Can Narrative Skills Improve in Autism Spectrum Disorder? A Preliminary Study with Verbally Fluent Adolescents Receiving the Cognitive Pragmatic Treatment.

Autism spectrum disorder (ASD) is a neurodevelopmental condition affecting social and communicative skills, including narrative ability, namely the description of real-life or fictive accounts of temporally and causally related events. With this study, we aimed to determine whether a communicative-pragmatic training, i.e., the version for adolescents of the Cognitive-Pragmatic Treatment, is effective in improving the narrative skills of 16 verbally fluent adolescents with ASD. We used a multilevel approach to assess pre- and post-training narrative production skills. Discourse analysis focused on micro- (i.e., mean length of utterance, complete sentences, omissions of morphosyntactic information) and macrolinguistic measures (i.e., cohesion, coherence errors, lexical informativeness). Results revealed a significant improvement in mean length of utterance and complete sentences and a decrease in cohesion errors. No significant change was found in the other narrative measures investigated. Our findings suggest that a pragmatically oriented training may be useful in improving grammatical efficiency in narrative production.

Non-linguistic comprehension, social inference and empathizing skills in autistic young adults, young adults with autistic traits and control young adults: Group differences and interrelatedness of skills.

BACKGROUND: Despite increasing knowledge of social communication skills of autistic peole, the interrelatedness of different skills such as non-linguistic comprehension, social inference and empathizing skills is not much known about. A better understanding of the complex interplay between different domains of social communication helps us to develop assessment protocols for individuals with social communication difficulties. AIMS: To compare the performances of autistic young adults, young adults with autistic traits identified in childhood and control young adults in social communication tasks measuring non-linguistic comprehension, social inference and empathizing skills. In addition, to examine associations between the different social communication measures. METHODS & PROCEDURES: Autistic young adults (n = 34), young adults with autistic traits (n = 19) and control young adults (n = 36) completed the extra- and paralinguistic scales of the Assessment Battery for Communication (ABaCo), the Faux Pas Recognition Test, Social-Pragmatic Questions (SoPra) and the Empathy Quotient (EQ). OUTCOMES & RESULTS: Group differences were found in the performance in the ABaCo, SoPra and EQ scores. Compared with the control young adults, autistic young adults scored lower. The performance of the young adults in the autistic traits group fell in between the other two groups. There were no group differences in the Faux Pas Recognition Test. The variability within the groups was large in all measurements. In the control group, there was a significant correlation between EQ and SoPra scores and between the Faux Pas and SoPra scores. In the autistic group, a significant correlation was found between Faux Pas and SoPra scores. Also, other patterns were observed but these were not statistically significant. CONCLUSIONS & IMPLICATIONS: The young adults with autistic traits fell in between the control and autistic young adults, highlighting the presence of the continuum in the terms of features of social communication. The results support other current research that suggests that theory of mind and other social communication skills may not be universally or widely impaired in all autistic individuals without cognitive deficits. Although all tasks examined social communication skills, only a small number of significant correlations were found between test scores. This highlights that clinical conclusions about a person's social communication should be based on the outcomes of different types of methods measuring different aspects of social communication. It is clear that the interrelatedness of different social communication skills needs further research. WHAT THIS PAPER ADDS: What is already known on this subject For successful communication, the ability to infer others' emotions, intentions and mental states is crucial. Autistic people have difficulty with many aspects of social communication. However, the associations between different aspects of social communication need to be better understood. What this paper adds to existing knowledge The unique contribution of this study is to compare the performance of autistic people not only with that of a control group but also with people with childhood autistic traits. This provides an understanding of the interrelatedness of different social communication skills in people with varying degrees of autistic traits. This study used four assessment methods focusing on three different social communication elements (non-linguistic comprehension, social inference and empathizing skills). These elements have complex relationships to one another, some being closely overlapping, some more distally related and some reflect more complex multifactorial elements. This study shows that although groups differ from each other in most of the assessments, the performance of different groups overlapped showing that many autistic young adults can perform well in non-linguistic and social inference tasks in structured assessment contexts. What are the potential or actual clinical implications of this work? Our findings suggest that in the assessment of social communication, self-reports and clinical assessments can be used effectively together. They can complement each other, pointing out the strengths and weaknesses of a person, leading to more personalized therapeutic interventions.

A cross-sectional study to assess pragmatic strengths and weaknesses in healthy ageing.

BACKGROUND: Ageing refers to the natural and physiological changes that individuals experience over the years. This process also involves modifications in terms of communicative-pragmatics, namely the ability to convey meanings in social contexts and to interact with other people using various expressive means, such as linguistic, extralinguistic and paralinguistic aspects of communication. Very few studies have provided a complete assessment of communicative-pragmatic performance in healthy ageing. METHODS: The aim of this study was to comprehensively assess communicative-pragmatic ability in three samples of 20 (N = 60) healthy adults, each belonging to a different age range (20-40, 65-75, 76-86 years old) and to compare their performance in order to observe any potential changes in their ability to communicate. We also explored the potential role of education and sex on the communicative-pragmatic abilities observed. The three age groups were evaluated with a between-study design by means of the Assessment Battery for Communication (ABaCo), a validated assessment tool characterised by five scales: linguistic, extralinguistic, paralinguistic, contextual and conversational. RESULTS: The results indicated that the pragmatic ability assessed by the ABaCo is poorer in older participants when compared to the younger ones (main effect of age group: F(2,56) = 9.097; p < .001). Specifically, significant differences were detected in tasks on the extralinguistic, paralinguistic and contextual scales. Whereas the data highlighted a significant role of education (F(1,56) = 4.713; p = .034), no sex-related differences were detected. CONCLUSIONS: Our results suggest that the ageing process may also affect communicative-pragmatic ability and a comprehensive assessment of the components of such ability may help to better identify difficulties often experienced by older individuals in their daily life activities.

An eye-tracking investigation of the cognitive processes involved in the comprehension of simple and complex communicative acts.

Indirect speech acts communicate more than their literal meaning, and their comprehension relies on the listener's ability to draw the appropriate inferences in a given context. We used eye tracking to investigate the cognitive processing involved in the comprehension of simple (direct) and complex (unconventional indirect) communicative acts, a more general distinction that applies not only to sincere speech acts, but also to irony and deceit. We recorded the eye movements of 40 participants while they read 60 stories (20 sincere, 20 deceitful, 20 ironic) consisting of a context and a target answer. For each story, we created two different contexts so that the same identical target answer was a simple (direct) and a complex (unconventional indirect) communicative act, respectively. We also assessed the indirectness of simple and complex communicative acts, as well as participants' working memory (WM) and theory of mind (ToM). Eye-pattern analysis showed that complex communicative acts were more difficult to understand than simple acts; differences between simple and complex acts held for all the pragmatic phenomena investigated, though processing differences were greater for sincere acts than for irony and deceit. We found a role of indirectness and ToM in the pragmatic processing of simple and complex acts, whereas the role of WM was modest. The present findings underscore the importance of adopting an encompassing theory that can account for different types of indirect speech acts, such as sincere, deceitful and ironic acts; they also suggest the importance of assessing individual differences in inferential and cognitive abilities.

Multimodal assessment of communicative-pragmatic features in schizophrenia: a machine learning approach.

An impairment in pragmatic communication is a core feature of schizophrenia, often associated with difficulties in social interactions. The pragmatic deficits regard various pragmatic phenomena, e.g., direct and indirect communicative acts, deceit, irony, and include not only the use of language but also other expressive means such as non-verbal/extralinguistic modalities, e.g., gestures and body movements, and paralinguistic cues, e.g., prosody and tone of voice. The present paper focuses on the identification of those pragmatic features, i.e., communicative phenomena and expressive modalities, that more reliably discriminate between individuals with schizophrenia and healthy controls. We performed a multimodal assessment of communicative-pragmatic ability, and applied a machine learning approach, specifically a Decision Tree model, with the aim of identifying the pragmatic features that best separate the data into the two groups, i.e., individuals with schizophrenia and healthy controls, and represent their configuration. The results indicated good overall performance of the Decision Tree model, with mean Accuracy of 82%, Sensitivity of 76%, and Precision of 91%. Linguistic irony emerged as the most relevant pragmatic phenomenon in distinguishing between the two groups, followed by violation of the Gricean maxims, and then extralinguistic deceitful and sincere communicative acts. The results are discussed in light of the pragmatic theoretical literature, and their clinical relevance in terms of content and design of both assessment and rehabilitative training.

Understanding communicative intentions in schizophrenia using an error analysis approach.

Patients with schizophrenia (SCZ) have a core impairment in the communicative-pragmatic domain, characterized by severe difficulties in correctly inferring the speaker's communicative intentions. While several studies have investigated pragmatic performance of patients with SCZ, little research has analyzed the errors committed in the comprehension of different communicative acts. The present research investigated error patterns in 24 patients with SCZ and 24 healthy controls (HC) during a task assessing the comprehension of different communicative acts, i.e., sincere, deceitful and ironic, and their relationship with the clinical features of SCZ. We used signal detection analysis to quantify participants' ability to correctly detect the speakers' communicative intention, i.e., sensitivity, and their tendency to wrongly perceive a communicative intention when not present, i.e., response bias. Further, we investigated the relationship between sensitivity and response bias, and the clinical features of the disorder, namely symptom severity, pharmacotherapy, and personal and social functioning. The results showed that the ability to infer the speaker's communicative intention is impaired in SCZ, as patients exhibited lower sensitivity, compared to HC, for all the pragmatic phenomena evaluated, i.e., sincere, deceitful, and ironic communicative acts. Further, we found that the sensitivity measure for irony was related to disorganized/concrete symptoms. Moreover, patients with SCZ showed a stronger response bias for deceitful communicative acts compared to HC: when committing errors, they tended to misattribute deceitful intentions more often than sincere and ironic ones. This tendency to misattribute deceitful communicative intentions may be related to the attributional bias characterizing the disorder.

Pragmatics, Theory of Mind and executive functions in schizophrenia: Disentangling the puzzle using machine learning.

OBJECTIVE: Schizophrenia is associated with a severe impairment in the communicative-pragmatic domain. Recent research has tried to disentangle the relationship between communicative impairment and other domains usually impaired in schizophrenia, i.e. Theory of Mind (ToM) and cognitive functions. However, the results are inconclusive and this relationship is still unclear. Machine learning (ML) provides novel opportunities for studying complex relationships among phenomena and representing causality among multiple variables. The present research explored the potential of applying ML, specifically Bayesian network (BNs) analysis, to characterize the relationship between cognitive, ToM and pragmatic abilities in individuals with schizophrenia and healthy controls, and to identify the cognitive and pragmatic abilities that are most informative in discriminating between schizophrenia and controls. METHODS: We provided a comprehensive assessment of different aspects of pragmatic performance, i.e. linguistic, extralinguistic, paralinguistic, contextual and conversational, ToM and cognitive functions, i.e. Executive Functions (EF)-selective attention, planning, inhibition, cognitive flexibility, working memory and speed processing-and general intelligence, in a sample of 32 individuals with schizophrenia and 35 controls. RESULTS: The results showed that the BNs classifier discriminated well between patients with schizophrenia and healthy controls. The network structure revealed that only pragmatic Linguistic ability directly influenced the classification of patients and controls, while diagnosis determined performance on ToM, Extralinguistic, Paralinguistic, Selective Attention, Planning, Inhibition and Cognitive Flexibility tasks. The model identified pragmatic, ToM and cognitive abilities as three distinct domains independent of one another. CONCLUSION: Taken together, our results confirmed the importance of considering pragmatic linguistic impairment as a core dysfunction in schizophrenia, and demonstrated the potential of applying BNs in investigating the relationship between pragmatic ability and cognition.

The Ability of Patients With Schizophrenia to Comprehend and Produce Sincere, Deceitful, and Ironic Communicative Intentions: The Role of Theory of Mind and Executive Functions.

Patients with schizophrenia are often described as impaired in several cognitive domains. Specifically, patients with schizophrenia often exhibit problems in solving tasks requiring theory of mind (ToM), i.e., the ability to ascribe mental states to oneself and others, communicative-pragmatic ability, i.e., the ability to use language and non-verbal expressive means to convey meaning in a given context, and executive functions (EF). This study aims to investigate the role of cognitive functions, such as general intelligence, selective attention, processing speed, and especially EF (working memory, cognitive flexibility, inhibition, and planning), and ToM in explaining the performance of individual with schizophrenia in comprehending and producing communicative acts expressed with different communicative intentions (i.e., sincere, deceitful, and ironic), and realized through linguistic and extralinguistic/non-verbal expressive means. Thirty-two patients with schizophrenia and an equal number of healthy controls performed tasks aiming to investigate their capacity to comprehend and produce sincere, deceitful, and ironic communicative acts in addition to a series of cognitive tasks evaluating EF and ToM. The results indicated that individuals with schizophrenia performed worse than the controls in the comprehension and production of all pragmatic phenomena investigated, as well as in all the cognitive functions examined. The patients with schizophrenia also exhibited an increasing trend of difficulty in comprehending and producing sincere, deceitful, and ironic communicative acts expressed through either linguistic or extralinguistic means. Furthermore, a multiple regression analysis of the patients' performance on the pragmatic tasks revealed that overall, the role of attention, general intelligence, and processing speed did not appear to significantly explain the patients' communicative-pragmatic performance. The inclusion of EF into the analysis did not contribute to increase the explained variance of the patients' ability to comprehend and produce the various pragmatic phenomena investigated. Only the addition of ToM could significantly increase the explained variance, but only in the comprehension and production of deceit expressed by language and the production of sincere communicative acts, also limited to linguistic production. We conclude that neither EF nor ToM are able to explain the decreasing trend detected in the patients' pragmatic performance.

Why Pragmatics and Theory of Mind Do Not (Completely) Overlap.

Aim of the paper is to discuss the extent to which pragmatics, i.e., the ability to use language and other expressive means to convey meaning in a specific interactional context, overlaps with Theory of Mind (ToM), i.e., the ability to ascribe mental states to oneself and the others. We present empirical data available in the current literature concerning the relation between these two faculties, with specific reference to the developmental and clinical domains. Part of the literature we take into account appears to show that ToM does correlate with pragmatic ability; however, other studies appear to show that pragmatic ability alone cannot explain the empirical differences of performance across different kinds of pragmatic tasks, and therefore that another, at least partially different faculty is required to account for human communication. We argue that to conceive pragmatics as a sort of subcomponent of ToM, and thus to conflate or reduce the notion of pragmatics into the (wider) notion of ToM, is not theoretically correct and a possible cause of methodological confusion in the relevant empirical research. It thus turns out to be necessary that the two faculties be investigated with separate theories as well as different experimental tasks.

Cognitive abilities and theory of mind in explaining communicative-pragmatic disorders in patients with schizophrenia.

Patients with schizophrenia usually show an impairment in their communicative-pragmatic performance; they also have difficulties in cognitive functioning and Theory of Mind (ToM). In the literature it has been proposed that ToM and cognitive deficits have a role in explaining the communicative-pragmatic difficulties of patients with schizophrenia. However, the exact interplay of these functions is still not completely clear. The present research investigates the relationship between communicative-pragmatic, ToM and cognitive impairments (i.e. general intelligence, selective attention, speed processing and EF -working memory, inhibition and flexibility-) in a sample of 26 individuals with schizophrenia and matched controls. The linguistic and extralinguistic scales of the Assessment Battery of Communication (ABaCo), and a series of ToM and cognitive tasks were administered to patients and healthy controls. The results showed that individuals with schizophrenia performed less well than controls in all the tasks investigated. However, a hierarchical regression analysis showed that only ToM, and not cognitive functions, seems to be a predictive variable of patients' performance. Finally, a Fisher's exact test showed that there was not a stable significant relationship between ToM or EF and pragmatic impairment.

Neural correlates underlying the comprehension of deceitful and ironic communicative intentions.

Neuroimaging studies have shown that a left fronto-temporo-parietal cerebral network is recruited in the comprehension of both deceitful and ironic speech acts. However, no studies to date have directly compared neural activation during the comprehension of these pragmatic phenomena. We used fMRI to investigate the existence of common and specific neural circuits underlying the comprehension of the same speech act, uttered with different communicative intentions, i.e., of being sincere, deceitful or ironic. In particular, the novelty of the present study is that it explores the existence of a specific cerebral area involved in the recognition of irony versus deceit. We presented 23 healthy participants with 48 context stories each followed by a target sentence. For each story we designed different versions eliciting, respectively, different pragmatic interpretations of the same target sentence - literal, deceitful or ironic-. We kept the semantic and syntactic complexity of the target sentence constant across the conditions. Our results showed that the recognition of ironic communicative intention activated the left temporo-parietal junction (lTPJ), the left inferior frontal gyrus (lIFG), the left middle frontal gyrus (lMFG), the left middle temporal gyrus (lMTG), and the left dorsolateral prefrontal cortex (lDLPFC). Comprehension of deceitful communicative intention activated the lIFG, the lMFG, and the lDLPFC. fMRI analysis revealed that a left fronto-temporal network-including the inferior frontal gyrus (IFG), the dorsolateral prefrontal cortex (DLPFC) and the middle frontal gyrus (MFG)-is activated in both irony and deceit recognition. The original result of the present investigation is that the lMTG was found to be more active in the comprehension of ironic versus deceitful communicative intention, thus suggesting its specific role in irony recognition. To conclude, our results showed that common cerebral areas are recruited in the comprehension of both pragmatic phenomena, while the lMTG has a key role in the recognition of ironic versus deceitful communicative intention.

Sincere, Deceitful, and Ironic Communicative Acts and the Role of the Theory of Mind in Childhood.

The aim of the study is to investigate the relationship among age, first- and second-order Theory of Mind and the increasing ability of children to understand and produce different kinds of communicative acts - sincere, ironic, and deceitful communicative acts - expressed through linguistic and extralinguistic expressive means. To communicate means to modify an interlocutor's mental states (Grice, 1989), and pragmatics studies the inferential processes that are necessary to fill the gap, which often exists in human communication, between the literal meaning of a speaker's utterance and what the speaker intends to communicate to the interlocutor. We administered brief video-clip stories showing different kinds of pragmatic phenomena - sincere, ironic, and deceitful communicative acts - and first- and second-order ToM tasks, to 120 children, ranging in age from 3 to 8 years. The results showed the existence of a trend of difficulty in children's ability to deal with both linguistic and extralinguistic pragmatic tasks, from the simplest to the most difficult: sincere, deceitful, and ironic communicative acts. A hierarchical regression analysis indicated that age plays a significant role in explaining children's performance on each pragmatic task. Furthermore, the hierarchical regression analysis revealed that first-order ToM has a causal role in explaining children's performance in handling sincere and deceitful speech acts, but not irony. We did not detect any specific role for second-order ToM. Finally, ToM only partially explains the observed increasing trend of difficulty in children's pragmatic performance: the variance in pragmatic performance explained by ToM increases between sincere and deceitful communicative acts, but not between deceit and irony. The role of inferential ability in explaining the improvement in children's performance across the pragmatic tasks investigated is discussed.

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.

Cognitive Pragmatic Rehabilitation Program in Schizophrenia: A Single Case fMRI Study.

Introduction. The present study was intended to evaluate the effects of a rehabilitative training, the Cognitive Pragmatic Treatment (CPT), aimed at improving communicative-pragmatic abilities and the related cognitive components, on the cerebral modifications of a single case patient diagnosed with schizophrenia. Methods. The patient underwent two functional magnetic resonance imaging (fMRI) sessions, before and after the treatment. In order to assess brain changes, we calculated the Amplitude of Low Frequency Fluctuation (ALFF) index of the resting-state fMRI signal, which is interpreted as reflecting the intensity of the spontaneous regional activity of the brain. Behavioural measures of the patient's communicative performance were also gathered before and after training and at follow-up. Results. The patient improved his communicative performance in almost all tests. Posttraining stronger ALFF signal emerged in the superior, inferior, and medial frontal gyri, as well as the superior temporal gyri. Conclusions. Even if based on a single case study, these preliminary results show functional changes at the cerebral level that seem to support the patient's behavioural improvements.

Group Membership Modulates the Neural Circuitry Underlying Third Party Punishment.

This research aims to explore the neural correlates involved in altruistic punishment, parochial altruism and anti-social punishment, using the Third-Party Punishment (TPP) game. In particular, this study considered these punishment behaviors in in-group vs. out-group game settings, to compare how people behave with members of their own national group and with members of another national group. The results showed that participants act altruistically to protect in-group members. This study indicates that norm violation in in-group (but not in out-group) settings results in increased activity in the medial prefrontal cortex and temporo-parietal junction, brain regions involved in the mentalizing network, as the third-party attempts to understand or justify in-group members' behavior. Finally, exploratory analysis during anti-social punishment behavior showed brain activation recruitment of the ventromedial prefrontal cortex, an area associated with altered regulation of emotions.

Psychometric Properties of the Theory of Mind Assessment Scale in a Sample of Adolescents and Adults.

This research aimed at the evaluation of the psychometric properties of the Theory of Mind Assessment Scale (Th.o.m.a.s.). Th.o.m.a.s. is a semi-structured interview meant to evaluate a person's Theory of Mind (ToM). It is composed of several questions organized in four scales, each focusing on one of the areas of knowledge in which such faculty may manifest itself: Scale A (I-Me) investigates first-order first-person ToM; Scale B (Other-Self) investigates third-person ToM from an allocentric perspective; Scale C (I-Other) again investigates third-person ToM, but from an egocentric perspective; and Scale D (Other-Me) investigates second-order ToM. The psychometric proprieties of Th.o.m.a.s. were evaluated in a sample of 156 healthy persons: 80 preadolescent and adolescent (aged 11-17 years, 42 females) and 76 adults (aged from 20 to 67 years, 35 females). Th.o.m.a.s. scores show good inter-rater agreement and internal consistency; the scores increase with age. Evidence of criterion validity was found as Scale B scores were correlated with those of an independent instrument for the evaluation of ToM, the Strange Stories task. Confirmatory factor analysis (CFA) showed good fit of the four-factors theoretical model to the data, although the four factors were highly correlated. For each of the four scales, Rasch analyses showed that, with few exceptions, items fitted the Partial credit model and their functioning was invariant for gender and age. The results of this study, along with those of previous researches with clinical samples, show that Th.o.m.a.s. is a promising instrument to assess ToM in different populations.

Rehabilitation of Communicative Abilities in Patients with a History of TBI: Behavioral Improvements and Cerebral Changes in Resting-State Activity.

A targeted training program for the rehabilitation of communicative abilities-Cognitive Pragmatic Treatment (CPT)-has been developed and previously tested on a sample of patients with traumatic brain injury (TBI), whose performance was found to have improved. Since cortical plasticity has been recognized as the main mechanism of functional recovery, we investigated whether and how behavioral improvements following the training program are accompanied by brain modifications. Eight TBI patients took part in the training program and were behaviorally assessed pre- and post-treatment; six of these patients were also evaluated with pre- and post-treatment resting state (rs) functional magnetic resonance imaging (fMRI). At the end of the rehabilitation program patients showed improvement in overall communicative performance, in both comprehension and production tasks. A follow-up retest revealed the stability of these results 3 months after completing the training program. At the brain level, we found significant increases in the amplitude of low frequency fluctuation (ALFF) index in the bilateral precentral gyrus, in the right middle and superior temporal gyri, in the right cingulate gyrus, and in the left inferior parietal lobule. We discuss these differences of brain activity in terms of their possible contribution to promoting recovery.

Communicative-Pragmatic Treatment in Schizophrenia: A Pilot Study.

This paper aims to verify the efficacy of Cognitive Pragmatic Treatment (CPT), a new remediation training for the improvement of the communicative-pragmatic abilities, in patients with schizophrenia. The CPT program is made up of 20 group sessions, focused on a number of communication modalities, i.e., linguistic, extralinguistic and paralinguistic, theory of mind (ToM) and other cognitive functions able to play a role on the communicative performance, such as awareness and planning. A group of 17 patients with schizophrenia took part in the training program. They were evaluated before and after training, through the equivalent forms of the Assessment Battery for Communication (ABaCo), a tool for testing, both in comprehension and in production, a wide range of pragmatic phenomena such as direct and indirect speech acts, irony and deceit, and a series of neuropsychological and ToM tests. The results showed a significant improvement in patients' performance on both production and comprehension tasks following the program, and in all the communication modalities evaluated through the ABaCo, i.e., linguistic, extralinguistic, paralinguistic, and social appropriateness. This improvement persisted after 3 months from the end of the training program, as shown by the follow-up tests. These preliminary findings provide evidence of the efficacy of the CPT program in improving communicative-pragmatic abilities in schizophrenic individuals.

"No more a child, not yet an adult": studying social cognition in adolescence.

There are several reasons why adolescence is interesting. It is in this phase that an individual finds herself fully facing the external world: basically equipped with the kind of social cognition that s/he has acquired at home, at school and through the media during childhood, s/he has now to meet a host of other, diverse views of what "reasonable," "appropriate," or "expected" courses of thought and emotions are, in the wild with friends and peers, romantic or sexual partners, teachers and employers, and the society at large. Furthermore, she is also expected, both at home and in the external world, to have a wholly new degree of control over such courses. While the idea that the development of social cognition still progresses after infancy (and possibly throughout the life span) is clearly gaining consensus in the field, the literature building on it is still scarce. One of the reasons for this probably is that most tests used to study it focus on its basic component, namely theory of mind, and have been mostly devised for us with children; therefore, they are not suitable to deal with the hugely increasing complexity of social and mental life during adolescence and adulthood. Starting from a review of the literature available, we will argue that the development of social cognition should be viewed as a largely yet-to-be-understood mix of biological and cultural factors. While it is widely agreed upon that the very initial manifestations of social life in the newborn are largely driven by an innate engine with which all humans are equally endowed, it is also evident that each culture, and each individual within it, develops specific adult versions of social cognition.