Treating underlying attention deficits as a means for improving conversational discourse in individuals with closed head injury: A preliminary study

Abstract

Background: It is documented that individuals with closed head injury (CHI) demonstrate difficulty with narrative and conversational discourse. Effective conversational discourse requires a complex interaction of linguistic, cognitive, and social abilities [6]. Reduced attention and concentration are among the most common cognitive sequela following CHI [39]. Aims: The present study investigated whether treatment of attention would facilitate conversational discourse for individuals with CHI. Two treatment protocols were investigated, the first social skills-based, and the second attention-based. It was hypothesized that attention training would improve not only attentional skills but also conversation, however social skills training, would only facilitate conversational skills. Methods and Procedures: A single subject multiple treatments comparison design was employed with two individuals who were post-onset of CHI. Treatment effects on conversational performance were calculated using the f statistic [18] for measures of response appropriateness during conversations. Outcomes and Results: Effect sizes suggested that both treatments were active; however, the participants' performances were variable reducing the magnitude of change observed. Results indicated minimal change from baselines, only partially supporting the research hypotheses. Conclusions: Although the two treatment regimens had some effect on the participants' conversational performances it was not to the extent anticipated. The issues of candidacy for such treatments as well as the importance of incorporating natural contingencies into interventions for conversation training are discussed. discourse. Generally, individuals with CHI demonstrate difficulty with the dynamic aspects of conversation, which forces the communication partner to assume the greater responsibility for providing conversational structure [9,10,27,40,41]. Individuals with CHI appear less adept at developing and managing appropriate conversational content [40-42] and meeting the informational needs of the listener [22,34,35]. This is consistent with a noted decrease in response appropriateness [9,10], topic management [8,10,27], and cohesion [26] as well as the inclusion of irrelevant and tangential information [34,35]. As a result, conversations with individuals with CHI have been char-

Joint Video Self-Modeling as a Conversational Intervention for an Individual with Traumatic Brain Injury and His Everyday Partner: A Pilot Investigation

“…IPR capitalizes on authentic interpersonal interactions and footage is reviewed immediately afterwards, fostering identification of insights related directly to the interaction dynamics. This technique improved situational anxiety, overall self-concept, interpersonal communication skills, and specific behavior associated with effective interpersonal communication [54]. Further, the authors noted that participants experienced improvements in day-to-day interactions supporting generalization of skills developed through IPR.…”

“…Investigators found that joint intervention was superior to solo interventions, where addressing a jointly constructed conversation is less feasible. Youse and Coelho [54] used a similar video-review approach. In order to avoid a conversation that feels awkward or forced, interpersonal process recall (IPR) [54] is used to facilitate the interaction within guided review of videos.…”

“…Youse and Coelho [54] used a similar video-review approach. In order to avoid a conversation that feels awkward or forced, interpersonal process recall (IPR) [54] is used to facilitate the interaction within guided review of videos. IPR capitalizes on authentic interpersonal interactions and footage is reviewed immediately afterwards, fostering identification of insights related directly to the interaction dynamics.…”

The Leap of Mind of Linguistic Humans over Animals

“…It is necessary to adopt the episodic coordination to understand the meaning of the whole long sentences [1] [2]. Certainly, it is also necessary for narration of paragraph and story to use episodic coordination [19] [20] [21]. In computer simulation, classifying the sentence/paragraph into the episodic category of natural/social subjects like physics, biology, art, economy, and so on is designed to improve the comprehension of language [25].…”

Discourse and cognition in speakers with acquired brain injury (ABI): a systematic review

“…Attention has focused on exploring the nature and extent of these difficulties, with the view to developing efficacious treatment methods (Galski et al 1998, Galvin et al 2010, McCarthy et al 2005. As cognitive-communication deficits arise from cognitive impairments following ABI, it is not surprising that treatment methods targeting cognitive and discourse skills independently have had limited success (Cannizzaro and Coelho 2002, Youse andCoelho 2009). The integrated treatment of related cognitive and discourse behaviours, as part of a broader approach that considers other psychosocial and emotional factors, may be a more prosperous approach to remediation , Yeates et al 2007, where clinicians are encouraged to design and implement holistic approaches to management and consider a wide variety of factors that influence social competence (Whyte 2014).…”