Communicative impairment in traumatic brain injury: a complete pragmatic assessment.

The aim of the present study was to examine the communicative abilities of traumatic brain injury patients (TBI). We wish to provide a complete assessment of their communicative ability/disability using a new experimental protocol, the Assessment Battery of Communication, (ABaCo) comprising five scales--linguistic, extralinguistic, paralinguistic, context and conversational--which investigate all the main pragmatic elements involved in a communicative exchange. The ABaCo was administered to 21 TBI subjects and to a control group. The results showed that performance by TBI patients was worse than that of controls on all scales; moreover they showed a trend of increasing difficulty in understanding and producing different pragmatic phenomena, i.e., standard communication acts, deceits and ironies, whether such phenomena are expressed through the linguistic or extralinguistic modality.

The intentional network: how the brain reads varieties of intentions.

Social neuroscience provides insights into the neural correlates of the human capacity to explain and predict other people's intentions, a capacity that lies at the core of the Theory of Mind (ToM) mechanism. Results from neuroimaging research describe a widely distributed neural system underlying ToM, including the right and left temporo-parietal junctions (TPJ), the precuneus, and the medial prefrontal cortex (MPFC). Nevertheless, there is disagreement in the literature concerning the key region for the ToM network. Some authors point to the MPFC, others to the right TPJ. In the effort to make a contribution to the debate, we propose a model of a dynamic ToM network consisting of four regions. We also introduce a novel theoretical distinction among varieties of intention, which differ by the nature of an individual's pursued goal (private or social) and by the social interaction's temporal dimension (present or future). Our results confirm the crucial role of both the MPFC and the right TPJ, but show that these areas are differentially engaged depending on the nature of the intention involved. Whereas the right TPJ and the precuneus are necessary for processing all types of prior intentions, the left TPJ and the anterior paracingulate cortex are specifically involved in the understanding of social intention. More specifically, the left TPJ is activated only when a subset of social intentions are involved (communicative intentions). Taken together, these results demonstrate the progressive recruitment of the ToM network along the theoretical dimensions introduced in the present paper.

Communicative abilities in autism: evidence for attentional deficits.

Although there are many theories about autism, something all of them agree upon is that autistics are impaired in the ability to communicate. The explanation is either their incapacity to attribute mental states to others or the interference of irrelevant stimuli with the access and processing of the communication (low). Our study on mute autistic children aims to investigate their communicative ability in order to bring some new evidence on the debate. We used an experimental technique that allows autistic children to access and process the communicative acts in a familiar context for as long as needed. The experimental results show that our sample of autistic children performs as well as the control group of normal children in dealing with directs, indirects, ironies, deceits, and recoveries of failure. Independent of their respective difficulty, the felicitous outcome of any of these acts requires the capacity to attribute an adequate communicative intention to the actor. Moreover, our results show that, contrary to the established findings in the literature, autistics' performance in the standard false belief task, a task that requires one to understand the mental states of other people, is equivalent to the performance of normal subjects. We argue that an attentional deficit affects the communicative performance of autistics in experiments where classic methodologies are used; with the proper methodology, we can access the unexplored world where mute autistic children also communicate. As far as we know, this is the first systematic experiment on pragmatic abilities in mute autistic children. Indeed, our work shows that tests and methodologies which help to focus on the communicative task improve the autistics' performance with respect to those used in the literature. We conclude that the autistic communicative deficit is at the performance level and that it has an attentional nature.

Neuropragmatics: extralinguistic communication after closed head injury.

This work is concerned with the decay of communicative abilities after head trauma. A protocol composed of 16 videotaped scenes was devised in order to investigate the comprehension of several types of communicative actions realized with extralinguistic means, like pointing or clapping. The protocol was administered to 30 closed-head-injured individuals. The results showed that performance decreased from simple standard acts to complex standard acts, deceits, and ironies. The subjects' performance was worse with the scenes reproducing failing, rather than successful, communicative actions. The results are compared with those we previously obtained with a linguistic protocol. A theory of the cognitive processes underlying intentional communication is outlined and used to explain the results.

Development and decay of extra-linguistic communication.

Cognitive Pragmatics theory is concerned with analyzing the cognitive processes underlying communication. In previous works we have explained the emergence of communication in context, as revealed by very young children, and the communicative deficits shown by closed head injury patients. The aim of the present work is an extension of Cognitive Pragmatics to the emergence and the decay of extra-linguistic communication. In particular, we investigate the performance of 2- to 7-year-old children and that of Alzheimer's patients in standard and nonstandard (irony and deceit) pragmatic tasks. The predictions derived by Cognitive Pragmatics are confirmed. Comprehension of pragmatic phenomena which are more complex according to the theory emerges later in the development (Experiment 1), and their decay is most severe in Alzheimer's patients (Experiment 2). We conclude that the framework provided by Cognitive Pragmatics can accommodate both the development and the decay of extra-linguistic communication.

Developmental pragmatics in normal and abnormal children.

We propose a critical review of current theories of developmental pragmatics. The underlying assumption is that such a theory ought to account for both normal and abnormal development. From a clinical point of view, we are concerned with the effects of brain damage on the emergence of pragmatic competence. In particular, the paper deals with direct speech acts, indirect speech acts, irony, and deceit in children with head injury, closed head injury, hydrocephalus, focal brain damage, and autism. Since no single theory covers systematically the emergence of pragmatic capacity in normal children, it is not surprising that we have not found a systematic account of deficits in the communicative performance of brain injured children. In our view, the challenge for a pragmatic theory is the determination of the normal developmental pattern within which different pragmatic phenomena may find a precise role. Such a framework of normal behavior would then permit the systematic study of abnormal pragmatic development.

Neuropragmatics: neuropsychological constraints on formal theories of dialogue.

We are interested in the validation of a cognitive theory of human communication, grounded in a speech acts perspective. The theory we refer to is outlined, and a number of predictions are drawn from it. We report a series of protocols administered to 13 brain-injured subjects and to a comparable control group. The tasks included direct and indirect speech acts, irony, deceits, failures of communication, and theory of mind inferences. All the predicted trends of difficulty are consistently verified; in particular, difficulty increases form direct/indirect speech acts to irony, from irony to deceits, and from deceits to failure recovery. This trend symmetrically shows both in the successful situation and in the failure situation. Further, failure situations prove more difficult to handle than the relevant successful situation. In sharp contrast with previous literature, there is no difference between the subjects' comprehension of direct and indirect speech acts. The results are discussed in the light of our theoretical approach.