Communicative-pragmatic disorders in traumatic brain injury: The role of theory of mind and executive functions.

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.

Explaining pragmatic performance in traumatic brain injury: a process perspective on communicative errors.

BACKGROUND: The purpose of this study is to investigate the pragmatic abilities of individuals with traumatic brain injury (TBI). Several studies in the literature have previously reported communicative deficits in individuals with TBI, however such research has focused principally on communicative deficits in general, without providing an analysis of the errors committed in understanding and expressing communicative acts. Within the theoretical framework of Cognitive Pragmatics theory and Cooperative principle we focused on intermediate communicative errors that occur in both the comprehension and the production of various pragmatic phenomena, expressed through both linguistic and extralinguistic communicative modalities. AIMS: To investigate the pragmatic abilities of individuals with TBI. METHODS & PROCEDURES: A group of 30 individuals with TBI and a matched control group took part in the experiment. They were presented with a series of videotaped vignettes depicting everyday communicative exchanges, and were tested on the comprehension and production of various kinds of communicative acts (standard communicative act, deceit and irony). The participants' answers were evaluated as correct or incorrect. Incorrect answers were then further evaluated with regard to the presence of different intermediate errors. OUTCOMES & RESULTS: Individuals with TBI performed worse than control participants on all the tasks investigated when considering correct versus incorrect answers. Furthermore, a series of logistic regression analyses showed that group membership (TBI versus controls) significantly predicted the occurrence of intermediate errors. This result holds in both the comprehension and production tasks, and in both linguistic and extralinguistic modalities. CONCLUSIONS & IMPLICATIONS: Participants with TBI tend to have difficulty in managing different types of communicative acts, and they make more intermediate errors than the control participants. Intermediate errors concern the comprehension and production of the expression act, the comprehension of the actors' meaning, as well as the respect of the Cooperative principle.

Cognitive Pragmatic Treatment: A Rehabilitative Program for Traumatic Brain Injury Individuals.

OBJECTIVE: To verify the efficacy of Cognitive Pragmatic Treatment (CPT), a new rehabilitation training program for improving communicative-pragmatic abilities. DESIGN: The CPT program consists of 24 group sessions, concerned with improving several communication modalities, theory of mind (ToM), and cognitive components that can affect pragmatic performance, such as awareness and executive functions. PARTICIPANTS: A sample of 15 adults with severe traumatic brain injury. MAIN MEASURES: Improvements were evaluated before and after training, using the equivalent forms of the Assessment Battery for Communication (ABaCo), a tool for evaluating comprehension and production of a wide range of pragmatic phenomena. A neuropsychological and ToM assessment was also conducted. RESULTS: The patients' performance improved after training, in terms of both comprehension and production, in all the communication modalities assessed by the ABaCo, that is, linguistic, extralinguistic, paralinguistic, and social appropriateness abilities. The follow-up showed that the improvement of patients persists after 3 months from the end of the training. CONCLUSIONS: The results suggest that the CPT program is efficacious in improving communicative-pragmatic abilities in individuals with TBI, and that improvements at this level are still detectable even in chronic patients years after the injury.

The development of joke and irony understanding: a study with 3- to 6-year-old children.

Previous research suggests that comprehending ironic utterances is a relatively late-developing skill, emerging around 5-6 years of age. This study investigated whether younger children might show an earlier understanding when ironic utterances are performed in familiar communicative situations, and investigated the relationships among irony comprehension, language, and theory of mind (ToM) abilities. A group of 100 children aged 3.0-6.5 years was presented with 4 types of puppet scenarios depicting different communicative interactions: control, joke, contingent irony and background irony stories. Results suggested that (a) even younger children easily understand jokes, and may sometimes understand ironies; (b) children's comprehension of irony continues to develop across early childhood; and (c) receptive vocabulary scores had simultaneous effects on irony comprehension and ToM performance.

Communicative abilities in children: an assessment through different phenomena and expressive means.

Previous studies on children's pragmatic abilities have tended to focus on just one pragmatic phenomenon and one expressive means at a time, mainly concentrating on comprehension, and overlooking the production side. We assessed both comprehension and production in relation to several pragmatic phenomena (simple and complex standard communication acts, irony, and deceit) and several expressive means (linguistic, extralinguistic, paralinguistic). Our study involved 390 Italian-speaking children divided into three age groups: 5;0-5;6, 6;6-7;0, and 8;0-8;6. Children's performance on all tasks improved with their age. Within each age group, children responded more accurately to tasks involving standard communication than to those involving deceit and irony, across all expressive means and for both comprehension and production. Within each pragmatic phenomenon, children responded more accurately to simple acts than to complex ones, regardless of age group and expressive means, i.e., linguistic or extralinguistic. Overall results fit well with the Cognitive Pragmatics theory (Bara, 2010).

A retrospective two-center study of antiepileptic prophylaxis in patients with surgically treated high-grade gliomas.

BACKGROUND: The effectiveness of antiepileptic prophylaxis in patients with newly diagnosed high-grade glioma is debated. Craniotomy, surgical manipulation and bleeding are believed to favor the onset of seizures and, therefore, perioperative antiepileptic drugs (AEDs) are generally used. Nevertheless, evidence to initiate preoperative AED prophylaxis are weak. AIM: Aim of this paper was to evaluate the need for AED prophylaxis in surgically-treated malignant glioma patients without history of seizures. MATERIALS AND METHODS: We conducted a retrospective, two-center cohort study to assess the effectiveness of preoperative AED prophylaxis. Patients were divided in two groups: one with AED preoperative administration and the other without. Because of its non-hepatic metabolism, levetiracetam (LEV) was chosen. Logistic regression models were used to investigate the odds ratio for each group. The explanatory variables included the treatment received, sex, age, and site of lesion. The outcome measure of successful LEV prophylaxis was seizure vs. no seizure post-operatively, at three and six months after surgery. RESULTS: Our results showed that LEV prophylaxis was not a significant predictor of seizure occurrence, although the regression coefficient indicated a slight reduction in seizure risk following LEV administration. Patient's age was a significant predictor of seizure occurrence. Younger patients had a higher risk of seizure in the six months post-surgery. CONCLUSIONS: We conclude that AEDs prophylaxis does not provide a substantial benefit to surgically treated high-grade glioma patients and should not be administered routinely. Further investigations are required to detect subgroups of patients at higher risk of developing seizures in order to selectively administer AED.

Understanding the communicative impairments in schizophrenia: a preliminary study.

UNLABELLED: The aim of the present study was to evaluate the pragmatic abilities of patients with schizophrenia in a variety of pragmatic phenomena expressed through different communicative means (language, gestures, and paralinguistic modality). For this purpose we used the Assessment Battery of Communication (ABaCo; Sacco et al., 2008). The ABaCo is a validated clinical tool for assessing pragmatic skills, which comprises five evaluation scales-linguistic, extralinguistic, paralinguistic, context, and conversational-investigating both comprehension and production of the main pragmatic phenomena involved in a communicative exchange, such as direct and indirect speech acts, irony, deceit, the violation of Grice's maxims, topic management, and turn-taking. The battery was administered to a group of seventeen patients with schizophrenia, and matched healthy controls. We expected the clinical group to perform widely worse than the control group in the different pragmatic dimensions investigated. Results showed that patients with schizophrenia performed significantly worse than controls on all the five scales of the battery, both in comprehension and production tasks. Moreover, the results within each scale showed a differentiated performance in the clinical group among the pragmatic phenomena, with irony assessed as the most difficult task. The implications of these results for research and treatment in schizophrenia are discussed. LEARNING OUTCOMES: After reading this article, the reader will be able to: (1) summarize thepreliminary assessment of pragmatic impairments in patients with schizophrenia; (2) describea variegated communicative profile regarding different pragmatic phenomena; and (3) discuss the planning and evaluating specific rehabilitation programs.

Assessment Battery for Communication: development of two equivalent forms.

UNLABELLED: The aim of this paper was to develop and test two equivalent forms of the Assessment Battery for Communication (ABaCo), a tool for evaluating pragmatic abilities in patients with neuropsychological and psychiatric disorders. The equivalent forms were created using the data from a sample of 390 children, then tested in a sample of 30 patients with traumatic brain injury. Equivalent forms of the same test are useful in clinical practice and intervention research, when performance needs to be tested on two separate occasions, for example before and after a rehabilitation program. The present results provide additional evidence on the psychometric functioning of the equivalent forms of the ABaCo and their usability in a clinical context. LEARNING OUTCOMES: The reader will be able to discuss the evidence of the psychometric propriety of the equivalent forms of the ABaCo and describe its potential usefulness.

Assessment battery for communication (ABaCo): normative data.

The Assessment Battery for Communication (ABaCo) was introduced to evaluate pragmatic abilities in patients with cerebral lesions. The battery is organized into five evaluation scales focusing on separate components of pragmatic competence. In the present study, we present normative data for individuals 15-75 years of age (N = 300). The sample was stratified by age, sex, and years of education, according to Italian National Institute of Statistics indications in order to be representative of the general national population. Since performance on the ABaCo decreases with age and lower years of education, the norms were stratified for both age and education. The ABaCo is a valuable tool in clinical practice; the normative data provided here will enable clinicians to determine different kinds and specific levels of communicative impairments more precisely.

Situation-sensitive use of insincerity: pathways to communication in young children.

The present research focused on the development of children's ability to spontaneously suspend sincerity or tell a lie according to different communicative contexts. The issue of sincerity in communication is rather complex since in everyday interactions sincerity is expected, while there are specific communicative acts where sincerity is not prescribed or even banished. This study investigated how children (N= 80, ranging in age from 3 to 6.5 years) handled communications involving insincerity: fantasy stories, lies, and politeness situations. The results showed that the ability to deal with insincerity emerges gradually during the preschool years with an increasing trend of difficulty, from fantasy to politeness situations, and a notable amount of variability not equally distributed among the tasks.

The evolution of autistic-like and schizotypal traits: a sexual selection hypothesis.

In this paper we present a new hypothesis on the evolution of autistic-like and schizotypal personality traits. We argue that autistic-like and schizotypal traits contribute in opposite ways to individual differences in reproductive and mating strategies, and have been maintained - at least in part - by sexual selection through mate choice. Whereas positive schizotypy can be seen as a psychological phenotype oriented to high-mating effort and good genes displays in both sexes, autistic-like traits in their non-pathological form contribute to a male-typical strategy geared toward high parental investment, low-mating effort, and long-term resource allocation. At the evolutionary-genetic level, this sexual selection hypothesis is consistent with Crespi and Badcock's "imprinted brain" theory of autism and psychosis; the effect of offspring mating behavior on resource flow within the family connects sexual selection with genomic imprinting in the context of human biparental care. We conclude by presenting the results of an empirical study testing one of the predictions derived from our hypothesis. In a sample of 199 college students, autistic-like traits predicted lower interest in short-term mating, higher partner-specific investment, and stronger commitment to long-term romantic relations, whereas positive schizotypy showed the opposite pattern of effects.