Do all right brain-damaged subjects show a deficit in non-literal language comprehension?

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... This analysis revealed different groups of patients and different patterns of performance: one patient did well in all areas (P10), three patients (P2, P3, P11) were deficient in topic maintenance only, three patients were impaired on all tasks (P6, P7, P8), and four fell in-between (P1, P4, P5, P9). This substantial performance heterogeneity has already been noted in other populations of brain-damaged patients, notably among patients with right lesions (Champagne & Joanette, 2009;Champagne, Nespoulous, & Joanette, 2002). It is not possible here to give "definitive" explanations for these differing profiles. ...
... After brain damage, subtle language disorders without aphasia may arise in persons with a frontal-lobe lesion. Our analysis of the patients' profiles suggests a high degree of heterogeneity in the communication disorders of these individuals, as noted in other studies of right brain-damaged patients (Champagne et al., 2004;Champagne, Nespoulous, & Joanette, 2002;Harden, Cannito, & Dagenais, 1995). For McDonald, Flanagan, Martin, and Saunders (2004), "Not all people who suffer severe traumatic brain injuries would be expected to have problems with social perception" (p. ...
Unlabelled: The purpose of this study was to gain insight into the social (pragmatic) aspects of language use by French-speaking individuals with frontal lesions following a severe traumatic brain injury. Eleven participants with traumatic brain injury performed tasks in three areas of communication: production (interview situation), comprehension (direct requests, conventional indirect requests, and hints), and metapragmatic knowledge. The results of the patients pointed out some strengths (turn-taking in production, and request comprehension, including hints and the speaker's intention) and some weaknesses (topic maintenance in production and metapragmatic knowledge). The patients' good comprehension of requests and their difficulty expressing metapragmatic knowledge suggest that they differ from controls in how they "explain the world": their knowledge of the event sequence was not based on verbally expressible knowledge about the relationship between the structural characteristics of a request utterance and those of its social production context. The pragmatic skills of persons with traumatic brain injury seem to vary across tasks: these individuals have specific strengths and weaknesses in different domains. In addition, marked interindividual differences were noted among the patients: three of them had only one weak point, topic maintenance. These interindividual differences were not systematically linked to performance on executive function tests, but lesion unilaterality (right or left) seems to help preserve patients' pragmatic and metapragmatic skills. The discussion stresses the need to take each patient's strengths and weaknesses into account in designing remediation programs. Learning outcomes: As a result of this activity, the reader will be able to explain the social/pragmatic aspects of language in typical and atypical participants with TBI. As a result of this activity, the reader will be able to identify social/pragmatic weaknesses and strengths.
... Such a pattern of performance is in line with deficits found after right-hemisphere lesions in other studies. 8,[11][12][13][14] For instance, Champagne-Lavau and Joanette, who indicated a close association between pragmatics and executive functions, reported on pragmatic deficit and executive dysfunction in RHD patients. 11 Furthermore, Tompkins et al. demonstrated that incompatibility interpretation was associated with poorer discourse comprehension performance in patients with RHD. 12 In another study, Cutica et al. reported on weak performance in extralinguistic pragmatic abilities in RHD patients in comparison with healthy individuals and left hemisphere damaged patients. ...
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Background: Pragmatics is appropriate use of language across a variety of social contexts that provides accurate interpretation of intentions. The occurrence of the right hemisphere lesions can interfere with pragmatic abilities, and particularly with the processing of nonliteral speech acts. Methods: Since the objective of this study was to assess different aspects of pragmatic competence in the right hemisphere damage (RHD) patients, 20 Iranian patients with right hemisphere lesions were examined by adult pragmatic profile (APP) and a novel checklist was introduced for Persian language speaking individuals. Meanwhile, 40 healthy adult individuals, who were age and gender matched with RHD patients, were considered as the control group. After obtaining video records, all subjects were evaluated for 35 pragmatic skills, including 24 verbal, 5 paralinguistic, and 6 nonverbal aspects, by a two-point scale system. Results: Studying RHD patients and their healthy counterparts revealed that the performance by participants with right hemisphere lesions exhibited a high degree of inappropriate pragmatic abilities compared with controls in all domains. Furthermore, RHD patients showed a trend of increasing difficulty in understanding and producing different pragmatic phenomena, including standard communication acts. Conclusion: Present results indicated that the right hemisphere lesions significantly affected pragmatic abilities in verbal, paralinguistic and nonverbal aspects. Such a pattern of performance, which is in line with deficits previously reported for RHD, proved the unquestioned role of the right hemisphere in processing nonliteral language.
... The main results confirmed that not all RHD participants had diffi- culties processing non-literal language or attributing and understanding mental states (ToM), as some of them were able to do pragmatic tests as well as the control group. Such heterogeneous patterns of performance are in line with the known heterogeneity of deficits found after a right-hemisphere lesion (Champagne, Nespoulous, & Joanette, 2002;Côté et al., 2007). Three patterns of pragmatic perfor- mance were found across the RHD group. ...
The occurrence of a right-hemisphere lesion can interfere with pragmatic abilities, and particularly with the processing of non-literal speech acts in which the listener has to identify the speaker's intention. A few studies have shown that RHD individuals may exhibit moderate difficulties in tasks requiring attribution of second-order mental states (ToM), suggesting a link between pragmatic and ToM abilities. Although links seem to exist between pragmatic abilities, ToM and executive functions in other populations, no study had tested those three abilities in RHD individuals to explore the possible co-occurrence of impairments in these three abilities. This study evaluated pragmatic and ToM abilities and executive functions in 15 RHD individuals and 15 healthy control participants. The results suggest that the ability to understand pragmatic aspects of language is closely associated with the ability to make inferences about other people's intentions. More interestingly, the association of ToM deficits with executive dysfunction rather than executive dysfunction alone might be the best predictor of different patterns of pragmatic deficits found in different RHD subgroups of patients.
Four non-ecological studies (Heeschen and Reisches 1979, Hirst et al. 1984, Foldi 1987, Weylman et al. 1989) have shown that a lesion to the right hemisphere can cause deficits in the processing of indirect speech acts. The authors have suggested that an alternative interpretation based on contextual elements could underlie this difficulty. The purpose of this study was to verify whether subjects who suffer a right hemisphere lesion have as much difficulty interpreting context and speech acts in a natural communicative situation as in a non-natural or pseudo-natural situation. A group of 28 subjects (14 RHD subjects and 14 normal controls) were given three tasks, which represented three different communicative situations: natural, nonnatural, and pseudo-natural. The results show that RHD subjects process speech acts as efficiently as controls when they occur in a natural or pseudo-natural situation. However, they process direct and indirect speech acts significantly worse than controls in a non-natural communicative context. These results suggest that the natural character of the situation is crucial to this type of study. The ecological validity of previous studies is questioned, and it is suggested that the types of tasks formerly used do not measure the processing of speech acts per se, but rather the ability to judge the plausibility of a statement expressing an indirect speech act based on the naturalness of the contextual elements.
Unilaterally right (RHD)- and left (LHD)-hemisphere-damaged patients were tested on their ability to discern the correct, nonliteral interpretation of indirect requests (e.g., "Can you open the door?") embedded in short vignettes and presented without any pictorial support. Each stimulus vignette incorporated two verbal cues--context and conventionality of form--designed to influence interpretations of a critical utterance located at the end of each vignette. Contexts were biased to encourage either the direct, literal reading of critical utterances as a question, or the indirect meaning of the utterance as a request for action. The critical utterances themselves were either high in conventionality (e.g., "Can you ...?") which encouraged an indirect interpretation, or low in conventionality (e.g., "Is it possible for you to ...?") which encouraged a direct interpretation. Results indicated that RHD patients were significantly impaired, relative to controls, in their ability to make judgments based on contextual information. RHD patients performed comparably to the aphasic, LHD group in the use of both context and conventionality. These results replicate earlier findings of disrupted indirect request comprehension by RHD patients tested in pictorially supported paradigms.
Several researchers have investigated the comprehension of "indirect requests" by right hemisphere brain-damaged (RHD) individuals. Until the present, however, no sound description of the phenomenon under investigation has been reached and explanatory attempts of the observed behavior are diverse. Based on a theoretical framework issued from studies in cross-cultural pragmatics, the present study is an attempt to provide a systematic description of the production of request sequences and the evaluation of direct and nonconventionally indirect requests by RHD patients. The analyses of the production data showed that, relative to the control group, the RHD patients behaved differently concerning the application of nonconventionally indirect requests, the use of external request modifiers, the evaluation of nonconventionally indirect requests, and the use of propositions. No differences in production performance were observed with regard to direct requests, conventionally indirect requests, and internal request modifiers. Further, the RHD group and the control group behaved similarly in evaluating direct requests. The results are discussed in relation to previous findings and a mental model approach is proposed as an explanatory framework. The findings suggest that the RHD patients were able to build a mental representation at a text level and a situational level but may have had problems within the realm of monitoring or planning integration processes if more than one mental model is involved. There is some indication that attention and visuospatial abilities may have influenced the verbal and evaluation abilities of the RHD subjects. It seems a worthy endeavor to pursue this issue in future research.
This article examines several factors that influence the production of requests for behavior. Using a role-play methodology, we elicited request productions from well-recovered patients with right-hemisphere brain damage (RHD) and from non brain-damaged control participants. The stimulus items represented variation both on interpersonal factors based on characteristics of the people in the interaction and on situational factors based on what was being requested. A large corpus of responses was elicited from each patient. Responses were coded for request directness, amount of explanatory material over and above the request proper (a relatively demanding method for manipulating the tone of a request), and use of "please" (a relatively simple device for signaling a request). Case-by-case analysis of the patients' performances revealed some common areas of abnormality and also some idiosyncratic features. Some patients produced less explanatory supportive material than control participants, and they tended not to vary the amount of explanatory material as a function of the request scenario. Of interest is that some of the same patients overused "please," and varied their use of this simple device as a function of request scenarios. The discourse strategies observed were likely due to deficits both in pragmatic awareness and in planning utterances. One implication of these results concerns an apt description of the abnormal discourse of RHD patients. The relative lack of supportive explanatory material in their requests may result in patients' seeming rude or inappropriate.