RESUMEN
The relationship between working memory and speech has been a topic of intense research interest and investigation for many years. Memory studies have found that the active processing of working memory is required for language comprehension and speech production. Though there are studies that discuss the capacity of working memory, the processing of verbal stimuli into verbal memory remains unclear. Therefore, it is essential to understand the functioning of the working memory and how it processes verbal information. As working memory is intricately linked with communication, any deficits in working memory could cause communication disorders. Also, the disruption in the storage and retrieval of verbal memory could cause a disturbance in the speech pattern. To this point, this review elaborates on the active processing of working memory and its role in communication. Further, by studying the deficits in working memory that could cause cognitive-communication disorders such as apraxia of speech, dementia, and dysarthria, this article highlights the importance of verbal memory in speech.
Asunto(s)
Trastornos de la Comunicación , Memoria a Corto Plazo , Humanos , Labio , Encéfalo , CogniciónRESUMEN
OBJECTIVES: This study applied the discourse task and related cognitive items of the Brief Test of Cognitive-Communication Disorders (BCCD) to normal, mild cognitive impairment (MCI), and moderate dementia groups and compared the scores of each area. In addition, the cognitive functions affecting the discourse performance were investigated by group. PARTICIPANTS: 117 normal adults, 38 MCI, and 31 patients with moderate dementia (DEM) conducted BCCD, including discourse and cognitive items. DESIGN/SETTING: The discourse item included repeating an explanatory discourse, and the total discourse score was calculated by summing the scores for each of the four areas of coherence, cohesion, proposition, and pause. The cognitive areas of BCCD were attention, visuospatial ability, memory, organization, reasoning, problem-solving, and executive function. This study performed a one-way multivariate analysis of covariance to compare the scores of the three groups and multiple regression analysis determined the cognitive functions influencing the total discourse score. MEASUREMENTS: The discourse scores reporting differences among all groups were the pause and the total discourse scores, with the normal group showing a higher performance than the patient groups in the cohesion score and the DEM group in the propositions score, respectively. In addition, the cognitive functions affecting discourse performance were attention, organization, and problem-solving in the normal group, and organization and problem-solving in the MCI group. CONCLUSIONS: Organizing information into a series of semantic units related to each other is necessary for coherent and efficient utterances, and the ability to correctly recognize the task and establish a strategy to grasp the core content is necessary for pragmatic language.
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Trastornos del Conocimiento , Disfunción Cognitiva , Demencia , Adulto , Humanos , Disfunción Cognitiva/psicología , Cognición , Función Ejecutiva , Pruebas NeuropsicológicasRESUMEN
PURPOSE: This systematic review explored how virtual reality (VR) has been used to rehabilitate aphasia. MATERIALS AND METHODS: Empirical studies were included where VR was used to target language, well-being, or quality of life in adults with acquired language impairment. Degenerative communication disabilities were excluded. Seven health databases were searched in October 2021. Risk of Bias was assessed using published checklists and completeness of intervention reporting evaluated. Narrative synthesis described forms of VR, rationales given, outcome measures, communication functions targeted, characteristics of interventions, and outcomes achieved within the framework of impairment, activity, and participation. RESULTS: Fourteen studies, involving 229 participants, met the criteria. The studies employed four forms of VR with various rationales given. Interventions used published and novel protocols. Primary outcomes targeted language impairment (12/14), activity (1/14), and well-being (1/14) and achieved positive outcomes in impairment and activity. All studies were exploratory. Risk of bias was high. Findings are discussed in the context of gains achieved by VR in other health contexts and the multi-user gaming literature. CONCLUSIONS: Uses of VR in aphasia rehabilitation described in the literature are limited. Most applications target the remediation of language impairments. Opportunities to address activity, participation, and wider aspects of well-being are rare.IMPLICATIONS FOR REHABILITATIONResearch documenting the use of virtual reality (VR) to rehabilitate aphasia is limited and exploratory, so does not yet offer clear guidance for clinicians.Many of the identified studies have used known published protocols (e.g., naming therapy or scripts therapy) delivered through the novel VR format and focus on language impairment outcomes.VR offers clinicians a unique opportunity to address communication activity and participation through the use of multi-user virtual worlds, but this has only been explored by only two research teams.
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Afasia , Terapia de Exposición Mediante Realidad Virtual , Adulto , Humanos , Afasia/rehabilitación , Calidad de VidaRESUMEN
Purpose: Across Australia and New Zealand, speech-language pathologists (SLPs) routinely assess and treat adults with cognitive-communication disorders following traumatic brain injury (TBI). Despite their regular involvement, little is known about how clinicians provide management to this client group, particularly in community-based contexts. Therefore the aim of this study is to explore the clinical practices of SLPs who have experience working in community-based rehabilitation services with adults with cognitive-communication disorders following TBI.Method: A qualitative descriptive study using one-on-one semi-structured interviews was conducted as part of an explanatory sequential mixed-methods design. Fourteen SLPs with experience working with individuals with TBI completed an interview with content analysis used to explore the data.Result: The overarching theme identified was that a "Client-centred and inclusive approach to community-based rehabilitation services" is required. The three subthemes to emerge from the data included the importance of utilising a (1) "flexible service delivery approach", with (2) "meaningful therapy focus", and (3) "collaboration" with multidisciplinary team members and significant others when managing this client group.Conclusion: SLPs play a crucial role in client-centred inclusive rehabilitation for community-dwelling adults with cognitive-communication disorders following TBI. The complexity of working with this population requires current and future models of care to incorporate an interdisciplinary approach that is flexible in its delivery and meaningful in focus.
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Lesiones Traumáticas del Encéfalo , Trastornos de la Comunicación , Patología del Habla y Lenguaje , Humanos , Adulto , Patólogos , Habla , Patología del Habla y Lenguaje/métodos , Lesiones Traumáticas del Encéfalo/complicaciones , Trastornos de la Comunicación/etiología , Trastornos de la Comunicación/terapiaRESUMEN
BACKGROUND AND OBJECTIVES: Tools to measure self-perceived communication between persons with early-stage dementia and their caregivers are lacking. Therefore, we developed a questionnaire for Experienced Communication in Dementia (ECD) with a patient version (ECD-P) and a caregiver version (ECD-C), which contains items on (a) caregiver competence, (b) social communication, (c) communication difficulties, and (d) experienced emotions. This article describes the feasibility and clinimetric evaluation of this instrument. RESEARCH DESIGN AND METHODS: A prospective observational cohort study was conducted with 57 dyads (community-dwelling person with dementia and primary caregiver). ECD-P, ECD-C, and measures on quality of life, caregiver burden, cognitive functioning, physical functioning, and functional independence were administered. After 2 weeks, the dyads filled out the ECD again. Feasibility (completion time and missing values per item), internal consistency (Cronbach's α), test-retest reliability (intraclass correlation coefficients [ICCs]), and construct validity (hypotheses testing with Spearman's r) were evaluated. RESULTS: Mean completion time was 10 min per questionnaire. ICCs for test-retest reliability ranged from 0.67 to 0.78, except for ECD-P2 (ICC = 0.31). Internal consistency ranged from α = 0.75 to 0.82 for ECD-P1 and all parts of ECD-C, except for ECD-P2 (α = 0.66). Correlation coefficients for convergent validity ranged from r = 0.31 to 0.69 and correlation coefficients for divergent validity were r < 0.20 and statistically insignificant. DISCUSSION AND IMPLICATIONS: Pending future research, the ECD, except part ECD-P2, seems to be a promising tool to measure experienced communication between persons with early-stage dementia and their caregivers.
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Demencia , Calidad de Vida , Humanos , Estudios Prospectivos , Reproducibilidad de los Resultados , Comunicación , Cuidadores/psicología , Encuestas y Cuestionarios , Demencia/psicología , PsicometríaRESUMEN
OBJECTIVE: To investigate the experiences and perspectives of speech pathologists when delivering cognitive-communication therapy to adults following traumatic brain injury (TBI). METHODS: An explanatory sequential mixed methods design was used to explore the practices of speech pathologists working in community-based rehabilitation (CBR) settings. The first participant group completed an in-depth online survey, whilst the second group participated in an interview to discuss their processes and recommendations when managing adults following TBI. RESULTS: Participants highlighted the need for services to be client-centered and inclusive in their approaches to meet the rehabilitation needs of people following TBI in community-based settings. The key features identified to achieve this included utilizing a flexible service delivery approach, implementation of meaningful therapy, as well as inclusion of significant others. CONCLUSIONS: These findings provide a snapshot of the current practices employed by a range of speech pathology services across Australia and New Zealand. Health professionals and rehabilitation service providers should consider the key factors highlighted by the participants when designing future CBR models of care for this client group.
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Lesiones Traumáticas del Encéfalo , Trastornos de la Comunicación , Patología del Habla y Lenguaje , Adulto , Lesiones Traumáticas del Encéfalo/complicaciones , Lesiones Traumáticas del Encéfalo/rehabilitación , Cognición , Trastornos de la Comunicación/etiología , Trastornos de la Comunicación/rehabilitación , Humanos , Encuestas y CuestionariosRESUMEN
OBJECTIVES: The aim of this systematic review was to identify the presence and nature of relationships between specific forms of aprosodia (i.e., expressive and receptive emotional and linguistic prosodic deficits) and other cognitive-communication deficits and disorders in individuals with right hemisphere damage (RHD) due to stroke. METHODS: One hundred and ninety articles from 1970 to February 2020 investigating receptive and expressive prosody in patients with relatively focal right hemisphere brain damage were identified via database searches. RESULTS: Fourteen articles were identified that met inclusion criteria, passed quality reviews, and included sufficient information about prosody and potential co-occurring deficits. Twelve articles investigated receptive emotional aprosodia, and two articles investigated receptive linguistic aprosodia. Across the included studies, receptive emotional prosody was not systematically associated with hemispatial neglect, but did co-occur with deficits in emotional facial recognition, interpersonal interactions, or emotional semantics. Receptive linguistic processing was reported to co-occur with amusia and hemispatial neglect. No studies were found that investigated the co-occurrence of expressive emotional or linguistic prosodic deficits with other cognitive-communication impairments. CONCLUSIONS: This systematic review revealed significant gaps in the research literature regarding the co-occurrence of common right hemisphere disorders with prosodic deficits. More rigorous empirical inquiry is required to identify specific patient profiles based on clusters of deficits associated with right hemisphere stroke. Future research may determine whether the co-occurrences identified are due to shared cognitive-linguistic processes, and may inform the development of evidence-based assessment and treatment recommendations for individuals with cognitive-communication deficits subsequent to RHD.
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Trastornos de la Percepción , Accidente Cerebrovascular , Humanos , Trastornos del Habla , Emociones , Lingüística , Accidente Cerebrovascular/complicaciones , Trastornos de la Percepción/etiologíaRESUMEN
Background@#Speech and language pathologists (SLPs) are responsible for the management of cognitive-communication disorders brought about by cerebrovascular diseases (CVD). These disorders are managed to support positive and functional changes in the skills needed to participate in the social, education, and vocational responsibilities of an individual. @*Objective@#This study aimed to describe the demographic information and practices of Filipino SLPs through self-ratings of their knowledge, confidence, and experience in relation to their cognitive-communication assessment tools and intervention practices when working with clients with post-CVD and have cognitive-communication disorders. It also aimed to identify the felt needs of SLPs in this area of practice. @*Methodology@#The survey tool was patterned after the questionnaire used by Reideman and Turkstra (2018) in a similar study, validated by SLP experts in cognitive-communication disorders, and pilot tested by SLPs who met inclusion criteria for study participants. @*Results@#A total of 34 SLPs with at least one year of experience working with patients post-CVD responded to the survey. Results showed that the SLPs were most knowledgeable, experienced, and confident in the use of a nonstandardized translation of the Western Aphasia Battery (WAB) and in the use of counseling and education as an intervention method for their patients with cognitive-communication disorders. Despite familiarity with the WAB, they showed a preference for informal assessment practices.@*Conclusion@#The SLPs felt the need for additional training on assessment and treatment practices in cognitive communication disorders and emphasized the need for culturally-appropriate materials and established practice guidelines for the Filipino clientele.
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Trastornos Cerebrovasculares , Encuestas y CuestionariosRESUMEN
Purpose: To examine the long-term consequences of early childhood traumatic brain injury (TBI), approximately 6.8 years post-injury, on cognitive communication competency within a complex interplay of individual, contextual, and psychosocial factors. Additionally, we were interested in looking at the association of communication competence with social competence and overall functioning.Methods: 64 children with orthopedic injury, 40 children with moderate traumatic brain injury, and 14 children with severe traumatic brain injury who were between 3 years and 6 years 11 months at injury completed a narrative discourse task and clinical measures in a single visit at a longer term follow up in early adolescence, an average of 6.8 years post injury. Analyses of covariance were conducted to compare groups on the discourse task, and hierarchical linear regressions were conducted to examine the association of discourse measures with clinical measures of cognitive and psychosocial functioning.Results: Children with severe traumatic brain injury performed worse than children with moderate traumatic brain injury and orthopedic injury on all discourse indices and clinical measures. Injury severity, pragmatic skills, and socioeconomic status were associated with discourse gist. Discourse gist was the most sensitive measure of communication competence, and it was significantly associated with psychosocial outcomes independent of group.Conclusion: Children who sustain a severe traumatic brain injury in early childhood are at risk for long-term cognitive communication impairments that may be related to a complex interplay of injury, individual, and social factors.Implications for rehabilitationThe assessment and treatment of cognitive communication impairments after traumatic brain injury are complex and require consideration of individual, contextual, and psychosocial factors.Discourse, in general, and gist reasoning specifically, is a sensitive measure for detecting cognitive communication competence several years after pediatric traumatic brain injury.Treatments to address gist reasoning deficits may support improvements in global and social functioning.
Asunto(s)
Lesiones Traumáticas del Encéfalo , Trastornos de la Comunicación , Adolescente , Niño , Preescolar , Humanos , Narración , Funcionamiento Psicosocial , Ajuste SocialRESUMEN
AIMS: To investigate if metacognitive strategy instruction (MSI) improves the receptive language skills of adults with cognitive-communication disorders secondary to acquired brain injury (ABI). RESEARCH DESIGN: An ABA intervention programme was implemented with eight adults with ABI, aged 25-70 years. The Measure of Cognitive-Linguistic Abilities (MCLA) was administered at baseline and following treatment. The treatment employed in this study involved three components: individual goal-based therapy, group remediation therapy using self-instruction and home practice. RESULTS: No receptive language sub-tests of the MCLA reached statistical significance. However, participants' raw score improvements in receptive language sub-tests indicated that MSI may be effective at remediating CCDs following ABI. CONCLUSIONS: Preliminary findings indicate that MSI may be effective in improving receptive language skills in adults with CCDs following ABI. Further research involving a more rigorous study, a larger sample size and a more reliable outcome measure is necessary and may provide statistically significant evidence for the effectiveness of MSI for remediating receptive language disorders.