1/6. Discourse deficits following right hemisphere damage in deaf signers.Previous findings have demonstrated that hemispheric organization in deaf users of American sign language (ASL) parallels that of the hearing population, with the left hemisphere showing dominance for grammatical linguistic functions and the right hemisphere showing specialization for non-linguistic spatial functions. The present study addresses two further questions: first, do extra-grammatical discourse functions in deaf signers show the same right-hemisphere dominance observed for discourse functions in hearing subjects; and second, do discourse functions in ASL that employ spatial relations depend upon more general intact spatial cognitive abilities? We report findings from two right-hemisphere damaged deaf signers, both of whom show disruption of discourse functions in absence of any disruption of grammatical functions. The exact nature of the disruption differs for the two subjects, however. Subject AR shows difficulty in maintaining topical coherence, while SJ shows difficulty in employing spatial discourse devices. Further, the two subjects are equally impaired on non-linguistic spatial tasks, indicating that spared spatial discourse functions can occur even when more general spatial cognition is disrupted. We conclude that, as in the hearing population, discourse functions involve the right hemisphere; that distinct discourse functions can be dissociated from one another in ASL; and that brain organization for linguistic spatial devices is driven by its functional role in language processing, rather than by its surface, spatial characteristics.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
2/6. "Pure word deafness": implications for assessment and management in communication disorder--a report of two cases.In "pure word deafness" after acquired brain injury, the auditory comprehension of words is much more impaired than other aspects of communication or cognition. Two cases are presented, one early and one late presentation. The key to diagnosis of communication disorders is to remember to assess all six basic aspects of language function and to be vigilant for coexisting diagnoses that can complicate such assessment (especially psychiatric diagnoses). rehabilitation management of impaired communication should emphasize the teaching of specific coping mechanisms to the patient and to all others who are involved.- - - - - - - - - - ranking = 72.021179033213keywords = brain injury, brain, injury (Clic here for more details about this article) |
3/6. Accessibility of spoken, written, and sign language in landau-kleffner syndrome: a linguistic and functional MRI study.landau-kleffner syndrome (LKS) is an acquired aphasia which begins in childhood and is thought to arise from an epileptic disorder within the auditory speech cortex. Although the epilepsy usually subsides at puberty, a severe communication impairment often persists. Here we report on a detailed study of a 26-year old, left-handed male, with onset of LKS at age 5 years, who is aphasic for English but who learned British sign language (BSL) at age 13. We have investigated his skills in different language modalities, recorded EEGs during wakefulness, sleep, and under conditions of auditory stimulation, measured brain stem auditory-evoked potentials (BAEP), and performed functional MRI (fMRI) during a range of linguistic tasks. Our investigation demonstrated severe restrictions in comprehension and production of spoken English as well as lip-reading, while reading was comparatively less impaired. BSL was by far the most efficient mode of communication. All EEG recordings were normal, while BAEP showed minor abnormalities. fMRI revealed: 1) powerful and extensive bilateral (R > L) activation of auditory cortices in response to heard speech, much stronger than when listening to music; 2) very little response to silent lip-reading; 3) strong activation in the temporo-parieto-occipital association cortex, exclusively in the right hemisphere (RH), when viewing BSL signs. Analysis of these findings provides novel insights into the disturbance of the auditory speech cortex which underlies LKS and its diagnostic evaluation by fMRI, and underpins a strategy of restoring communication abilities in LKS through a natural sign language of the deaf (with Video)- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
4/6. Determining decision-making capacity in individuals with severe communication impairments after stroke: the role of augmentative-alternative communication (AAC).A speech-language pathologist and occupational therapist specializing in assistive technology were requested to assess an individual 2 years post hemorrhagic lesion in his brainstem, with significant medial issues, limited expressive communication skills, and motor function. The family wanted to determine if he had an adequate quality of life and whether he could provide informed consent if asked about the continuation or withdrawal of medical treatment to maintain his life. Issues discussed include determining competency for decision making regarding quality of life with individuals who cannot speak, write, or type, and what role the speech-language pathologist and occupational therapist can play in attempting to find these answers. A means of communication for this individual was identified that allowed him to provide information related to his preferences including physical state. Use of appropriate augmentative-alternative communication equipment and techniques became the means to further explore more complex medical decisions for this individual.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
5/6. ADHD couple and family relationships: enhancing communication and understanding through Imago Relationship Therapy.This article reviews the relationship deficits experienced by many individuals who have attention deficit hyperactivity disorder (ADHD) and proposes effective strategies, based on Imago Relationship Therapy (IRT), to assist them in communicating more effectively. The neurological underpinnings of the disorder often contribute to the development of poor social and communication skills and can lead to a lifetime of relationship difficulties. IRT, a brain-based approach, is compatible with the neurological challenges of living with ADHD because it slows the communication process, provides structure, reduces reactivity, and helps individuals to be fully present so that their loved one can feel fully heard and understood. The couple's dialogue strengthens relationships by encouraging the development of stronger listening skills, better self-control, and problem solving. Two case examples illustrate the clinical methods used.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
6/6. Assessment of pragmatic communication skills in adolescents after traumatic brain injury.Deficits in pragmatic communication ability have a significant impact on functional outcome from traumatic brain injury (TBI), particularly during adolescence, when sophisticated social communication skills are developing. There are few published tests designed to assess pragmatic skills in this age group. In the present study, four tasks designed to tap various aspects of pragmatic communication ability were administered to three brain-injured adolescents and 36 of their uninjured peers aged 15-18 years. The tasks evaluated the ability to negotiate, hint, describe a simple procedure, and understand sarcasm. The four tasks were found to tap distinct aspects of pragmatic ability in control subjects. Further, within the control group, task performance was related more to non-verbal reasoning ability than vocabulary skills. Scores for two of the three TBI subjects were poorer than those of their peers, while a third mildly injured subject performed within normal limits. Pragmatic task scores were consistent with the results of neuropsychological testing in the three TBI subjects. Implications for clinical management and recommendations for future research are discussed.- - - - - - - - - - ranking = 1050.8452932243keywords = traumatic brain injury, brain injury, traumatic brain, brain, injury (Clic here for more details about this article) |