong, Hong Kong, Hong Kong
- The Aphasia Research and Therapy (ART) Laboratory, The University of Hong Kong, Hong Kong, Hong Kong
| | - Dustin Kai-Yan Lau
- Department of Chinese and Bilingual Studies, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Daisy Ho-Ying Lai
- Department of Chinese and Bilingual Studies, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
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Büttner-Kunert J, Blöchinger S, Falkowska Z, Rieger T, Oslmeier C. Interaction of discourse processing impairments, communicative participation, and verbal executive functions in people with chronic traumatic brain injury. Front Psychol 2022; 13:892216. [PMID: 36275227 PMCID: PMC9586152 DOI: 10.3389/fpsyg.2022.892216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 08/25/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction Especially in the chronic phase, individuals with traumatic brain injury (TBI) (IwTBI) may still have impairments at the discourse level, even if these remain undetected by conventional aphasia tests. As a consequence, IwTBI may be impaired in conversational behavior and disadvantaged in their socio-communicative participation. Even though handling discourse is thought to be a basic requirement for participation and quality of life, only a handful of test procedures assessing discourse disorders have been developed so far. The MAKRO Screening is a recently developed screening tool designed to assess discourse impairments. The test construction is based on psycholinguistic frameworks and the concept of macro-rules, which refer to cognitive functions responsible for organizing and reducing complex information (e.g., propositional content) in discourse. Aim The aim of our study was to investigate discourse processing in IwTBI in different tasks and to assess problems in communicative participation in the post-acute and chronic phase. In this context, we also aimed to analyze the influence of the severity of the initial impairment and the verbal executive abilities on the discourse performance. Additionally, the impact of macrolinguistic discourse impairments and verbal fluency on perceived communicative participation was targeted in our analysis. Methods Data from 23 IwTBI (moderate to severe) and 23 healthy control subjects have been analyzed. They completed two subtests of the MAKRO screening: Text production and Inferences. Discourse performance was examined in relation to measures of semantic fluency and verbal task-switching. Socio-communicative problems were evaluated with the German version of the La Trobe Communication Questionnaire (LCQ). Results IwTBI showed lower test results than the control group in the two subtests of the MAKRO-Screening. Difficulties in picture-based narrative text production also indicated greater perceived difficulties in communicative participation (LCQ). We also found that the subject’s performance on the MAKRO-Screening subtests can partly be explained by underlying dysexecutive symptoms (in terms of verbal fluency and verbal task switching) and the severity of their injury. The preliminary results of our study show that cognitive-linguistic symptoms in IwTBI are also evident in the chronic phase. These can be detected with procedures referring to the discourse level, such as the MAKRO-Screening. The assessment of discourse performance should be an integral part in the rehabilitation of IwTBI in order to detect cognitive-linguistic communication disorders and to evaluate their impact on socio-communicative participation.
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Affiliation(s)
- Julia Büttner-Kunert
- Department of Linguistics, Project NEUROPRAG, Ludwig Maximilians University, Munich, Germany
- Department of Linguistics, Speech-Language-Therapy, Ludwig Maximilians University, Munich, Germany
- *Correspondence: Julia Büttner-Kunert,
| | - Sarah Blöchinger
- Department of Linguistics, Project NEUROPRAG, Ludwig Maximilians University, Munich, Germany
- Department of Linguistics, Speech-Language-Therapy, Ludwig Maximilians University, Munich, Germany
| | - Zofia Falkowska
- Department of Linguistics, Project NEUROPRAG, Ludwig Maximilians University, Munich, Germany
- Department of Linguistics, Speech-Language-Therapy, Ludwig Maximilians University, Munich, Germany
| | - Theresa Rieger
- Department of Linguistics, Speech-Language-Therapy, Ludwig Maximilians University, Munich, Germany
| | - Charlotte Oslmeier
- Department of Linguistics, Speech-Language-Therapy, Ludwig Maximilians University, Munich, Germany
- Speech-Language Therapy Unit, NEUROKOM, Bad Tölz, Germany
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Büttner-Kunert J, Falkowska Z, Klonowski M. The MAKRO Screening – an assessment tool for discourse deficits in adults with dysexecutive symptoms following TBI. Brain Inj 2022; 36:514-527. [DOI: 10.1080/02699052.2022.2034957] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Julia Büttner-Kunert
- Department of Linguistics and Speech-Language Therapy Ludwig Maximilians University, Munich, Germany
| | - Zofia Falkowska
- Department of Linguistics and Speech-Language Therapy Ludwig Maximilians University, Munich, Germany
| | - Madleen Klonowski
- Speech-Language Therapy Unit, Schoen Klinik München Schwabing, Munich, Germany
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Girardi G, Farnese ML, Scarponi F, De Tanti A, Bartolo M, Intiso D, Formisano R, Antonucci G. User-centered practices in the eyes of informal caregivers of in-patients with severe acquired brain injury: needs, caring experience, and satisfaction. Brain Inj 2021; 35:1402-1412. [PMID: 34487469 DOI: 10.1080/02699052.2021.1972338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE This study examines the perceived needs, experience, and satisfaction of informal caregivers (ICGs) in in-hospital settings, related to their involvement in the design and delivery of services together with hospital staff, namely co-production. DESIGN To obtain a picture of current ICG-staff relationship, a multicenter observational study was carried out. Participants were 75 ICGs recruited in five dedicated in-patient neurorehabilitation wards. Participants answered a self-report questionnaire tapping perceived information/communication needs, emotional/social needs, and their satisfaction; family-centered practices implemented by the staff (namely involving practices and cooperative communication); and ICGs' satisfaction with the service. RESULTS Need satisfaction related positively to staff practices aimed at involving IGCs in treatment and training, but not in decision-making. Involving practices concerning treatment also related positively to ICGs' information/communication needs. In addition, the more the staff involved ICGs in decision-making and promoted cooperative communication regarding treatment, the more ICGs felt that their collaboration in the healthcare process was valuable. Finally, all involvement practices and cooperative communication were positively related to ICGs' overall satisfaction with the service. CONCLUSION The results of the study help to identify gaps in meeting ICGs' needs and to promote strategies to implement family participation toward co-production in in-hospital settings.
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Affiliation(s)
- Giovanna Girardi
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | | | | | - Antonio De Tanti
- Istituto S. Stefano Riabilitazione, Centro Cardinal Ferrari, Fontanellato, PR, Italy
| | - Michelangelo Bartolo
- Neurorehabilitation Unit, Department of Rehabilitation, HABILITA Zingonia, Bergamo, Italy
| | - Domenico Intiso
- UOC di Medicina Fisica e Riabilitativa, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy
| | | | - Gabriella Antonucci
- Department of Psychology, Sapienza University of Rome, Rome, Italy.,IRCSS Santa Lucia Foundation, Rome, Italy
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Nasir H, Tan CS, Pheh KS. The Executive Skills Questionnaire-Revised: Adaptation and Psychometric Properties in the Working Context of Malaysia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18178978. [PMID: 34501571 PMCID: PMC8430784 DOI: 10.3390/ijerph18178978] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 08/08/2021] [Accepted: 08/13/2021] [Indexed: 11/16/2022]
Abstract
Executive functions (EFs) are a set of high-level cognitive and behavioral monitoring skills that are important to employees’ work performance. The 25-item Executive Skills Questionnaire-Revised (ESQ-R) measures executive dysfunction in five dimensions (e.g., emotional regulation). Nevertheless, the usability of this newly developed scale for employees remains unclear. The present study evaluated the psychometric properties of the adopted ESQ-R for working adults in Malaysia. A total of 325 employees responded to an online survey consisted of the ESQ-R, Executive Function Index (EFI), self-rated creativity scale (SRCS), and 9-item Utretch Work Engagement Scale (UWES-9) and Employee Well-being Scale. Several CFAs were conducted to compare three competing models. While all models showed a good fit, the 5-factor second-order model that is in line with the theoretical structure is preferable. The ESQ-R showed excellent internal consistency. Moreover, the ESQ-R score was negatively correlated with EFI, creativity, and UWES-9 scores, supporting the convergent, discriminant, and concurrent validity. The ESQ-R score also explained incremental variance in well-being above and beyond scores of the UWES-9 and SRCS. Taken together, the ESQ-R is a useful tool for assessing employees’ executive dysfunction and suggesting intervention programs helping employees with deficits in EFs.
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Hoepner JK, Sievert A, Guenther K. Joint Video Self-Modeling for Persons With Traumatic Brain Injury and Their Partners: A Case Series. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:863-882. [PMID: 33784468 DOI: 10.1044/2021_ajslp-20-00074] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose Individuals with traumatic brain injury (TBI) experience impairments to self-regulation and social communication that strain relationships. Video self-modeling (VSM) provides visible and audible, tangible evidence of what they do well and what could improve. Conducting such training in the context of authentic exchanges with their everyday partners may support positive change in social communication. The present investigation sought to evaluate indices of improved social communication. Method A mixed-methods design was employed for this case series investigation. Quantitative measures include pre- and postoutcomes on goal attainment scales (GASs) and measures of conversational effectiveness. Qualitative measures include responsiveness to video-supported prompts, conversational behaviors, and metacognitive statements. Results Participants perceived gains on GAS of 3-4 SDs, as well as perceived improvements on the La Trobe Communication Questionnaire. Those gains were validated by gains on the adapted Measure of Participation in Conversation and Measure of Skill in Supported Conversation. Individuals with TBI and their partners reached consensus on most goals and postintervention La Trobe Communication Questionnaire ratings. Participants made accurate judgments about their behaviors at a high rate, given video review. Conversational behaviors and use of metacognitive statements varied across participants and conversational contexts. Field notes and session transcripts provide evidence that both dyads increased internalization of VSM goals and purpose. Conclusions Joint VSM shows promise as a method for eliciting accurate self-assessments among individuals with TBI and their close partners. Both dyads perceived positive gains in interactions within and outside their dyads. Furthermore, joint VSM and GAS appear to improve self-awareness and internalization of VSM goals and purpose.
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Affiliation(s)
- Jerry K Hoepner
- Department of Communication Sciences and Disorders, University of Wisconsin-Eau Claire
| | - Alexis Sievert
- Department of Communication Sciences and Disorders, University of Wisconsin-Eau Claire
| | - Kaitlin Guenther
- Department of Communication Sciences and Disorders, University of Wisconsin-Eau Claire
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Baraldi MA, Avanzino L, Pelosin E, Domaneschi F, Di Paola S, Lagravinese G. Pragmatic abilities in early Parkinson's disease. Brain Cogn 2021; 150:105706. [PMID: 33761383 DOI: 10.1016/j.bandc.2021.105706] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 02/08/2021] [Accepted: 02/09/2021] [Indexed: 12/01/2022]
Abstract
Language impairment in Parkinson's disease (PD) has been investigated at different levels of linguistic skills. Only a few studies dealt with pragmatic abilities in PD, and these suggest an impairment of pragmatic skills, which might affect quality of life. However, previous studies enrolled patients with heterogeneous symptom severity. The goal of this study is twofold: first, to investigate whether pragmatic skills are compromised at the early stage of PD; second, to explore whether an early pragmatic impairment is explained by a decay of a specific cognitive function. We assessed pragmatic abilities (discourse production, comprehension of narratives, humour, and figurative language), and a cluster of cognitive functions (memory, verbal fluency, inhibition, shifting, and ToM) in a sample of early PD patients and a group of age-matched healthy controls. Early PD patients showed impaired general pragmatic skills (the ability to perform different pragmatic tasks in language production and comprehension), as well as a deficit in the production and comprehension individual scores. Our results suggest that good general cognitive skills (a good overall cognitive level) and high education support patients' pragmatic competence. Inhibitory processes have been found to predict patients' ability to understand figurative language, such as metaphors, and this might be related to frontal lobe dysfunctions.
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Affiliation(s)
- Maria Alice Baraldi
- Department of Educational Sciences (DISFOR), Psychology Unit, Corso Podestà 2, University of Genoa, 16128 Genoa, Italy.
| | - Laura Avanzino
- IRCCS Policlinico San Martino, Largo Benzi 10, 16132 Genoa, Italy; Department of Experimental Medicine (DIMES), Section of Human Physiology, Via Leon Battista Alberti 2, University of Genoa, 16132 Genoa, Italy.
| | - Elisa Pelosin
- IRCCS Policlinico San Martino, Largo Benzi 10, 16132 Genoa, Italy; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health (DINOGMI), Largo Daneo 3, University of Genoa, 16132 Genoa, Italy.
| | - Filippo Domaneschi
- Laboratory of Language and Cognition, Via Balbi 30, University of Genoa, 16126 Genoa, Italy.
| | - Simona Di Paola
- Laboratory of Language and Cognition, Via Balbi 2, University of Genoa, 16126 Genoa, Italy.
| | - Giovanna Lagravinese
- IRCCS Policlinico San Martino, Largo Benzi 10, 16132 Genoa, Italy; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health (DINOGMI), Largo Daneo 3, University of Genoa, 16132 Genoa, Italy.
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Agrela N, Santos ME, Guerreiro S. Communication skills training pilot programme after traumatic brain injury: short and medium-term benefits. Brain Inj 2021; 35:304-314. [PMID: 33464934 DOI: 10.1080/02699052.2021.1872096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objective: The study aimed to evaluate whether a pilot communication rehabilitation programme improves different communicative modalities in people who have sustained a moderate to severe TBI immediately following the training and at 3 months follow up.Methods: We have recruited 12 participants who had moderate-to-severe TBI. Subjects were randomly divided into two groups, EG and CG. We have assessed the groups before and after treatment and we have performed a follow-up three months later, through of the ABaCo. The EG followed a very structured programme. In the CG, a programme to stimulate communication through free conversation was carried out. Each programme consisted of 24 group sessions, of 1h30 min, twice a week, for 12 weeks.Results: Improvements were observed in both groups, although more evident in the EG. Both groups had better results in extralinguistic production. In the EG, there was still an improvement in the paralinguistic production and extralinguistic comprehension, after ending the training. These improvements persisted 3 months after ending the programme.Conclusion: The results demonstrated the effectiveness of the intervention of a structured pragmatic rehabilitation programme. However, the existence of a communication group based solely on conversation can also have positive results and should be implemented whenever a more specific intervention is not possible. In future research, it will be important to increase the sample size and involve caregivers in person and regularly in the EG programme.
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Affiliation(s)
- Nicole Agrela
- Instituto de Ciências da Saúde, Universidade Católica Portuguesa, Lisbon, Portugal
| | - Maria Emília Santos
- Center for Interdisciplinary Research in Health (CIIS), Instituto de Ciências da Saúde, Universidade Católica Portuguesa, Lisbon, Portugal
| | - Sandra Guerreiro
- Centro de Reabilitação Profissional de Gaia (CRPG), Gaia, Portugal
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Rosell-Clari V, Hernández-Sacristán C, Cervera-Crespo T, Lorenzo-Cordero À. Assessing natural metalinguistic skills in people with Alzheimer's disease and frontotemporal dementia. JOURNAL OF COMMUNICATION DISORDERS 2021; 89:106058. [PMID: 33316623 DOI: 10.1016/j.jcomdis.2020.106058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 10/15/2020] [Accepted: 10/17/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE The aim of this paper is to assess whether the use of natural metalinguistic skills can be used to differentiate linguistic-communicative profiles of people with dementia (Alzheimer's disease and frontotemporal dementia in the behavioural and primary progressive aphasia variants) in the earliest stages of the disease. METHOD A sample of 180 people was selected. Sixty had Alzheimer's disease, 20 had frontotemporal dementia of the behavioural variant, and 40 had frontotemporal dementia of the primary progressive aphasia variant (20 had non-fluent primary progressive aphasia and 20 had semantic dementia). The control group was composed of 60 healthy people with ages, gender, and professions as similar as possible to those of the people in the dementia groups. All the participants were administered the Spanish adaptation of the Mini-Mental State Examination (MMSE) and the Global Deterioration Scale (GDS) to assess dementia severity. To assess the use of natural metalinguistic skills, a 40-item test (MetAphAs), specifically designed for this aim, was administered. RESULTS The test showed high internal validity and high positive correlations with the MMSE. Statistically significant differences were observed in the total scores on this test and in the scores on each of its sections, when comparing the whole group and the subgroups of people with dementia with the control group. Additionally, the scores on most of the sections of the MetAphAs test presented statistically significant differences when the different subgroups of people with dementia were compared. CONCLUSIONS A test like the MetAphAs, specifically designed to assess natural metalinguistic abilities, may be useful for obtaining differential communicative-linguistic profiles according to the type of dementia in the early stages of the disease. However, additional research is needed to obtain more conclusive results.
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Affiliation(s)
- Vicent Rosell-Clari
- Department of Basic Psychology, University of Valencia, 21 Blasco Ibanez Avenue, 46010, Valencia, Spain.
| | - Carlos Hernández-Sacristán
- Department of Linguistics and Communication Sciences, University of Valencia, 32 Blasco Ibanez Avenue, 46010, Valencia, Spain.
| | - Teresa Cervera-Crespo
- Department of Basic Psychology, University of Valencia, 21 Blasco Ibanez Avenue, 46010, Valencia, Spain.
| | - Àgata Lorenzo-Cordero
- Department of Basic Psychology, University of Valencia, 21 Blasco Ibanez Avenue, 46010, Valencia, Spain.
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Stafslien EHD, Turkstra LS. Sex-based differences in expectations for social communication after TBI. Brain Inj 2020; 34:1756-1762. [PMID: 33222531 DOI: 10.1080/02699052.2020.1849799] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Sex-based differences have been reported in several TBI outcome studies, including studies of social functioning. In some studies, social outcomes have been evaluated via perceptual judgments on questionnaires, which may be influenced by stereotypes about acceptable behaviour for men and women. To explore potential sex-based rater bias in social judgments, we asked 68 typical undergraduates (34 women) to identify problematic behaviour for men vs. women on a widely used questionnaire for TBI social outcome, the LaTrobe Communication Questionnaire. Results revealed more consensus among raters of both sexes about acceptable behaviours for men than behaviours for women, and women were more critical than men when judging persons of either sex. These findings support the importance of considering sex in TBI social outcome research, past and future, not only sex of the participant but also sex of the person judging social outcome. Sex-based differences here also have implications for social evaluations in clinic, where female clinicians are often judging male patients. Future research should consider gender (the social construct), as well as sex (the biological construct), as both may contribute to perceived social outcome after TBI.
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Affiliation(s)
- E H Despins Stafslien
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison , Madison, Wisconsin, USA
| | - L S Turkstra
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison , Madison, Wisconsin, USA
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Shorland J, Douglas J, O'Halloran R. Cognitive-communication difficulties following traumatic brain injury sustained in older adulthood: a scoping review. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2020; 55:821-836. [PMID: 32706482 DOI: 10.1111/1460-6984.12560] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 05/10/2020] [Accepted: 06/11/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Older adults are a peak incidence group for traumatic brain injury (TBI). However, empirical evidence on TBI in older adults is often limited to extrapolated findings from studies involving younger adults. While cognitive-communication deficits are an established consequence of TBI with substantial impact on social outcome for younger adults, little is known about the nature of cognitive-communication changes experienced by older adults following a new-onset TBI. In order to inform evidence-based service delivery and support older adults who sustain TBI, it is important to understand how these difficulties manifest in older adults. AIMS To review the empirical literature to determine the nature and breadth of research that has addressed the influence of older age on cognitive-communication outcomes following TBI sustained in older adulthood. METHODS & PROCEDURES A scoping review framework was used. Five electronic databases (Medline, PsycINFO, Embase, CINAHL and Scopus) were searched to locate peer-reviewed studies addressing cognitive-communication following TBI sustained at ≥ 55 years. Given the absence of dedicated investigations within the search yield, studies were included where at least 30% of participants were aged ≥ 55 years at injury, and age was a stated focus of the investigation. OUTCOMES & RESULTS A total of 2468 unique records were identified and reduced to 225 after title and abstract screening. Full-text review revealed only three studies that met the criteria. Collectively these studies included adults aged 55-93 years at injury. Two studies focused on age as a predictor for acute cognitive-communication difficulty, and one on the impact of age on facial emotion recognition in the chronic stages of injury. None of the studies had a dedicated focus on cognitive-communication outcomes for older adults who sustained a TBI within the defined period of older adulthood. CONCLUSIONS & IMPLICATIONS This scoping review produced limited results and insufficient evidence to inform rehabilitation for older adults. Indeed, very little is known about cognitive-communication outcomes for older adults who sustain a TBI. This review highlights the need, in the context of an ageing population, for research within this area to be prioritized. What this paper adds What is already known on the subject Empirical evidence to support the management of post-TBI cognitive-communication difficulties in adults predominantly stems from studies with young adults. However, the broader TBI literature suggests that outcome for older adults requires specific consideration due to its distinct nature and occurrence during a stage of life when there is the potential for subtle change to the processes of cognition and communication as part of typical ageing. What this paper adds to existing knowledge This scoping review identifies that research related to cognitive-communication outcomes for older adults who have sustained a TBI is very much in its infancy. Overarching statements about post-TBI cognitive-communication outcomes for older adults cannot be drawn, nor can it be determined if outcomes for older adults differ from younger adults. What are the potential or actual clinical implications of this work? The lack of research in this area means that tangible guidance cannot be provided to clinicians working with older adults following TBI to support evidence-based practice for cognitive-communication. This scoping review strongly supports the need for further research in this area.
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Affiliation(s)
- Joanna Shorland
- Discipline of Speech Pathology, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, Australia
- Speech Pathology Department, Acquired Brain Injury Unit, Caulfield Hospital, Alfred Health, Melbourne, VIC, Australia
| | - Jacinta Douglas
- Living with Disability Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, Australia
- Summer Foundation, Melbourne, VIC, Australia
| | - Robyn O'Halloran
- Discipline of Speech Pathology, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, Australia
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Paice L, Aleligay A, Checklin M. A systematic review of interventions for adults with social communication impairments due to an acquired brain injury: Significant other reports. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2020; 22:537-548. [PMID: 32135070 DOI: 10.1080/17549507.2019.1701082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose: To determine the most effective intervention for adults with social communication impairments due to an Acquired Brain Injury (ABI), using standardised outcome measures completed by significant others.Method: A systematic literature review was conducted. Four electronic databases relevant to the field of speech-language pathology or brain injury were searched: Medline, CINAHL, AMED and Embase. Grey literature, reference lists and citation indexes were also hand searched for additional research. Studies that met the broad inclusion and exclusion criteria were initially screened to determine articles for full text reviews by two independent reviewers. Reviewers independently extracted data from full-text reviews using a data extraction form and performed bias analysis using the Downs and Black quality checklist (Downs, S.H., & Black, N. (1998). The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. Journal of Epidemiology & Community Health, 52, 377-384.). Studies were categorised using a five-phase model of evidence (Robey, R.R., & Schultz, M.C. (1998). A model for conducting clinical-outcome research: An adaptation of the standard protocol for use in aphasiology. Aphasiology, 12, 787-810.).Result: 681 articles were identified after duplicates were removed. 15 articles were reviewed for full-text analysis. Six studies were ultimately included in the review. Of these, three were randomised controlled trials and three others were not. Four studies delivered intervention solely to the individual with an ABI, one to the communication partner only, and one delivered intervention both to the individual and their communication partner. Intervention programmes ranged from four to 12 weeks and from 12 to 48 hours total contact time. The reviews studies were heterogeneous, which made comparisons difficult. Risk of bias was also present to varying degrees in all studies. The current level of evidence has focussed on efficacy of treatments and effectiveness of treatment is not yet established.Conclusion: The current level of evidence is not yet established to make clear clinical guidelines on which interventions are most effective, based on significant others' reports. Further research is required, incorporating more rigorous study designs and larger sample sizes to enable accurate conclusions to be drawn.
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Byom L, O'Neil-Pirozzi TM, Lemoncello R, MacDonald S, Meulenbroek P, Ness B, Sohlberg MM. Social Communication Following Adult Traumatic Brain Injury: A Scoping Review of Theoretical Models. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2020; 29:1735-1748. [PMID: 32569483 DOI: 10.1044/2020_ajslp-19-00020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose Social communication is the set of abilities that allows individuals to achieve relevant social goals across contexts. Speech-language pathology evaluation and treatment of traumatic brain injury (TBI)-related social communication problems should be informed by evidence-supported theories of social communication. The primary purpose of this article is to summarize the results of a scoping review of theoretical models that speech-language pathologists may apply to the evaluation and treatment of social communication problems of adults with TBI. Method A scoping review was conducted of PubMed, PsycINFO, and Embase for sources published in English between 1989 and 2020 that described human social communication and participation. Resulting sources were systematically examined for social communication models. Results Nine theoretical models were identified that speech-language pathologists may apply to their assessment and treatment of social communication abilities of adults with TBI. Identified models were categorized thematically into one of three classes: cognitive models, social competence models, and pragmatic models. Using a framework developed for the purposes of this article, each identified model was evaluated, and one exemplar model in each class is described in depth. Conclusions Social communication problems in adults post-TBI are common. The existence of multiple models empowers speech-language pathologists to select individual-focused assessment and treatment approaches to maximize intervention outcomes.
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Affiliation(s)
- Lindsey Byom
- Division of Speech and Hearing Sciences, Department of Allied Health Sciences, University of North Carolina, Chapel Hill
| | - Therese M O'Neil-Pirozzi
- Communication Sciences and Disorders, Northeastern University and Spaulding-Harvard Traumatic Brain Injury Model System, Boston, MA
| | - Rik Lemoncello
- School of Communication Sciences and Disorders, Pacific University, Forest Grove, OR
| | - Sheila MacDonald
- Sheila MacDonald & Associates, University of Toronto, Ontario, Canada
| | - Peter Meulenbroek
- Communication Sciences and Disorders, University of Kentucky, Lexington
| | - Bryan Ness
- Communication Sciences and Disorders, California Baptist University, Riverside
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VanSolkema M, McCann C, Barker-Collo S, Foster A. Attention and Communication Following TBI: Making the Connection through a Meta-Narrative Systematic Review. Neuropsychol Rev 2020; 30:345-361. [PMID: 32712759 DOI: 10.1007/s11065-020-09445-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 07/08/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND AND AIM Communication difficulties are one of the hallmark characteristics of adults following traumatic brain injury (TBI), a difficulty that incorporates multiple aspects of cognition and language. One aspect of cognition that impacts communication is attention. This review explores both attention and communication following moderate to severe TBI and aims to connect them through a narrative analysis of the discourse surrounding the terms and how they have evolved over time. This includes exploring and reviewing theories and specific constructs of these two aspects of cognition. METHOD A meta-narrative systematic literature review was completed according to RAMESES methodology. RESULTS A total of 37 articles were included in the review. The disciplines that populated the articles included, but were not limited to, speech language pathology (SLP) 36.5%, psychology 23.8%, and a collaboration of neuropsychology and SLP 7.9%. Of the papers that were included, 10% explored and supported theories of attention related to executive function affecting communication. Specific levels of attention were mapped onto specific communication skills with the corresponding year and authors to create a timeline and narrative of these concepts. CONCLUSIONS The main communication behaviours that are related to attention in the context of post-TBI cognition include discourse, tangential communication, social communication, auditory comprehension, verbal reasoning, topic maintenance, interpretation of social cues and emotions, verbal expression, reading comprehension, verbal response speed, and subvocal rehearsal.
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Affiliation(s)
- Maegan VanSolkema
- Department of Speech Science, School of Psychology, University of Auckland, Auckland, New Zealand. .,ABI Rehabilitation, NZ, Ltd., Auckland, New Zealand.
| | - Clare McCann
- Department of Speech Science, School of Psychology, University of Auckland, Auckland, New Zealand
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Wiseman-Hakes C, Ryu H, Lightfoot D, Kukreja G, Colantonio A, Matheson FI. Examining the Efficacy of Communication Partner Training for Improving Communication Interactions and Outcomes for Individuals With Traumatic Brain Injury: A Systematic Review. Arch Rehabil Res Clin Transl 2020; 2:100036. [PMID: 33543065 PMCID: PMC7853340 DOI: 10.1016/j.arrct.2019.100036] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE To describe the evidence regarding communication partner training (CPT) interventions for individuals with traumatic brain injury (TBI) and their conversation partners. DATA SOURCES Eleven key databases-PubMed, CINAHL, Cochrane Registry of Controlled Trials, Embase, Linguistic and Language Behavior Abstracts, ProQuest, Scopus, Web of Science, PsycBITE, SpeechBITE, and ERIC-were searched from inception through 2019. STUDY SELECTION Selected articles had to be peer reviewed, written in English, experimental or quasiexperimental design, report on TBI communication partners, and describe interventions or strategies targeting communication partners. DATA EXTRACTION Of 1088 articles identified, 12 studies were selected for data extraction, critical appraisal, and analysis with considerations of sex and gender. The Oxford Centre for Evidence-Based Medicine's guideline was used to critically appraise Levels of Evidence. Assessment of bias was conducted using the Cochrane Collaboration tools for randomized controlled trials and risk of bias in nonrandomized studies of interventions for nonrandomized controlled trials and the risk of bias in N-of-1 trials scale. DATA SYNTHESIS A systematic review with a qualitative meta-analysis of themes and findings across the selected studies identified 3 major categories: (1) benefits of the training for those with TBI, (2) risks of CPT, and (3) suggestions to improve its efficacy. CONCLUSION Most of the evidence comes from 1 research group, which may be viewed as a weakness in the current body of literature. However, although the evidence to date is modest, CPT may help to increase accessibility and reduce participation inequities in the community for individuals with TBI.
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Affiliation(s)
- Catherine Wiseman-Hakes
- Department of Speech Language Pathology, School of Rehabilitation Science, McMaster University, Institute for Applied Health Sciences, Hamilton, Ontario, Canada
- KITE Toronto Rehab, University Health Network, Toronto, Ontario, Canada
| | - Hyun Ryu
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, Ontario, Canada
| | - David Lightfoot
- St. Michael’s Hospital Health Sciences Library, Unity Health Toronto, Toronto, Ontario, Canada
| | - Gazal Kukreja
- Acquired Brain Injury, Ontario Neurotrauma Foundation, Toronto, Ontario, Canada
| | - Angela Colantonio
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Flora I. Matheson
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health and Centre for Criminology and Sociolegal Studies, University of Toronto, Toronto, Ontario, Canada
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A Clinical Trial Investigating Telehealth and In-Person Social Communication Skills Training for People With Traumatic Brain Injury: Participant-Reported Communication Outcomes. J Head Trauma Rehabil 2020; 35:241-253. [DOI: 10.1097/htr.0000000000000554] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Adshead CD, Norman A, Holloway M. The inter-relationship between acquired brain injury, substance use and homelessness; the impact of adverse childhood experiences: an interpretative phenomenological analysis study. Disabil Rehabil 2019; 43:2411-2423. [PMID: 31825694 DOI: 10.1080/09638288.2019.1700565] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE Acquired Brain Injuries, caused by a range of illnesses and injuries, can lead to long-term difficulties for individuals; mental health problems, cognitive and executive impairment and psychosocial problems including relationship breakdown, substance abuse and potentially homelessness. The study aimed to seek and gain a more definitive understanding of the inter-relationship of Acquired Brain Injury, substance abuse and homelessness by identifying key themes associated with the inter-relationship between these variables. MATERIALS AND METHODS The study recruited eight participants through homeless organisations and treatment centres. Participants were screened for suitability (Brain Injury Screening Index; Drug Abuse Screening Tool; Alcohol Use Disorders Identification Test and then participated in recorded semi-structured interviews, transcribed and analysed using Interpretative Phenomenological Analysis. RESULTS The study identified five master themes: Adverse Childhood Experiences and Trauma; Mental Health; Cognitive Decline and Executive Function; Services; Relationships. CONCLUSION Healthcare professionals need to engage with children, their families, and adults, who have been exposed to adverse childhood experiences and should employ routine screening tools for brain injury to ensure their presence is factored into developing appropriate models of intervention.IMPLICATIONS FOR REHABILITATIONNeed person-centred approaches to intervention for those with acquired brain injury who are homeless and have substance abuse issues.Need to screen for the presence of acquired brain injury when engaging with individuals who are homeless or have substance abuse.Need screening of acquired brain injury and adverse childhood experiences to improve access to services post-brain injury.
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Affiliation(s)
| | - Alyson Norman
- School of Psychology, University of Plymouth, Plymouth, UK
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Elbourn E, Kenny B, Power E, Togher L. Psychosocial Outcomes of Severe Traumatic Brain Injury in Relation to Discourse Recovery: A Longitudinal Study up to 1 Year Post-Injury. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2019; 28:1463-1478. [PMID: 31487472 DOI: 10.1044/2019_ajslp-18-0204] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose The interrelationship between psychosocial outcomes and discourse after severe traumatic brain injury remains largely unknown. This study examines outcomes relating to work, relationships, and independence within the context of discourse recovery across the 1st year post-injury. Method An inception cohort comprising 57 participants with severe traumatic brain injury was assessed at 3, 6, 9, and 12 months post-injury. Outcomes were measured with the Sydney Psychosocial Reintegration Scale-2 (Tate et al., 2012; Tate, Simpson, Loo, & Lane-Brown, 2011), and discourse was evaluated with Main Concept Analysis of a narrative retell. Correlation and linear regression analyses were utilized. Results Significant correlations were found between psychosocial outcomes reported by relatives and discourse performance across the 1st year. The 6-month discourse scores significantly predicted the 12-month psychosocial outcomes reported by relatives. Initial discourse severity and recovery pattern also informed outcomes. Conclusions Discourse disorders have a strong relationship with everyday outcomes relating to work, relationships, and independence as reported by relatives. Six months post-injury is a beneficial time for assessment, education, and service planning. Age, years of education, and aphasia may mediate recovery and outcomes. A clinical decision tree is offered to support goal setting. Supplemental Material https://doi.org/10.23641/asha.9755444.
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Affiliation(s)
- Elise Elbourn
- Discipline of Speech Pathology, The University of Sydney, New South Wales, Australia
| | - Belinda Kenny
- Discipline of Speech Pathology, The University of Sydney, New South Wales, Australia
| | - Emma Power
- Graduate School of Health, University of Technology Sydney, New South Wales, Australia
| | - Leanne Togher
- Discipline of Speech Pathology, The University of Sydney, New South Wales, Australia
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Ceccarelli F, Pirone C, Mina C, Mascolo A, Perricone C, Massaro L, Spinelli FR, Alessandri C, Valesini G, Conti F. Pragmatic language dysfunction in systemic lupus erythematosus patients: Results from a single center Italian study. PLoS One 2019; 14:e0224437. [PMID: 31682630 PMCID: PMC6827908 DOI: 10.1371/journal.pone.0224437] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 10/14/2019] [Indexed: 01/07/2023] Open
Abstract
Background Cognitive impairment (CI) in systemic lupus erythematosus (SLE) is a frequent neuropsychiatric manifestation affecting several domains, even in apparently asymptomatic patients. Current research revealed that the typical CI pattern affects frontal-subcortical circuit and thus executive functions. The impairment of non-literal language or pragmatic language (PL), including metaphors, idioms, inferences or irony has been well described in several conditions such as autism disorders, Parkinson’s disease, brain injury and even in earlier phases of neurodegenerative processes. Even if PL neuro-anatomy remains controversial, correlation between executive dysfunctions and non-literal language involvement has been reported both in traumatic injury and mild cognitive impairment patients. Nonetheless, no specific study has been performed to evaluate PL impairment in SLE patients so far. Objectives We aimed at assessing the PL domain in a Italian monocentric SLE cohort in comparison to healthy controls, matched to age and education, through a specific battery, the batteria sul linguaggio dell'emisfero destro (BLED). Secondly, we focused attention on possible correlations between CI and clinical and laboratory SLE-related features. Methods Forty adult patients affected by SLE, according to the American College of Rheumatology (ACR) criteria, and thirty healthy subjects were enrolled consecutively in this cross-sectional study. The protocol included complete physical examination, extensive clinical and laboratory data collection (comprehensive of demographics, past medical history, co-morbidities, disease activity, chronic damage evaluation, previous and concomitant treatments) and cognitive assessment for five different domains: memory, attention, pragmatic language, executive and visuospatial functions. Self-reported scale for anxiety and depression were performed to exclude the influence of mood disorders on cognitive dysfunction. Results We studied 40 Caucasian SLE patients [male (M)/ female (F) 3/37; mean±standard deviation (SD) age 45.9±10.1 years, mean±SD disease duration 120.8±81.2 months] and 30 healthy subjects (M/F 9/21; mean±SD age 41.3±13 years). According to the low level of disease activity and damage (mean±SD Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) of 1.3±2.3, mean±SD Systemic Lupus International Collaborative Clinics/American College of Rheumatology (SLICC/ACR) Damage Index (SDI) of 0.2±0.5), only 30% of patients was on glucocorticoid treatment at the study entry. PL was the most compromised domain in terms of Mean Domain Z scores. As for the Domain Cognitive Dysfunction score, a deficit of PL was observed in 45% of patients and was significantly more prevalent than memory, executive and visuospatial functions impairment (P = 0.0002, P = 0.0002 and P<0.000001, respectively). According to Global Cognitive Dysfunction score, 25% of patients experienced a mild impairment and 7.5% a moderate one. Anti-phospholipid antibodies positivity was significantly associated with memory impairment (P<0.0005), whereas the presence of other neuropsychiatric events was associated with executive dysfunctions (P<0.05); no further significant association nor correlation were identified. Conclusion In this study we evaluated for the first time PL in SLE patients finding a dysfunction in almost half of patients. The dysfunction of PL was significantly more frequent than the other domains assessed.
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Affiliation(s)
- Fulvia Ceccarelli
- Lupus Clinic, Dipartimento di Medicina Interna e Specialità Mediche, Sapienza University of Rome, Rome, Italy
| | - Carmelo Pirone
- Lupus Clinic, Dipartimento di Medicina Interna e Specialità Mediche, Sapienza University of Rome, Rome, Italy
| | - Concetta Mina
- Dipartimento di Neurologia e Psichiatria, Sapienza Università di Roma, Rome, Italy
| | - Alfredo Mascolo
- Clinica Neurologica, Dipartimento di Neuroscienze, Università degli studi di Roma Tor Vergata, Rome, Italy
| | - Carlo Perricone
- Lupus Clinic, Dipartimento di Medicina Interna e Specialità Mediche, Sapienza University of Rome, Rome, Italy
| | - Laura Massaro
- Lupus Clinic, Dipartimento di Medicina Interna e Specialità Mediche, Sapienza University of Rome, Rome, Italy
| | - Francesca Romana Spinelli
- Lupus Clinic, Dipartimento di Medicina Interna e Specialità Mediche, Sapienza University of Rome, Rome, Italy
| | - Cristiano Alessandri
- Lupus Clinic, Dipartimento di Medicina Interna e Specialità Mediche, Sapienza University of Rome, Rome, Italy
| | - Guido Valesini
- Lupus Clinic, Dipartimento di Medicina Interna e Specialità Mediche, Sapienza University of Rome, Rome, Italy
| | - Fabrizio Conti
- Lupus Clinic, Dipartimento di Medicina Interna e Specialità Mediche, Sapienza University of Rome, Rome, Italy
- * E-mail:
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Rigon A, Turkstra LS, Mutlu B, Duff MC. Facial-affect recognition deficit as a predictor of different aspects of social-communication impairment in traumatic brain injury. Neuropsychology 2019; 32:476-483. [PMID: 29809034 DOI: 10.1037/neu0000368] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE To examine the relationship between facial-affect recognition and different aspects of self- and proxy-reported social-communication impairment following moderate-severe traumatic brain injury (TBI). METHOD Forty-six adults with chronic TBI (>6 months postinjury) and 42 healthy comparison (HC) adults were administered the La Trobe Communication Questionnaire (LCQ) Self and Other forms to assess different aspects of communication competence and the Emotion Recognition Test (ERT) to measure their ability to recognize facial affects. RESULTS Individuals with TBI underperformed HC adults in the ERT and self-reported, as well as were reported by close others, as having more communication problems than did HC adults. TBI group ERT scores were significantly and negatively correlated with LCQ-Other (but not LCQ-Self) scores (i.e., participants with lower emotion-recognition scores were rated by close others as having more communication problems). Multivariate regression analysis revealed that adults with higher ERT scores self-reported more problems with disinhibition-impulsivity and partner sensitivity and had fewer other-reported problems with disinhibition-impulsivity and conversational effectiveness. CONCLUSIONS Our findings support growing evidence that emotion-recognition deficits play a role in specific aspects of social-communication outcomes after TBI and should be considered in treatment planning. (PsycINFO Database Record
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Affiliation(s)
- Arianna Rigon
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center
| | | | - Bilge Mutlu
- Department of Computer Sciences, University of Wisconsin-Madison
| | - Melissa C Duff
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center
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Socher M, Lyxell B, Ellis R, Gärskog M, Hedström I, Wass M. Pragmatic Language Skills: A Comparison of Children With Cochlear Implants and Children Without Hearing Loss. Front Psychol 2019; 10:2243. [PMID: 31649586 PMCID: PMC6794448 DOI: 10.3389/fpsyg.2019.02243] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 09/19/2019] [Indexed: 11/27/2022] Open
Abstract
Pragmatic language ability refers to the ability to use language in a social context. It has been found to be correlated with success in general education for deaf and hard of hearing children. It is therefore of great importance to study why deaf and hard of hearing children often perform more poorly than their hearing peers on tests measuring pragmatic language ability. In the current study the Pragmatics Profile questionnaire from the CELF-IV battery was used to measure pragmatic language ability in children using cochlear implants (N = 14) and children without a hearing loss (N = 34). No significant difference was found between the children with cochlear implants (CI) and the children without hearing loss (HL) for the sum score of the pragmatics language measure. However, 35.71% of the children with CI performed below age norm, while only 5.89% of the children without HL performed below age norm. In addition, when dividing the sum score into three sub-measures: Rituals and Conversational skills (RCS), Asking for, Giving, and Responding to Information (AGRI), and Nonverbal Communication skills (NCS), significant differences between the groups were found for the NCS measure and a tendency for a difference was found for the RCS measure. In addition, all three sub-measures (NCS, AGRI, RCS) were correlated to verbal fluency in the children with CI, but not the children without HL.
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Affiliation(s)
- Michaela Socher
- Swedish Institute of Disability Research, Linköping University, Linköping, Sweden
| | - Björn Lyxell
- Swedish Institute of Disability Research, Linköping University, Linköping, Sweden.,Special Needs Education, University of Oslo, Oslo, Norway
| | - Rachel Ellis
- Swedish Institute of Disability Research, Linköping University, Linköping, Sweden
| | - Malin Gärskog
- Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Ingrid Hedström
- Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Malin Wass
- Department of Business Administration, Technology and Social Sciences, Luleå University of Technology, Luleå, Sweden
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Babaei Z, Ghayoumi-Anaraki Z, Mahmoodi-Bakhtiari B. Discourse in aging: Narrative and Persuasive. Dement Neuropsychol 2019; 13:444-449. [PMID: 31844499 PMCID: PMC6907699 DOI: 10.1590/1980-57642018dn13-040012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 04/12/2019] [Indexed: 11/22/2022] Open
Abstract
The growth in the elderly population has posed a social, economic and health challenge for the twenty-first century. OBJECTIVE Aging is often characterized by changes in cognitive functions which affect the receptive and expressive capabilities of language. Since language plays a significant role in human life, we evaluate the existence of age-related differences in narrative and persuasive discourses. METHODS The narrative discourse of 91 adults and persuasive discourse of 92 adults,aged from 19 to 75 years and stratified into four age groups,were examined. RESULTS There was a statistically significant difference between coherence in the elderly group and each of the other three age groups for both types of discourse. There was also a significant difference for the cohesion variable between the elderly and the first age group for narrative discourse only. CONCLUSION The results of this study demonstrate that discourse is influenced by aging and type (genre) of discourse task. Therefore, it is essential for clinicians to take into account the linguistic needs of elderly and incorporate these into their clinical programs. Also, this finding can help clinicians to distinguish between discourses of normal aging and other neurologic disorders (for example dementia, right hemisphere damage, aphasia).
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Affiliation(s)
- Zahra Babaei
- MSc, Department of Speech Therapy, University of Social Welfare and
Rehabilitation Sciences, Tehran, Iran
| | - Zahra Ghayoumi-Anaraki
- PhD,Department of Speech Therapy, School of Paramedical Sciences,
Mashhad University of Medical Sciences, Mashhad, Iran
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Chia AA, Power E, Kenny B, Elbourn E, McDonald S, Tate R, MacWhinney B, Turkstra L, Holland A, Togher L. Patterns of early conversational recovery for people with traumatic brain injury and their communication partners. Brain Inj 2019; 33:690-698. [DOI: 10.1080/02699052.2019.1571632] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- An An Chia
- Discipline of Speech Pathology, Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia
| | - Emma Power
- Discipline of Speech Pathology, Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia
- Discipline of Speech Pathology, UTS Graduate School of Health, University of Technology, Sydney, Australia
| | - Belinda Kenny
- Discipline of Speech Pathology, Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia
- NHMRC Centre of Research Excellence in Brain Recovery, Sydney, NSW, Australia
| | - Elise Elbourn
- Discipline of Speech Pathology, Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia
- NHMRC Centre of Research Excellence in Brain Recovery, Sydney, NSW, Australia
| | - Skye McDonald
- NHMRC Centre of Research Excellence in Brain Recovery, Sydney, NSW, Australia
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Robyn Tate
- NHMRC Centre of Research Excellence in Brain Recovery, Sydney, NSW, Australia
- Faculty of Medicine, University of Sydney, Sydney, NSW, Australia
| | - Brian MacWhinney
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Lyn Turkstra
- Department of Communicative Disorders, University of Wisconsin-Madison, Madison, WI, USA
| | - Audrey Holland
- Department of Speech, Language and Hearing Sciences, University of Arizona, Tucson, AZ, USA
| | - Leanne Togher
- Discipline of Speech Pathology, Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia
- NHMRC Centre of Research Excellence in Brain Recovery, Sydney, NSW, Australia
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Douglas J. Loss of friendship following traumatic brain injury: A model grounded in the experience of adults with severe injury. Neuropsychol Rehabil 2019; 30:1277-1302. [PMID: 30755079 DOI: 10.1080/09602011.2019.1574589] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Relationships make important contributions to wellbeing and maintenance of self-worth. For those who sustain traumatic brain injury (TBI), life is frequently characterized by declining interpersonal relationships. The aim of this study was to understand the post-injury experience of friendship from the perspective of adults with severe TBI. Participants were 23 adults who had sustained severe TBI on average 10 years earlier; the majority was between 25 and 45 years old. The experience of friendship was explored using a convergent mixed methods design (quantitative self-report measures and in-depth interviews). Qualitative analysis of interview transcripts employed open and focussed coding to reveal themes and categories. Participants nominated on average 3.35 (SD 2.19) friends. When paid carers and family members were excluded, the mean dropped to 1.52 (SD 1.38). Exploratory correlations between number of friends and quality of life, depression and strong-tie support revealed significant associations of moderate to large effects. The post-injury experience of friendship was broadly conceptualized as "going downhill" with four overlapping phases: losing contact, being misunderstood, wanting to share and hanging on. Participants' stories illustrated how rehabilitation can focus on friendship by supporting established relationships and facilitating access to activities that afford interpersonal encounters and opportunities to share experiences.
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Affiliation(s)
- Jacinta Douglas
- Living with Disability Research Centre, College of Science, Health and Engineering, La Trobe University, Melbourne, Australia.,Summer Foundation, Melbourne, Australia.,NHMRC Centre of Research Excellence in Traumatic Brain Injury Psychosocial Rehabilitation, Canberra, Australia
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Holloway M, Orr D, Clark-Wilson J. Experiences of challenges and support among family members of people with acquired brain injury: a qualitative study in the UK. Brain Inj 2019; 33:401-411. [PMID: 30663417 DOI: 10.1080/02699052.2019.1566967] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PRIMARY OBJECTIVE Family members (FM) are affected by the impact of an Acquired Brain Injury (ABI) upon their relatives and play an important role in rehabilitation and long-term support. This study explores how families are affected and integrates their views on the formal/informal support received as a consequence of ABI. RESEARCH DESIGN A qualitative research design was employed to capture the lived experience of FM of people with ABI. METHOD Semi-structured interviews were conducted with 16 FM of people with severe ABI. Participants were chosen from respondents to a UK national online survey of affected individuals. Interview data were analysed using inductive thematic analysis. RESULTS Family members' experiences are complex, enduring and are affected by the context in which the ABI occurs as well as by formal/informal support. The grief experienced by FM is ambiguous, develops over time and FM perceive little option but to remain involved. Experience of formal and informal support is noted to vary significantly in availability and quality, poor support exacerbates difficulties and isolates family members. CONCLUSION Greater understanding of the lived experience of FM is needed to support more effective responses to both them and the individual with ABI, integrating services and families to improve quality-of-life.
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Affiliation(s)
| | - David Orr
- b University of Sussex , Brighton , UK
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29
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Camodeca A, Todd KQ, Hosack A. Intact verbal fluency abilities in the Broad Autism Phenotype. Psychiatry Res 2018; 270:443-452. [PMID: 30316172 DOI: 10.1016/j.psychres.2018.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 09/28/2018] [Accepted: 10/01/2018] [Indexed: 12/15/2022]
Abstract
This study attempted to replicate the findings of Camodeca and Voelker (2016), who demonstrated that controlled processing weaknesses were evident in the Broad Autism Phenotype (BAP), and that these weaknesses were predictive of real-world pragmatic language problems. One hundred eighty-two undergraduates completed the Delis-Kaplan Executive Function System Verbal Fluency (D-KEFS-VF) test and the Broad Autism Phenotype Questionnaire (BAPQ). Results were partially replicated. Contrary to the previous study, the BAP group (n = 31) did not demonstrate comparative weaknesses in controlled processing, nor were controlled processing abilities predictive of BAPQ Pragmatic Language score. Similar to the previous study, controlled processing did not predict pragmatic language abilities for Non-BAP (n = 151) subjects. For each group, letter fluency score predicted 2nd 15″ interval score (controlled processing abilities); automatic processing (1st 15″ interval) did not. Results suggest that verbal fluency skills in the BAP are similar to controls, and that controlled processing does not account for significant variance in real-world social language in the BAP.
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Affiliation(s)
- Amy Camodeca
- The Pennsylvania State University, 100 University Drive, Monaca, PA 15061, USA.
| | - Kylie Q Todd
- The Pennsylvania State University, 100 University Drive, Monaca, PA 15061, USA
| | - Alexandra Hosack
- The Pennsylvania State University, 100 University Drive, Monaca, PA 15061, USA
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Rietdijk R, Power E, Brunner M, Togher L. A single case experimental design study on improving social communication skills after traumatic brain injury using communication partner telehealth training. Brain Inj 2018; 33:94-104. [DOI: 10.1080/02699052.2018.1531313] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Rachael Rietdijk
- Faculty of Health Sciences, The University of Sydney, Sydney, Australia
| | - Emma Power
- Faculty of Health Sciences, The University of Sydney, Sydney, Australia
- Graduate School of Health, The University of Technology, Sydney, Australia
| | - Melissa Brunner
- Faculty of Health Sciences, The University of Sydney, Sydney, Australia
- Graduate School of Health, The University of Technology, Sydney, Australia
| | - Leanne Togher
- Faculty of Health Sciences, The University of Sydney, Sydney, Australia
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Bosco FM, Gabbatore I, Angeleri R, Zettin M, Parola A. Do executive function and theory of mind predict pragmatic abilities following traumatic brain injury? An analysis of sincere, deceitful and ironic communicative acts. JOURNAL OF COMMUNICATION DISORDERS 2018; 75:102-117. [PMID: 29887277 DOI: 10.1016/j.jcomdis.2018.05.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 05/09/2018] [Accepted: 05/24/2018] [Indexed: 05/25/2023]
Abstract
Quality of life and social integration are strongly influenced by the ability to communicate and previous research has shown that pragmatic ability can be specifically impaired in individuals with traumatic brain injury (TBI). In addition, TBI usually results in damage to the frontotemporal lobes with a consequent impairment of cognitive functions, i.e., attention, memory, executive function (EF) and theory of mind (ToM). The role of the underlying cognitive deficits in determining the communicative-pragmatic difficulties of an individual with TBI is not yet completely clear. This study examined the relationship between the ability to understand and produce various kinds of communicative acts, (i.e., sincere, deceitful and ironic) and the above-mentioned cognitive and ToM abilities following TBI. Thirty-five individuals with TBI and thirty-five healthy controls were given tasks assessing their ability to comprehend and produce sincere, deceitful and ironic communicative acts belonging to the linguistic and extralinguistic scales of the Assessment Battery for Communication (ABaCo), together with a series of EF and ToM tasks. The results showed that, when compared to healthy individuals, participants with TBI performed poorly overall in the comprehension and production of all the pragmatic phenomena investigated, (i.e., sincere, deceitful and ironic communicative acts), and they also exhibited impaired performance at the level of all the cognitive functions examined. Individuals with TBI also showed a decreasing trend in performance in dealing with sincere, deceitful and ironic communicative acts, on both the comprehension and production subscales of the linguistic and extralinguistic scales. Furthermore, a hierarchical regression analysis revealed that - in patients with TBI but not in the controls - EF had a significant effect on the comprehension of linguistic and extralinguistic irony only, while the percentage of explained variance increased with the inclusion of theory of mind. Indeed, ToM had a significant role in determining patients' performance in the extralinguistic production of sincere and deceitful communicative acts, linguistic and extralinguistic comprehension of deceit and the linguistic production of irony. However, with regard to the performance of patients with TBI in the various pragmatic tasks investigated, (i.e., sincere, deceitful and ironic communicative acts), EF was able to explain the pattern of patients' scores in the linguistic and extralinguistic comprehension but not in production ability. Furthermore, ToM seemed not to be able to explain the decreasing trend in the performance of patients in managing the various kinds of communicative acts investigated.
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Affiliation(s)
- F M Bosco
- Department of Psychology, University of Turin, Italy; Institute of neuroscience of Turin, Italy
| | - I Gabbatore
- Department of Psychology, University of Turin, Italy; Child Language Research Center, Research Unit of Logopedics, University of Oulu, Finland.
| | - R Angeleri
- Department of Psychology, University of New Mexico, Albuquerque, NM, USA
| | | | - A Parola
- Department of Psychology, University of Turin, Italy
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32
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Gonçalves APB, Mello C, Pereira AH, Ferré P, Fonseca RP, Joanette Y. Executive functions assessment in patients with language impairment A systematic review. Dement Neuropsychol 2018; 12:272-283. [PMID: 30425791 PMCID: PMC6200159 DOI: 10.1590/1980-57642018dn12-030008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Acquired language impairments may accompany different conditions. Most recent studies have shown that there is an important relationship between language and cognitive functions, such as executive functions (EF). Therefore, we aimed to investigate which main EF components appear to have the greatest impact in the most prevalent acquired communication disorders in adults, and which neuropsychological tests are being used to evaluate them. In addition, we sought to characterize the relationship between the executive functions and language in these conditions. Working memory (WM) was the most frequently chosen cognitive measure, being evaluated by different span tasks. A relationship between WM and narrative and conversational discourse, writing abilities and grammatical comprehension was found. Other currently used cognitive tests included the Trail Making, Wisconsin, Stroop and Verbal Fluency tests. Language and EF have a complex relationship; hence, a complete assessment should reflect the dynamic processing of cognitive brain functions.
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Affiliation(s)
| | - Clarissa Mello
- Psychology Graduate Student, Pontifícia Universidade Católica do Rio Grande do Sul, RS, Brazil
| | | | - Perrine Ferré
- PhD, Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal
| | | | - Yves Joanette
- PhD, Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal
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33
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Bosco FM, Parola A, Angeleri R, Galetto V, Zettin M, Gabbatore I. Improvement of Communication Skills after Traumatic Brain Injury: The Efficacy of the Cognitive Pragmatic Treatment Program using the Communicative Activities of Daily Living. Arch Clin Neuropsychol 2018; 33:875-888. [DOI: 10.1093/arclin/acy041] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 05/18/2018] [Indexed: 11/14/2022] Open
Affiliation(s)
- F M Bosco
- Department of Psychology, University of Turin, Turin, Italy
- Institute of Neurosciences of Turin, Italy
| | - A Parola
- Department of Psychology, University of Turin, Turin, Italy
| | - R Angeleri
- Department of Psychology, University of New Mexico, USA
| | | | | | - I Gabbatore
- Department of Psychology, University of Turin, Turin, Italy
- Child Language Research Center, Research Unit of Logopedics, University of Oulu, Finland
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34
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Hoepner JK, Olson SE. Joint Video Self-Modeling as a Conversational Intervention for an Individual with Traumatic Brain Injury and His Everyday Partner: A Pilot Investigation. ACTA ACUST UNITED AC 2018. [DOI: 10.21849/cacd.2018.00262] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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35
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“So that's the way it is for me — always being left out.” Acquired Pragmatic Language Impairment and Social Functioning following Traumatic Brain Injury. BRAIN IMPAIR 2017. [DOI: 10.1017/brimp.2017.20] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Our ability to interact appropriately in everyday interpersonal situations is fundamental to successful social integration. Impaired pragmatic competence correlates significantly and substantially with indices of social function across several domains for adults with acquired neurological disorders. In particular, evidence supports the negative impact of pragmatic impairments on the development and maintenance of relationships and community integration more generally.Pragmatic language competence sits in a complex, multifactorial space characterised by interacting associations with cognitive and psychological functions and social and environmental parameters. This complexity is evident in much of the research seeking to unravel the nature and magnitude of interactions between pragmatic language competence and social outcomes in adults with acquired neurological disorders.Over recent years our understanding of the impact of pragmatic impairments on social outcome has benefited substantially from inclusion of the insider's perspective in our research evidence base. Indeed, a methodological inclusion of constructivist paradigms has enabled the development of a rich understanding of the devastating social impact of impaired pragmatic competence.The aim of this paper is to review pragmatic language impairment in the context of traumatic brain injury (TBI) and detail its impact on social functioning from the perspectives of people with TBI and their intimate partners/spouses and friends. With these perspectives as background, the paper concludes with consideration of therapeutic developments and a brief look at a novel intervention designed to reduce the negative impact of pragmatic deficits and improve functional language use following TBI.
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36
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Rowley DA, Rogish M, Alexander T, Riggs KJ. Cognitive correlates of pragmatic language comprehension in adult traumatic brain injury: A systematic review and meta-analyses. Brain Inj 2017; 31:1564-1574. [DOI: 10.1080/02699052.2017.1341645] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Dane A Rowley
- Clinical Psychology Programme, University of Hull, Hull, UK
| | - Miles Rogish
- Brain Injury Rehabilitation Trust, The Disabilities Trust, West Sussex, UK
| | | | - Kevin J Riggs
- Department of Psychology, University of Hull, Hull, UK
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Marcotte K, McSween MP, Pouliot M, Martineau S, Pauzé AM, Wiseman-Hakes C, MacDonald S. Normative Study of the Functional Assessment of Verbal Reasoning and Executive Strategies (FAVRES) Test in the French-Canadian Population. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2017; 60:2217-2227. [PMID: 28793151 DOI: 10.1044/2017_jslhr-l-17-0012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 03/17/2017] [Indexed: 06/07/2023]
Abstract
PURPOSE The Functional Assessment of Verbal Reasoning and Executive Strategies (FAVRES; MacDonald, 2005) test was designed for use by speech-language pathologists to assess verbal reasoning, complex comprehension, discourse, and executive skills during performance on a set of challenging and ecologically valid functional tasks. A recent French version of this test was translated from English; however, it had not undergone standardization. The development of normative data that are linguistically and culturally sensitive to the target population is of importance. The present study aimed to establish normative data for the French version of the FAVRES, a commonly used test with native French-speaking patients with traumatic brain injury in Québec, Canada. METHOD The normative sample consisted of 181 healthy French-speaking adults from various regions across the province of Québec. Age and years of education were factored into the normative model. RESULTS Results indicate that age was significantly associated with performance on time, accuracy, reasoning subskills, and rationale criteria, whereas the level of education was significantly associated with accuracy and rationale. CONCLUSION Overall, mean scores on each criterion were relatively lower than in the original English version, which reinforces the importance of using the present normative data when interpreting performance of French speakers who have sustained a traumatic brain injury.
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Affiliation(s)
- Karine Marcotte
- Centre de Recherche de l'Hôpital du Sacré-Cœur de Montréal, Québec, Canada
- École d'Orthophonie et d'Audiologie, Faculty of Medicine, Université de Montréal, Québec, Canada
| | - Marie-Pier McSween
- Centre de Recherche de l'Hôpital du Sacré-Cœur de Montréal, Québec, Canada
| | | | - Sarah Martineau
- Centre de Recherche de l'Hôpital du Sacré-Cœur de Montréal, Québec, Canada
| | | | - Catherine Wiseman-Hakes
- Cognitive Neurorehabilitation Sciences Laboratory, Toronto Rehab Institute, Ontario, Canada
- Department of Speech-Language Pathology, Rehabilitation Sciences Institute, University of Toronto, Ontario, Canada
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Byom L, Turkstra L. Cognitive task demands and discourse performance after traumatic brain injury. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2017; 52:501-513. [PMID: 27891725 PMCID: PMC5620021 DOI: 10.1111/1460-6984.12289] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 08/10/2016] [Accepted: 08/19/2016] [Indexed: 05/11/2023]
Abstract
BACKGROUND Social communication problems are common in adults with traumatic brain injury (TBI), particularly problems in spoken discourse. Social communication problems are thought to reflect underlying cognitive impairments. AIMS To measure the contribution of two cognitive processes, executive functioning (EF) and theory of mind (ToM), to the communication of adults with TBI, and to investigate the relationships between discourse performance and potential communication partners' perceptions. METHODS & PROCEDURES Twenty-one adults with moderate-to-severe TBI and 23 uninjured adults completed a discourse task in which EF and ToM demands were manipulated across three conditions: baseline, high-EF and high-ToM. Dependent variables were fluency (for EFs), number of mental state terms (MSTs; for ToM) and speech rate. Discourse from high-EF/ToM conditions was judged by naïve raters for social acceptability. OUTCOMES & RESULTS The TBI group produced significantly fewer MSTs than the comparison group across conditions and also spoke at a slower rate, and there were significant effects of condition on both measures (MST: high-EF < baseline = high-ToM; speech rate: high-EF < high-ToM < baseline). There were no significant between-groups differences in fluency or interaction of fluency with condition. MST use and fluency were associated with social acceptability ratings. CONCLUSIONS & IMPLICATIONS Results added further evidence of social communication problems in adults with TBI and demonstrated that discourse behaviours may negatively affect how a speaker is perceived. Results also indicated that task manipulations can affect discourse performance, suggesting that general cognitive demands may influence social communication after TBI.
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Affiliation(s)
- Lindsey Byom
- William S. Middleton Memorial Veterans Hospital
- University of Wisconsin – Madison
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Berisha V, Wang S, LaCross A, Liss J, Garcia-Filion P. Longitudinal changes in linguistic complexity among professional football players. BRAIN AND LANGUAGE 2017; 169:57-63. [PMID: 28327371 PMCID: PMC6939664 DOI: 10.1016/j.bandl.2017.02.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 02/12/2017] [Accepted: 02/25/2017] [Indexed: 05/07/2023]
Abstract
Reductions in spoken language complexity have been associated with the onset of various neurological disorders. The objective of this study is to analyze whether similar trends are found in professional football players who are at risk for chronic traumatic encephalopathy. We compare changes in linguistic complexity (as indexed by the type-to-token ratio and lexical density) measured from the interview transcripts of players in the National Football League (NFL) to those measured from interview transcripts of coaches and/or front-office NFL executives who have never played professional football. A multilevel mixed model analysis reveals that exposure to the high-impact sport (vs no exposure) was associated with an overall decline in language complexity scores over time. This trend persists even after controlling for age as a potential confound. The results set the stage for a prospective study to test the hypothesis that language complexity decline is a harbinger of chronic traumatic encephalopathy.
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Affiliation(s)
- Visar Berisha
- Department of Speech and Hearing Science and School of Electrical Computer and Energy Engineering, Arizona State University, United States.
| | - Shuai Wang
- Department of Speech and Hearing Science, Arizona State University, United States
| | - Amy LaCross
- Department of Speech and Hearing Science, Arizona State University, United States
| | - Julie Liss
- Department of Speech and Hearing Science, Arizona State University, United States
| | - Pamela Garcia-Filion
- University of Arizona, College of Medicine-Phoenix, Dept of Biomedical Informatics, United States
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40
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Bosco FM, Parola A, Sacco K, Zettin M, Angeleri R. Communicative-pragmatic disorders in traumatic brain injury: The role of theory of mind and executive functions. BRAIN AND LANGUAGE 2017; 168:73-83. [PMID: 28161678 DOI: 10.1016/j.bandl.2017.01.007] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 10/19/2016] [Accepted: 01/23/2017] [Indexed: 06/06/2023]
Abstract
Previous research has shown that communicative-pragmatic ability, as well as executive functions (EF) and Theory of Mind (ToM), may be impaired in individuals with traumatic brain injury (TBI). However, the role of such cognitive deficits in explaining communicative-pragmatic difficulty in TBI has still not been fully investigated. The study examined the relationship between EF (working memory, planning and flexibility) and ToM and communicative-pragmatic impairment in patients with TBI. 30 individuals with TBI and 30 healthy controls were assessed using the Assessment Battery of Communication (ABaCo), and a set of cognitive, EF and ToM, tasks. The results showed that TBI participants performed poorly in comprehension and production tasks in the ABaCo, using both linguistic and extralinguistic means of expression, and that they were impaired in EF and ToM abilities. Cognitive difficulties were able to predict the pragmatic performance of TBI individuals, with both executive functions and ToM contributing to explaining patients' scores on the ABaCo.
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Affiliation(s)
- Francesca M Bosco
- Center for Cognitive Science, Department of Psychology, University of Turin, Italy; Institute of Neurosciences of Turin, Italy
| | - Alberto Parola
- Center for Cognitive Science, Department of Psychology, University of Turin, Italy.
| | - Katiuscia Sacco
- Center for Cognitive Science, Department of Psychology, University of Turin, Italy; Institute of Neurosciences of Turin, Italy
| | | | - Romina Angeleri
- Department of Psychology, University of New Mexico, NM, United States
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Fisher F, Philpott A, Andrews SC, Maule R, Douglas J. Characterizing social communication changes in amyotrophic lateral sclerosis. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2017; 52:137-142. [PMID: 27363686 DOI: 10.1111/1460-6984.12267] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 04/21/2016] [Accepted: 04/25/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Speech and language impairments are well-established in individuals with amyotrophic lateral sclerosis (ALS). However, knowledge about particular aspects of social communication and everyday conversational abilities is limited. AIMS To investigate self- and informant-report ratings of social communicative abilities in ALS participants and matched healthy controls. METHODS & PROCEDURES Thirty-two participants with ALS and 24 controls completed the La Trobe Communication Questionnaire (LCQ). Participants nominated a close other to provide an informant report on the LCQ. Demographic and clinical information was also collected. OUTCOMES & RESULTS Informant ratings indicated greater difficulties in conversational initiation, effectiveness and partner sensitivity for ALS participants compared with controls. ALS participants did not rate their social communicative abilities as poorer than controls and self-reports only differed from informant ratings in the control group. LCQ scores were not significantly correlated with clinical/functional variables. CONCLUSIONS & IMPLICATIONS Social communication can be reduced in ALS and individuals may lack insight into these difficulties. In order to understand and provide targeted interventions for such difficulties, clinical speech and language assessment should incorporate social communication assessment, including both a self- and informant-report format.
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Affiliation(s)
- Fiona Fisher
- Calvary Health Care Bethlehem, Caulfield South, VIC, Australia
| | - April Philpott
- Calvary Health Care Bethlehem, Caulfield South, VIC, Australia
| | - Sophie C Andrews
- Calvary Health Care Bethlehem, Caulfield South, VIC, Australia
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, VIC, Australia
| | - Roxanne Maule
- Calvary Health Care Bethlehem, Caulfield South, VIC, Australia
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Psychosocial Aspects of Pragmatic Disorders. PERSPECTIVES IN PRAGMATICS, PHILOSOPHY & PSYCHOLOGY 2017. [DOI: 10.1007/978-3-319-47489-2_23] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Pearce B, Cartwright J, Cocks N, Whitworth A. Inhibitory control and traumatic brain injury: The association between executive control processes and social communication deficits. Brain Inj 2016; 30:1708-1717. [DOI: 10.1080/02699052.2016.1202450] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Bronte Pearce
- Department of Psychology and Speech Pathology, Curtin University, Perth, Australia
| | - Jade Cartwright
- Department of Psychology and Speech Pathology, Curtin University, Perth, Australia
| | - Naomi Cocks
- Department of Psychology and Speech Pathology, Curtin University, Perth, Australia
| | - Anne Whitworth
- Department of Psychology and Speech Pathology, Curtin University, Perth, Australia
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Frontal and Temporal Structural Connectivity Is Associated with Social Communication Impairment Following Traumatic Brain Injury. J Int Neuropsychol Soc 2016; 22:705-16. [PMID: 27405965 PMCID: PMC5823263 DOI: 10.1017/s1355617716000539] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Although it has been well documented that traumatic brain injury (TBI) can result in communication impairment, little work to date has examined the relationship between social communication skills and structural brain integrity in patients with TBI. The aim of the current study was to investigate the association between self- and other-perceived communication problems and white matter integrity in patients with mild to severe TBI. METHODS Forty-four individuals (TBI=24) and people with whom they frequently communicate, as well as demographically matched normal healthy comparisons (NC) and their frequent communication partners, were administered, respectively, the La-Trobe Communication Questionnaire Self form (LCQ-SELF) and Other form (LCQ-OTHER). In addition, diffusion tensor imaging data were collected, and fractional anisotropy (FA) measures were extracted for each lobe in both hemispheres. RESULTS Within the TBI group, but not within the NC group, participants who were perceived by their close others as having more communication problems had lower FA in the left frontal and temporal lobes (p<.01), but not in other brain regions. CONCLUSIONS Frontotemporal white matter microstructural integrity is associated with social communication abilities in adults with TBI. This finding contributes to our understanding of the mechanisms leading to communication impairment following TBI and can inform the development of new neuromodulation therapies as well as diagnostic tools. (JINS, 2016, 22, 705-716).
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Douglas JM, Bracy CA, Snow PC. Return to Work and Social Communication Ability Following Severe Traumatic Brain Injury. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2016; 59:511-520. [PMID: 27124205 DOI: 10.1044/2015_jslhr-l-15-0025] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 11/05/2015] [Indexed: 06/05/2023]
Abstract
PURPOSE Return to competitive employment presents a major challenge to adults who survive traumatic brain injury (TBI). This study was undertaken to better understand factors that shape employment outcome by comparing the communication profiles and self-awareness of communication deficits of adults who return to and maintain employment with those who do not. METHOD Forty-six dyads (46 adults with TBI, 46 relatives) were recruited into 2 groups based on the current employment status (employed or unemployed) of participants with TBI. Groups did not differ in regard to sex, age, education, preinjury employment, injury severity, or time postinjury. The La Trobe Communication Questionnaire (Douglas, O'Flaherty, & Snow, 2000) was used to measure communication. Group comparisons on La Trobe Communication Questionnaire scores were analyzed by using mixed 2 × 2 analysis of variance (between factor: employment status; within factor: source of perception). RESULTS Analysis yielded a significant group main effect (p = .002) and a significant interaction (p = .004). The employed group reported less frequent difficulties (self and relatives). Consistent with the interaction, unemployed participants perceived themselves to have less frequent difficulties than their relatives perceived, whereas employed participants reported more frequent difficulties than their relatives. CONCLUSION Communication outcome and awareness of communication deficits play an important role in reintegration to the workplace following TBI.
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Togher L, McDonald S, Tate R, Rietdijk R, Power E. The effectiveness of social communication partner training for adults with severe chronic TBI and their families using a measure of perceived communication ability. NeuroRehabilitation 2016; 38:243-55. [DOI: 10.3233/nre-151316] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Leanne Togher
- Speech Pathology, Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia
- National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Brain Recovery, Sydney, NSW, Australia
| | - Skye McDonald
- School of Psychology, The University of New South Wales, Sydney, NSW, Australia
- National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Brain Recovery, Sydney, NSW, Australia
| | - Robyn Tate
- John Walsh Centre for Rehabilitation Research, Northern Clinical School, Faculty of Medicine, University of Sydney, Sydney, NSW, Australia
- National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Brain Recovery, Sydney, NSW, Australia
| | - Rachael Rietdijk
- Speech Pathology, Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia
- National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Brain Recovery, Sydney, NSW, Australia
| | - Emma Power
- Speech Pathology, Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia
- National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Brain Recovery, Sydney, NSW, Australia
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Williamson J, Isaki E. Facial Affect Recognition Training Through Telepractice: Two Case Studies of Individuals with Chronic Traumatic Brain Injury. Int J Telerehabil 2015; 7:13-20. [PMID: 27563379 PMCID: PMC4985275 DOI: 10.5195/ijt.2015.6167] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
The use of a modified Facial Affect Recognition (FAR) training to identify emotions was investigated with two case studies of adults with moderate to severe chronic (> five years) traumatic brain injury (TBI). The modified FAR training was administered via telepractice to target social communication skills. Therapy consisted of identifying emotions through static facial expressions, personally reflecting on those emotions, and identifying sarcasm and emotions within social stories and role-play. Pre- and post-therapy measures included static facial photos to identify emotion and the Prutting and Kirchner Pragmatic Protocol for social communication. Both participants with chronic TBI showed gains on identifying facial emotions on the static photos.
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Affiliation(s)
| | - Emi Isaki
- NORTHERN ARIZONA UNIVERSITY, FLAGSTAFF, AZ, USA
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Brunner M, Hemsley B, Palmer S, Dann S, Togher L. Review of the literature on the use of social media by people with traumatic brain injury (TBI). Disabil Rehabil 2015; 37:1511-21. [DOI: 10.3109/09638288.2015.1045992] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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INCOG recommendations for management of cognition following traumatic brain injury, part IV: cognitive communication. J Head Trauma Rehabil 2015; 29:353-68. [PMID: 24984097 DOI: 10.1097/htr.0000000000000071] [Citation(s) in RCA: 159] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Cognitive-communication disorders are common in individuals with traumatic brain injury (TBI) and can have a major impact on long-term outcome. Guidelines for evidence-informed rehabilitation are needed, thus an international group of researchers and clinicians (known as INCOG) convened to develop recommendations for assessment and intervention. METHODS An expert panel met to select appropriate recommendations for assessment and treatment of cognitive-communication disorders based on available literature. To promote implementation, the team developed decision algorithms incorporating the recommendations, based on inclusion and exclusion criteria of published trials, and then prioritized recommendations for implementation and developed audit criteria to evaluate adherence to best practice recommendations. RESULTS Rehabilitation of individuals with cognitive-communication disorders should consider premorbid communication status; be individualized to the person's needs, goals, and skills; provide training in use of assistive technology where appropriate; include training of communication partners; and occur in context to minimize the need for generalization. Evidence supports treatment of social communication problems in a group format. CONCLUSION There is strong evidence for person-centered treatment of cognitive-communication disorders and use of instructional strategies such as errorless learning, metacognitive strategy training, and group treatment. Future studies should include tests of alternative service delivery models and development of participation-level outcome measures.
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Ghayoumi Z, Yadegari F, Mahmoodi-Bakhtiari B, Fakharian E, Rahgozar M, Rasouli M. Persuasive discourse impairments in traumatic brain injury. ARCHIVES OF TRAUMA RESEARCH 2015; 4:e21473. [PMID: 25798418 PMCID: PMC4360602 DOI: 10.5812/atr.21473] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Revised: 11/08/2014] [Accepted: 02/03/2015] [Indexed: 11/16/2022]
Abstract
Background: Considering the cognitive and linguistic complexity of discourse production, it is expected that individuals with traumatic brain injury (TBI) should face difficulties in this task. Therefore, clinical examination of discourse has become a useful tool for studying and assessment of communication skills of people suffering from TBI. Among different genres of discourse, persuasive discourse is considered as a more cognitively demanding task. However, little is known about persuasive discourse in individuals suffering from TBI. Objectives: The purpose of this study was to evaluate the performance of adults with TBI on a task of spoken persuasive discourse to determine the impaired linguistic measures. Patients and Methods: Thirteen TBI nonaphasic Persian speaking individuals, ranged between 19 to 40 years (Mean = 25.64 years; SD = 6.10) and 59 healthy adults matched by age, were asked to perform the persuasive discourse task. The task included asking the participants to express their opinion on a topic, and after the analysis of the produced discourse, the two groups were compared on the basis of their language productivity, sentential complexity, maze ratio and cohesion ratio. Results: The TBI group produced discourses with less productivity, sentential complexity, cohesion ratio and more maze ratio compared the control group. Conclusions: As it is important to consider acquired communication disorders particularly discourse impairment of brain injured patients along with their other clinical impairments and regarding the fact that persuasive discourse is crucial in academic and social situations, the persuasive discourse task presented in this study could be a useful tool for speech therapists, intending to evaluate communication disorders in patients with TBI.
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Affiliation(s)
- Zahra Ghayoumi
- Department of Speech Therapy, University of Social Welfare and Rehabilitation, Tehran, IR Iran
| | - Fariba Yadegari
- Department of Speech Therapy, University of Social Welfare and Rehabilitation, Tehran, IR Iran
- Corresponding author: Fariba Yadegari, Department of Speech Therapy, University of Social Welfare and Rehabilitation, Tehran, IR Iran. Tel: +98-2122180043, Fax: +98-2122180043, E-mail:
| | | | - Esmaeil Fakharian
- Trauma Research Center, Kashan University of Medical Sciences,Tehran, IR Iran
| | - Mehdi Rahgozar
- Department of Biostatistics and Computer, University of Social Welfare and Rehabilitation, Tehran, IR Iran
| | - Maryam Rasouli
- Department of Pediatrics, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
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