Research Items (19)
Hearing impaired (HI) children show difficulties in language and communication development (Svirsky, 2000). Recently, HI children are fitted with Cochlear Implants (CI), prosthetic devices that convert sound into electrical signals and transmit them to electrodes surgically implanted in the cochlea (Clark, 2004). By enabling HI children to hear surrounding sounds, this technology has enhanced their hearing and spoken language, especially when implanted at a very young age (Yoshinaga-Itano, 2017; Colletti et al., 2012). However, the benefits of the CI on the communicative-pragmatic ability development in HI children with CI have not been sufficiently studied. Pragmatic communication is the ability to communicate appropriately in a specific context (Levinson, 1983), using different expressive means, as language, non-verbal/extralinguistic, and paralinguistic ones (Bara, 2010). The aim of the present research is to provide preliminary empirical evidences supporting that an early (< 24 months) bilateral CI promotes a typical development of communicative-pragmatic skills in children with HI.
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.
Voice atypicalities characterize schizophrenia (SCZ) since its first definitions, often associated with core negative symptoms such as flat affect and alogia and with social impairment. While this suggests that voice atypicalities may represent a marker of clinical features and social functioning in SCZ, the state of evidence for this is uncertain. We systematically reviewed and meta-analyzed the evidence for distinctive acoustic patterns in SCZ, as well as their relation to clinical features. We identified 46 articles, including 55 studies for a total of 1254 participants with SCZ and 699 comparison participants. We calculate summary effect size (Hedges'g) estimates using multilevel Bayesian modeling. We identified weak atypicalities in pitch variability (g = - 0.55) related to flat affect, and stronger atypicalities in proportion of spoken time, speech rate, and pauses (g's between -0.75 and -1.89) related to alogia and flat affect. However, the effects are modest compared to perceptual and clinical judgments, and characterized by large heterogeneity between studies. Moderator analyses revealed that tasks with a more demanding cognitive and social components have significantly larger effects both in contrasting patients and controls and in assessing symptomatology. We conclude that studies of acoustic patterns are a promising but, yet unsystematic avenue for establishing markers of SCZ. We outlined recommendations towards more cumulative, open, and theory-driven research.
- Mar 2019
Objective: Pragmatic impairment and narrative difficulties commonly affect individuals after traumatic brain injury (TBI). Rehabilitative programs may improve such impaired capacities and promote social recovery. Cognitive Pragmatic treatment (CPT) is a rehabilitative group program that encompasses different communicative skills, including sessions dedicated to the ability to structure a discourse with an adequate amount of information and relevant contents. This study aims to determine the efficacy of the CPT program in improving informative skills during narrative production. We also investigated the impact of CPT on some of the patients' cognitive abilities that might affect their communicative skills (e.g., inhibitory control and cognitive flexibility). Methods: Ten individuals with chronic TBI took part in and completed the CPT program. The participants' narrative abilities were assessed before and after the CPT program, using a picture description task. Moreover, equivalent forms of the Assessment Battery for Communication (ABaCo), and a series of neuropsychological tasks, were administered to the participants to evaluate their pragmatic skills and cognitive profile. Results: The CPT program induced a significant improvement in pragmatic and informative skills, while no significant improvement was observed in neuropsychological tasks. Importantly, the improvement in pragmatic abilities persisted three months post-training. Conclusions: The study highlighted the efficacy of the CPT program in improving patients' in-formativeness, confirming previous reports of its effectiveness in the rehabilitation of communicative pragmatic skills.
Objective The pragmatic impairment often characterizing individuals after a traumatic brain injury (TBI) significantly limits their independence, preventing social participation. Rehabilitation programs aim to improve the impaired capacities to help participants communicate effectively, increasing their self-perceived life quality. The aim of this study was to verify the effectiveness of the Cognitive Pragmatic Treatment (CPT) in improving communication abilities after TBI, thus enabling better management of communication activities in daily living. Method Nineteen individuals with TBI in a post-acute phase completed the CPT, a group-based training program designed to improve pragmatic abilities. Pre- and post-training, participants were administered the Communication Activities of Daily Living (CADL-2), and the equivalent forms of the Assessment Battery for Communication (ABaCo). Results Comparison of pre- and post-training performance showed an overall improvement in pragmatic abilities. Post-training, participants scored higher in communication skills on both the CADL-2 and ABaCo, with such scores remaining constant at a 3-month follow–up assessment. Conclusions This study showed that the CPT was effective in improving the participants’ communicative abilities. The possibility that the benefits of the CPT may generalize to everyday communicative interactions is discussed.
Communication is a complex ability characterized by the interplay of many elements such as language, use of gestures and paralinguistic connotation that allows people to communicate effectively in everyday life. Elderly adults, even when healthy, may exhibit a reduction in the ability to communicate efficiently, due to a generalised cognitive decline that can characterise old age (Zanini et al., 2005, Aphasiology, 12, 1107-1133). Aim of this study is to provide preliminary results concerning a wide assessment of communicative-pragmatic ability in a sample of 30 healthy aging (N = 15: age range 65-75 years; N = 15: age range 76-86 years) and 15 controls (age range 20-40 years) to investigate a possible decline of such ability.
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.
Background Individuals with schizophrenia are characterized as presenting atypical voice patterns: poverty of speech, increased pauses, distinctive pitch (mean and variability). Voice atypicalities may play a role in the social impairment experienced by patients, and could constitute a window into motor, cognitive, emotional and social components of the disorder. Indeed, they have already been generally associated with negative symptoms. However, the state of the evidence for atypical voice patterns and their relation to clinical features is uncertain. Studies using clinical rating scales indicate that voice alterations are severe across many voice properties. In contrast, quantitative acoustic studies seem to have found less robust and more variable results limited to specific features. We therefore systematically reviewed the literature quantifying acoustic patterns in schizophrenia, and performed a meta-analysis of the evidence. We aimed at identifying evidence for acoustic markers of schizophrenia and its clinical features, needs for further research and barriers to collective advancements on these issues. Methods We adopted the “PRISMA Statement” guidelines for transparent reporting of a systematic review. The literature search was conducted on Pubmed and Google Scholar (details and pre-registration at https://goo.gl/H1yDpm). Study selection was conducted according to the following inclusion criteria: (a) empirical study, (b) quantification of acoustic features in the vocal production of participants with schizophrenia, (c) sample including at least two individuals with schizophrenia, (d) inclusion of a comparison group, or an assessment of variation in acoustic features in relation to severity of clinical features. We identified 54 studies as eligible for inclusion and contacted all authors to obtain missing estimates and individual-level data, where possible. 34 studies availed enough information to be included in a meta-analysis. The meta-analysis consisted of mixed effects regression models, one per each relevant acoustic feature. Results Of the 37 authors contacted, 59% responded and 5% provided at least some of the requested data. Chief reasons of denials were: i) data loss (n = 8), ii) effort required (n = 5), iii) ethical concerns with data sharing (n = 1). On the results available we found significant meta-analytic effects of schizophrenia in percentage of spoken time (n = 6, d = -1.16, 95% CIs: -2.06 -0.27) and proportion of pauses (n = 5, d = 0.56, 95% CIs: 0.15 0.96). After controlling for influential studies, we found significant differences also in pitch mean (n = 5, d = 0.40, 95% CIs: 0.12 0.68) and pitch variability (n = 6, d = -0.46, 95% CIs: -0.70 -0.23). No effects were found for pause duration (n = 7), speech rate (n = 9), speech duration (n = 5) and pitch intensity (n = 5). We found evidence for publication bias for studies investigating pause duration and pitch variability. Key concerns on the meta-analysis are: i) small sample sizes, ii) heterogeneity of task and acoustic processing methods, iii) lack of demographic and clinical individual-level data necessary to control for confounds (e.g. medication and relation to clinical features). Discussion We found clear effects of increased pause behavior in schizophrenia and less clear effects of pitch. However, the magnitude of these abnormalities is limited and contrast with the large effect sizes reported by studies using clinical rating scales. Future research should focus on larger sample sizes, systematic assessment of multiple acoustic features and multiple speech tasks, standardized acoustic processing methods, and individual level data available. More reflection is needed on how to make data sharing possible within privacy and ethical constraints.
Background Individuals with schizophrenia frequently exhibit a wide range of communicative-pragmatic disorders. Previous studies reported deicits in the comprehension of non-literal and figurative forms of language, such as indirect speech acts, deceit, irony, metaphors and idioms, as well as deficits in conversational and narrative skills. Moreover, schizophrenia is often associated with impairment in cognitive functions, such as Executive Functions (EF) and Theory of Mind (ToM). Few studies examined at the same time the role that ToM and EF can play in the comprehension of different communicative acts, such as sincere communicative acts, deceit and irony. Thus, the relation between ToM, EF and pragmatic ability in schizophrenia is still not completely clear. The aim of this study is to evaluate the relationship between the ability to manage different communicative pragmatic phenomena (i.e., sincere, deceitful and ironic communicative acts), and ToM and EF. Methods 26 individuals with schizophrenia and 26 matched controls took part in the study. We evaluated communicative pragmatic-ability using the lingusitic and extralinguistic scales of the Assement Battery for Communication (ABaCo). We assessed EF - working memory, inhibition and cognitive flexibility-, ToM and background cognitive functions - general intelligence, selective attention and speed processing - using a battery of standardized neuropsychological tests. Results To investigate the presence of significant differences in communicative-pragmatic performance between patients and controls, we performed a 2x3 ANOVA with participant (individuals with schizophrenia, healthy control) as between-subjects factor, and the type of pragmatic phenomena (sincere, deceitful and ironic) as within-subjects factor. For each of the ABaCo subscales, we found a main effect of participant (.0001 < p. < .001), showing that experimental group performed significantly worse than control group. We also found a linear trend in pragmatic performance (.0001 < p. < .008), that revealed a linear decrease in scores depending on the pragmatic phenomenon investigated: sincere communicative acts were the easiest to understand, followed by deceit and irony. To evaluate the role of cognitive and ToM tasks on pragmatic performance in patients, we performed a regression analysis. We included relevant predictors in the model, i.e. cognitive background factors, EF and ToM. We found that the only significant predictor was ToM, that contributed to increase the quote of explained variance in the comprehension and production of linguistic sincere communicative acts (p = .005) and linguistic deceit (p. = .009). Discussion Results showed that individuals with schizophrenia performed poorly in the comprehension and production of different kinds of pragmatic phenomena, i.e. sincere, deceitful and ironic communicative acts. This result confirms that communicative-pragmatic impairment is a core deficit in schizophrenia. In addition, we found an association between ToM and comprehension and production of sincere and deceitful communicative acts, while no association between irony and ToM was found. The results of the present investigation confirm the role that ToM can play in managing sincere and deceitful communicative acts, while do not seem to support previous evidences indicating ToM as the main factors in explaining irony understanding.
- Jan 2018
- Rehabilitation Medicine for Elderly Patients
The ability to communicate effectively allows people to solve several vital functions in everyday life, such as establishing and maintaining social relationships, obtaining health care and satisfying personal needs. Older adults may exhibit a reduction in the ability to communicate due to the generalised cognitive decline that can characterise old age or due to cerebrovascular disease and neurodegenerative pathologies, which frequently occur in late adulthood. The consequences of communicative difficulties can be serious, reducing the possibility of brain-injured patients to return to previous daily activities or contributing to cognitive decline in healthy older adults. In the present chapter, we describe the origin and the social consequences of the most frequent disorders that may affect communicative ability in older adults. Then we focus on rehabilitation programmes to improve the communicative abilities of older patients. In particular, we describe different rehabilitative approaches that have been proved to be effective in both people with brain damage and older adults, highlighting possible weaknesses and limitations. We thus present a novel rehabilitative treatment, i.e. the cognitive pragmatic treatment (CPT) that was recently found to be effective for the recovery of communicative abilities in traumatic brain-injured patients. Finally, we propose that the creation of a specific programme might be useful for enhancing communicative abilities in healthy older adults.
- Nov 2017
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.
- Jun 2017
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 vs. 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 frontal 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 IFG, the DLPFC and the 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 vs. 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 vs. deceitful communicative intention.
- Feb 2017
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.
- Jan 2017
- Research in Clinical Pragmatics
Patients with schizophrenia exhibit a range of pragmatic difficulties which compromise communicative interaction. The aim of this chapter is to provide an overview of these difficulties and to analyze whether impairments of cognitive factors such as theory of mind (ToM), executive functions and intelligence quotient (IQ) could be helpful in explaining them. First, we provide an overview of the communicative-pragmatic difficulties observed in schizophrenia. We describe how impairment of ToM has been proposed to explain schizophrenic pathology, and the role that such a deficit could play in explaining these patients’ pragmatic difficulties. We then describe executive function deficits in schizophrenia and the relationship between these deficits and pragmatic impairments. We consider studies that have examined the interplay between ToM, executive function and other cognitive abilities such as IQ. Finally, we summarize the empirical evidence presented, concluding that the role of ToM in explaining patients’ difficulty in comprehending certain pragmatic phenomena still persists when the role of IQ and executive functioning is controlled. However, neither an impairment of ToM nor an impairment of executive function or IQ seems to be able to systematically explain the pragmatic difficulties of patients with schizophrenia. We suggest that other cognitive factors, such as inferential ability, could be considered in future research.
- Aug 2016
Aim of the present study is to provide a multifocal assessment of pragmatic abilities in patients with right hemisphere damage (RHD). Pragmatics refers to the ability to use language and non-verbal expressive means (e.g., gestures) to convey meaning in a given context, and it also involves the appropriate use of connotative elements such as rhythm and prosody. Patients with RHD frequently report a wide range of pragmatic disorders: despite the heterogeneity of their clinical profiles, these difficulties can seriously undermine their ability to effectively communicate in everyday situations. We analysed the performance of 17 patients with RHD and 17 healthy controls using the Assessment Battery for Communication, a clinical tool for assessing a wide range of pragmatic phenomena - both in comprehension and production - and considering different expressive means. The results suggest patients have difficulties both in comprehending and producing pragmatic phenomena of differing complexity; in particular, patients seem to be significantly impaired when dealing with non-verbal modality, i.e., gestures and facial expressions. Moreover a hierarchical cluster analysis revealed the presence of a number of clusters corresponding to different outcomes of pragmatic performance, in line with the heterogeneity of communicative profiles following RHD frequently reported in the literature.