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  • Publication
    Accès libre
    Time reference in aphasia: are there differences between tenses and aphasia fluency type? A systematic review and individual participant data meta-analysis
    Time reference is used to build the temporal framework of discourse and is essential in ensuring efficient communication. Several studies have reported time reference deficits in fluent and non-fluent aphasia and have shown that tenses (past, present, future) are not all impaired to the same extent. However, there is little consensus on the dissociations between tenses, and the question of the influence of the type of aphasia (fluent vs. non-fluent) on time reference remains open. Therefore, a systematic review and an individual participant data meta-analysis (or mega-analysis) were conducted to determine (1) whether one tense is more impaired than another in fluent and non-fluent aphasia and, if so, (2) which task and speaker-related factors moderate tense effects. The systematic review resulted in 35 studies reporting the performance in time reference of 392 participants. The mega-analysis was then performed on 23 studies for a total of 232 participants and showed an alteration of past tense compared to present and future tenses in both types of aphasia. The analysis also showed a task and an age effect on time reference but no gender effect, independently of tenses. These results add to our knowledge of time reference in aphasia and have implications for future therapies.
  • Publication
    Accès libre
    Le test de compréhension de l’IRonie et des Requêtes Indirectes – version courte (IRRI-C) : développement, validité de contenu et données normatives préliminaires.
    (2024) ;
    Maud Champagne-Lavau
    ;
    Background: Following a traumatic brain injury or right hemisphere damage, many patients have difficulty understanding non-literal language. However, tools for assessing this disorder are sorely lacking in French. The existing tests (in particular the IRonie and Indirect Request comprehension test - IRRI) also have certain limitations, including the time-consuming administration. Objectives: The present study aims to present (1) the construction, (2) the content validity, and (3) the preliminary normative data of the short version of the Irony and Indirect Requests comprehension test (IRRI-C). Methods: (1) To select the twelve items of each IRRI-C task, difficulty and discrimination indices, item-total score correlations, and differences in correct responses between patients and control participants were calculated from the responses of 33 brain-damaged participants and 102 control subjects to the long version (36 items) of the IRRI test. (2) The tool was then given to seven speech and language therapists and neuropsychologists, who used a questionnaire to assess the clarity and relevance of the IRRI-C in assessing the target construct. (3) Finally, the IRRI-C was administered to 121 control subjects aged between 20 and 65 years to provide preliminary normative data. Results: (1) The twelve stimuli with the best difficulty and discrimination indices, item-total score correlations, and the greatest differences between patients and control participants were selected for each task. A PowerPoint presentation, a scoring sheet, and an introduction and scoring booklet were produced and made available to clinicians on the Internet. (2) Questionnaires on construct validity showed that the IRRI-C was highly relevant for assessing the target construct and that the introductory booklet, instructions, and scoring guide were very clear. (3) Norms stratified according to the variables of interest manipulated in the tasks (context, executive demand, and presence of markers) were calculated as percentiles. Conclusion: The IRRI-C fills an important gap in French-language pragmatics assessment tools. Its shorter format and stratification of norms make it a tool better adapted to clinical reality and conducive to the development of diagnostic hypotheses and therapeutic goals. Future improvements, including validation in different populations and a finer-grained analysis of production during scoring, will further enhance its clinical relevance.
  • Publication
    Accès libre
    Improved comprehension of irony and indirect requests following a severe traumatic brain injury: two case studies
    (2023-11-16) ;
    Maud Champagne-Lavau
    ;
    Background: Following a traumatic brain injury (TBI), people frequently have difficulty understanding nonliteral language, including irony and indirect requests. Despite the handicap that these disorders can represent in daily life, they are rarely treated clinically, and remediation studies are scarce. Aims: The present study thus aimed to evaluate the effectiveness of an explicit metapragmatic therapy targeting nonliteral language comprehension and taking into account cognitive processes likely to underlie this comprehension (i.e., contextual processing, theory of mind, and executive functions). Methods & Procedure: This study was registered on the ClinicalTrials.gov system (ID: NCT04708561) before participant recruitment. Two adults with severe TBI took part in the study. An ABA design with multiple baselines was used to assess the evolution of treated and non-treated written literal and nonliteral story comprehension, as well as ecological tasks and tasks assessing the cognitive processes of interest (theory of mind and executive functions). An interview was also conducted at the end of treatment to assess participant satisfaction. Outcomes & results: Therapy resulted in significant improvement in treated items, with one-month maintenance of gains and generalisation to untreated items in both participants. The generalisation to a working memory task was also observed in one participant. Finally, participant satisfaction with the treatment was high. Conclusions & implications: Our study demonstrated for the first time the potential of a therapy targeting irony and indirect request comprehension in TBI individuals. Clinically, it offers concrete therapeutic avenues and fills a critical gap in the TBI population’s evidence for the remediation of nonliteral language comprehension.
  • Publication
    Accès libre
    Déficits de compréhension de phrases
    (Louvain la neuve: de Boeck supérieur, 2022) ; ;
  • Publication
    Accès libre
    Differential Impairments in Irony comprehension in Brain-Damaged Individuals: Insight from contextual processing, theory of mind, and executive functions
    (2020-8-11) ; ;
    Champagne-Lavau, Maud
    Objective: The comprehension of irony can be affected after brain injuries. The cognitive mechanisms accounting for such disorders remain yet unclear. The heterogeneity of cognitive profiles of braindamaged individuals and the use of independent tests to measure the links between these mechanisms and the comprehension of irony might contribute to this lack of clarity. The present study aimed to further explore the underlying mechanisms of irony-understanding disorders (i.e., context processing, executive functions [EF], and theory of mind [ToM]) in patients with brain lesions. Method: We used a paradigm manipulating these mechanisms within an irony task to identify different patterns of pragmatic performance associated with cognitive profiles. We administered this task and standard neuropsychological tests assessing EF and ToM to 30 participants with acquired brain injury (ABI) and 30 healthy control (HC) participants. Results: A cluster analysis revealed that two thirds of the participants with ABI (3 subgroups out of 4) presented atypical pragmatic and neuropsychological patterns. The most severe disturbances in understanding irony, characterized by insensitivity to the context, were associated with a joint impairment of ToM and EF in 1 subgroup. In the 2 other context-sensitive subgroups, an isolated deficit in EF co-occurred with difficulties dealing with literal or ironic statements when the EF demand of the irony task was increased. However, the effect of this EF demand could be negated by the presence of markers helping the comprehension of irony. Conclusion: These results have important clinical implications for the evaluation and therapy of pragmatic disorders in individuals with ABI.
  • Publication
    Accès libre
    Differential impairments in irony comprehension in brain-damaged individuals: Insight from contextual processing, theory of mind and executive functions
    Objective: The comprehension of irony can be affected after brain injuries. The cognitive mechanisms accounting for such disorders remain yet unclear. The heterogeneity of cognitive profiles of brain-damaged individuals and the use of independent tests to measure the links between these mechanisms and the comprehension of irony might contribute to this lack of clarity. The present study aimed to further explore the underlying mechanisms of irony understanding disorders (i.e., context processing, executive functions (EF), and theory of mind (ToM)) in patients with brain lesions.
    Method: We used a paradigm manipulating these mechanisms within an irony task to identify different patterns of pragmatic performance associated with cognitive profiles. We administered this task and standard neuropsychological tests assessing EF, and ToM to thirty acquired brain injured (ABI) and thirty healthy control (HC) participants.
    Results: A cluster analysis revealed that two-thirds of the ABI participants (3 sub-groups out of 4) presented atypical pragmatic and neuropsychological patterns. The most severe disturbances in understanding irony, characterized by insensitivity to the context, were associated with a joint impairment on ToM and EF in one subgroup. In the two other context-sensitive subgroups, an isolated deficit in EF co-occurred with difficulties dealing with literal or ironic statements when the EF demand of the irony task was increased. However, the effect of this EF demand could be negated by the presence of markers helping the comprehension of irony.
    Conclusions: These results have important clinical implications for the evaluation and therapy of pragmatic disorders in ABI individuals.