Apragmatism: The renewal of a label for communication disorders associated with right hemisphere brain damage
Background Right hemisphere communication disorders are neither consistently labelled nor adequately defined. Labels associated with right hemisphere brain damage (RHD) are broad and fail to capture the essence of communication challenges needed for stroke‐related service provisions. Determination o...
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| Veröffentlicht in: | International journal of language & communication disorders 2023-03, Vol.58 (2), p.651-666 |
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| creator | Minga, Jamila Sheppard, Shannon M. Johnson, Melissa Hewetson, Ronelle Cornwell, Petrea Blake, Margaret Lehman |
| description | Background
Right hemisphere communication disorders are neither consistently labelled nor adequately defined. Labels associated with right hemisphere brain damage (RHD) are broad and fail to capture the essence of communication challenges needed for stroke‐related service provisions. Determination of rehabilitation needs and best‐practice guidelines for the education, management and functional improvement of communication disorders after RHD are all predicated on an apt diagnostic label and disorder characteristics.
Aims
In this paper apragmatism is proposed as a potential communication‐specific diagnostic label for the impairments in communication that occur after RHD. In particular, the researchers aimed: (1) to establish an operational definition of apragmatism; and (2) to describe the linguistic, paralinguistic and extralinguistic communication deficits under the umbrella term apragmatism.
Methods & Procedures
An international collaborative of researchers with expertise in RHD followed a multilevel approach to consider the utility of apragmatism as a diagnostic label. Adopting the relational approach to concept mapping, the researchers engaged in a series of group meetings to complete four levels of mapping: (1) identify and review, (2) define, (3) expert discussion and (4) label determination.
Main Contribution
Apragmatism was established as a suitable diagnostic label for the impairments in communication associated with RHD. The paper offers an operational definition and description of the linguistic, paralinguistic and extralinguistic features of apragmatism through evidence summaries and examples from people with RHD retrieved from the RHDBank.
Conclusions & Implications
The adoption of the term apragmatism offers an opportunity to capture the hallmark of RHD communication deficits. The use of the term is recommended when referencing the pragmatic language impairments in this population. Apragmatism, which may co‐occur with or be exacerbated by cognitive impairments, can interfere with the ability to interpret and convey intended meaning and impact the lives of right hemisphere stroke survivors and their families.
What this paper adds
What is already known on the subject
RHD results in a heterogeneous group of deficits that range in cognitive–communicative complexity. Many of the deficits are subsumed under pragmatics. For example, adults with RHD may demonstrate tangential or verbose communication, insensitivity to others’ needs and feelings, pros |
| doi_str_mv | 10.1111/1460-6984.12807 |
| format | Article |
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Right hemisphere communication disorders are neither consistently labelled nor adequately defined. Labels associated with right hemisphere brain damage (RHD) are broad and fail to capture the essence of communication challenges needed for stroke‐related service provisions. Determination of rehabilitation needs and best‐practice guidelines for the education, management and functional improvement of communication disorders after RHD are all predicated on an apt diagnostic label and disorder characteristics.
Aims
In this paper apragmatism is proposed as a potential communication‐specific diagnostic label for the impairments in communication that occur after RHD. In particular, the researchers aimed: (1) to establish an operational definition of apragmatism; and (2) to describe the linguistic, paralinguistic and extralinguistic communication deficits under the umbrella term apragmatism.
Methods & Procedures
An international collaborative of researchers with expertise in RHD followed a multilevel approach to consider the utility of apragmatism as a diagnostic label. Adopting the relational approach to concept mapping, the researchers engaged in a series of group meetings to complete four levels of mapping: (1) identify and review, (2) define, (3) expert discussion and (4) label determination.
Main Contribution
Apragmatism was established as a suitable diagnostic label for the impairments in communication associated with RHD. The paper offers an operational definition and description of the linguistic, paralinguistic and extralinguistic features of apragmatism through evidence summaries and examples from people with RHD retrieved from the RHDBank.
Conclusions & Implications
The adoption of the term apragmatism offers an opportunity to capture the hallmark of RHD communication deficits. The use of the term is recommended when referencing the pragmatic language impairments in this population. Apragmatism, which may co‐occur with or be exacerbated by cognitive impairments, can interfere with the ability to interpret and convey intended meaning and impact the lives of right hemisphere stroke survivors and their families.
What this paper adds
What is already known on the subject
RHD results in a heterogeneous group of deficits that range in cognitive–communicative complexity. Many of the deficits are subsumed under pragmatics. For example, adults with RHD may demonstrate tangential or verbose communication, insensitivity to others’ needs and feelings, prosodic changes, minimal gesture use and facial expression, and more. While descriptions of pragmatic impairments pervade the literature, there is no consistently used diagnostic label. The clinical consequences of this absence include difficulty with inter‐ and intra‐disciplinary communication about these patients, difficulty consolidating findings across research studies, and challenges in communicating about these pragmatic changes with patients, families and other stakeholders.
What this paper adds to existing knowledge
The term apragmatism is proposed as a diagnostic label to consistently describe pragmatic communication changes after RHD. Apragmatism is characterized using three components of pragmatics: linguistic, paralinguistic and extralinguistic. Descriptions and examples of these three components are provided with supplemental transcripts retrieved from the RHDBank.
What are the potential or actual clinical implications of this work?
Adoption of the term apragmatism by speech and language therapists and other medical and rehabilitation professionals has the potential to provide consistency in describing the abilities and challenges experienced by people following a right hemisphere stroke. Such improvements may help drive the development of evidence‐based assessments and treatments for this population.</description><identifier>ISSN: 1368-2822</identifier><identifier>ISSN: 1460-6984</identifier><identifier>EISSN: 1460-6984</identifier><identifier>DOI: 10.1111/1460-6984.12807</identifier><identifier>PMID: 36448626</identifier><language>eng</language><publisher>United States: Wiley</publisher><subject>Adult ; Brain ; Brain damage ; Brain Hemisphere Functions ; Clinical Diagnosis ; Cognitive impairment ; cognitive–communication ; Collaboration ; Communication ; Communication Disorders ; Communication Disorders - diagnosis ; Communication Disorders - etiology ; Communication Disorders - rehabilitation ; Concept Mapping ; Definitions ; discourse ; Families & family life ; Gestures ; Humans ; Labeling (of Persons) ; Language Disorders ; linguistic/language disorders ; Linguistics ; Neurological Impairments ; Paralinguistics ; Patients ; Pragmatics ; Prosody ; Rehabilitation ; right hemisphere brain damage ; Speech Language Pathology ; Speech-language pathologists ; Stroke ; Stroke - complications</subject><ispartof>International journal of language & communication disorders, 2023-03, Vol.58 (2), p.651-666</ispartof><rights>2022 Royal College of Speech and Language Therapists.</rights><rights>2023 Royal College of Speech and Language Therapists.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4507-b845cafd1859fcf3b78f89eef254c60585af589e323c7bfc7a45d49983d3440e3</citedby><cites>FETCH-LOGICAL-c4507-b845cafd1859fcf3b78f89eef254c60585af589e323c7bfc7a45d49983d3440e3</cites><orcidid>0000-0002-2301-8954</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2F1460-6984.12807$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2F1460-6984.12807$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,777,781,882,1412,27905,27906,45555,45556</link.rule.ids><backlink>$$Uhttp://eric.ed.gov/ERICWebPortal/detail?accno=EJ1368895$$DView record in ERIC$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36448626$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Minga, Jamila</creatorcontrib><creatorcontrib>Sheppard, Shannon M.</creatorcontrib><creatorcontrib>Johnson, Melissa</creatorcontrib><creatorcontrib>Hewetson, Ronelle</creatorcontrib><creatorcontrib>Cornwell, Petrea</creatorcontrib><creatorcontrib>Blake, Margaret Lehman</creatorcontrib><title>Apragmatism: The renewal of a label for communication disorders associated with right hemisphere brain damage</title><title>International journal of language & communication disorders</title><addtitle>Int J Lang Commun Disord</addtitle><description>Background
Right hemisphere communication disorders are neither consistently labelled nor adequately defined. Labels associated with right hemisphere brain damage (RHD) are broad and fail to capture the essence of communication challenges needed for stroke‐related service provisions. Determination of rehabilitation needs and best‐practice guidelines for the education, management and functional improvement of communication disorders after RHD are all predicated on an apt diagnostic label and disorder characteristics.
Aims
In this paper apragmatism is proposed as a potential communication‐specific diagnostic label for the impairments in communication that occur after RHD. In particular, the researchers aimed: (1) to establish an operational definition of apragmatism; and (2) to describe the linguistic, paralinguistic and extralinguistic communication deficits under the umbrella term apragmatism.
Methods & Procedures
An international collaborative of researchers with expertise in RHD followed a multilevel approach to consider the utility of apragmatism as a diagnostic label. Adopting the relational approach to concept mapping, the researchers engaged in a series of group meetings to complete four levels of mapping: (1) identify and review, (2) define, (3) expert discussion and (4) label determination.
Main Contribution
Apragmatism was established as a suitable diagnostic label for the impairments in communication associated with RHD. The paper offers an operational definition and description of the linguistic, paralinguistic and extralinguistic features of apragmatism through evidence summaries and examples from people with RHD retrieved from the RHDBank.
Conclusions & Implications
The adoption of the term apragmatism offers an opportunity to capture the hallmark of RHD communication deficits. The use of the term is recommended when referencing the pragmatic language impairments in this population. Apragmatism, which may co‐occur with or be exacerbated by cognitive impairments, can interfere with the ability to interpret and convey intended meaning and impact the lives of right hemisphere stroke survivors and their families.
What this paper adds
What is already known on the subject
RHD results in a heterogeneous group of deficits that range in cognitive–communicative complexity. Many of the deficits are subsumed under pragmatics. For example, adults with RHD may demonstrate tangential or verbose communication, insensitivity to others’ needs and feelings, prosodic changes, minimal gesture use and facial expression, and more. While descriptions of pragmatic impairments pervade the literature, there is no consistently used diagnostic label. The clinical consequences of this absence include difficulty with inter‐ and intra‐disciplinary communication about these patients, difficulty consolidating findings across research studies, and challenges in communicating about these pragmatic changes with patients, families and other stakeholders.
What this paper adds to existing knowledge
The term apragmatism is proposed as a diagnostic label to consistently describe pragmatic communication changes after RHD. Apragmatism is characterized using three components of pragmatics: linguistic, paralinguistic and extralinguistic. Descriptions and examples of these three components are provided with supplemental transcripts retrieved from the RHDBank.
What are the potential or actual clinical implications of this work?
Adoption of the term apragmatism by speech and language therapists and other medical and rehabilitation professionals has the potential to provide consistency in describing the abilities and challenges experienced by people following a right hemisphere stroke. Such improvements may help drive the development of evidence‐based assessments and treatments for this population.</description><subject>Adult</subject><subject>Brain</subject><subject>Brain damage</subject><subject>Brain Hemisphere Functions</subject><subject>Clinical Diagnosis</subject><subject>Cognitive impairment</subject><subject>cognitive–communication</subject><subject>Collaboration</subject><subject>Communication</subject><subject>Communication Disorders</subject><subject>Communication Disorders - diagnosis</subject><subject>Communication Disorders - etiology</subject><subject>Communication Disorders - rehabilitation</subject><subject>Concept Mapping</subject><subject>Definitions</subject><subject>discourse</subject><subject>Families & family life</subject><subject>Gestures</subject><subject>Humans</subject><subject>Labeling (of Persons)</subject><subject>Language Disorders</subject><subject>linguistic/language disorders</subject><subject>Linguistics</subject><subject>Neurological Impairments</subject><subject>Paralinguistics</subject><subject>Patients</subject><subject>Pragmatics</subject><subject>Prosody</subject><subject>Rehabilitation</subject><subject>right hemisphere brain damage</subject><subject>Speech Language Pathology</subject><subject>Speech-language pathologists</subject><subject>Stroke</subject><subject>Stroke - complications</subject><issn>1368-2822</issn><issn>1460-6984</issn><issn>1460-6984</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkUtv1DAUhS0EoqWwZgWyxKabtLZjJw4bVE3LoxqJTVlbjnM9cRXHg50w6r_HIWUEbPDG1j3fffkg9JqSC5rPJeUVKapG8gvKJKmfoNNj5Gl-l5UsmGTsBL1I6Z4Qwqigz9FJWXEuK1adIn-1j3rn9eSSf4_vesARRjjoAQeLNR50CwO2IWITvJ9HZzIZRty5FGIHMWGdUjBOT9Dhg5t6HN2un3AP3qV9DxFwG7XLCdrrHbxEz6weErx6vM_Qt483d5vPxfbrpy-bq21huCB10UoujLYdlaKxxpZtLa1sACwT3FRESKGtyIGSlaZurak1Fx1vGll2JecEyjP0Ya27n1sPnYFxinpQ--i8jg8qaKf-VkbXq134oWj-o4o1PFc4f6wQw_cZ0qTyQgaGQY8Q5qRYzcs8qqzrjL77B70PcxzzfpmSgkhJ-EJdrpSJIaUI9jgNJWrxUi3OqcU59cvLnPH2zyWO_G_zMvBmBSA6c5RvbhfbZSOyXq36wQ3w8L9-6na7uV47_wR17rQ3</recordid><startdate>202303</startdate><enddate>202303</enddate><creator>Minga, Jamila</creator><creator>Sheppard, Shannon M.</creator><creator>Johnson, Melissa</creator><creator>Hewetson, Ronelle</creator><creator>Cornwell, Petrea</creator><creator>Blake, Margaret Lehman</creator><general>Wiley</general><general>Wiley Subscription Services, Inc</general><scope>7SW</scope><scope>BJH</scope><scope>BNH</scope><scope>BNI</scope><scope>BNJ</scope><scope>BNO</scope><scope>ERI</scope><scope>PET</scope><scope>REK</scope><scope>WWN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T9</scope><scope>8BM</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-2301-8954</orcidid></search><sort><creationdate>202303</creationdate><title>Apragmatism: The renewal of a label for communication disorders associated with right hemisphere brain damage</title><author>Minga, Jamila ; Sheppard, Shannon M. ; Johnson, Melissa ; Hewetson, Ronelle ; Cornwell, Petrea ; Blake, Margaret Lehman</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4507-b845cafd1859fcf3b78f89eef254c60585af589e323c7bfc7a45d49983d3440e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Adult</topic><topic>Brain</topic><topic>Brain damage</topic><topic>Brain Hemisphere Functions</topic><topic>Clinical Diagnosis</topic><topic>Cognitive impairment</topic><topic>cognitive–communication</topic><topic>Collaboration</topic><topic>Communication</topic><topic>Communication Disorders</topic><topic>Communication Disorders - diagnosis</topic><topic>Communication Disorders - etiology</topic><topic>Communication Disorders - rehabilitation</topic><topic>Concept Mapping</topic><topic>Definitions</topic><topic>discourse</topic><topic>Families & family life</topic><topic>Gestures</topic><topic>Humans</topic><topic>Labeling (of Persons)</topic><topic>Language Disorders</topic><topic>linguistic/language disorders</topic><topic>Linguistics</topic><topic>Neurological Impairments</topic><topic>Paralinguistics</topic><topic>Patients</topic><topic>Pragmatics</topic><topic>Prosody</topic><topic>Rehabilitation</topic><topic>right hemisphere brain damage</topic><topic>Speech Language Pathology</topic><topic>Speech-language pathologists</topic><topic>Stroke</topic><topic>Stroke - complications</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Minga, Jamila</creatorcontrib><creatorcontrib>Sheppard, Shannon M.</creatorcontrib><creatorcontrib>Johnson, Melissa</creatorcontrib><creatorcontrib>Hewetson, Ronelle</creatorcontrib><creatorcontrib>Cornwell, Petrea</creatorcontrib><creatorcontrib>Blake, Margaret Lehman</creatorcontrib><collection>ERIC</collection><collection>ERIC (Ovid)</collection><collection>ERIC</collection><collection>ERIC</collection><collection>ERIC (Legacy Platform)</collection><collection>ERIC( SilverPlatter )</collection><collection>ERIC</collection><collection>ERIC PlusText (Legacy Platform)</collection><collection>Education Resources Information Center (ERIC)</collection><collection>ERIC</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Linguistics and Language Behavior Abstracts (LLBA)</collection><collection>ComDisDome</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>International journal of language & communication disorders</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Minga, Jamila</au><au>Sheppard, Shannon M.</au><au>Johnson, Melissa</au><au>Hewetson, Ronelle</au><au>Cornwell, Petrea</au><au>Blake, Margaret Lehman</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><ericid>EJ1368895</ericid><atitle>Apragmatism: The renewal of a label for communication disorders associated with right hemisphere brain damage</atitle><jtitle>International journal of language & communication disorders</jtitle><addtitle>Int J Lang Commun Disord</addtitle><date>2023-03</date><risdate>2023</risdate><volume>58</volume><issue>2</issue><spage>651</spage><epage>666</epage><pages>651-666</pages><issn>1368-2822</issn><issn>1460-6984</issn><eissn>1460-6984</eissn><abstract>Background
Right hemisphere communication disorders are neither consistently labelled nor adequately defined. Labels associated with right hemisphere brain damage (RHD) are broad and fail to capture the essence of communication challenges needed for stroke‐related service provisions. Determination of rehabilitation needs and best‐practice guidelines for the education, management and functional improvement of communication disorders after RHD are all predicated on an apt diagnostic label and disorder characteristics.
Aims
In this paper apragmatism is proposed as a potential communication‐specific diagnostic label for the impairments in communication that occur after RHD. In particular, the researchers aimed: (1) to establish an operational definition of apragmatism; and (2) to describe the linguistic, paralinguistic and extralinguistic communication deficits under the umbrella term apragmatism.
Methods & Procedures
An international collaborative of researchers with expertise in RHD followed a multilevel approach to consider the utility of apragmatism as a diagnostic label. Adopting the relational approach to concept mapping, the researchers engaged in a series of group meetings to complete four levels of mapping: (1) identify and review, (2) define, (3) expert discussion and (4) label determination.
Main Contribution
Apragmatism was established as a suitable diagnostic label for the impairments in communication associated with RHD. The paper offers an operational definition and description of the linguistic, paralinguistic and extralinguistic features of apragmatism through evidence summaries and examples from people with RHD retrieved from the RHDBank.
Conclusions & Implications
The adoption of the term apragmatism offers an opportunity to capture the hallmark of RHD communication deficits. The use of the term is recommended when referencing the pragmatic language impairments in this population. Apragmatism, which may co‐occur with or be exacerbated by cognitive impairments, can interfere with the ability to interpret and convey intended meaning and impact the lives of right hemisphere stroke survivors and their families.
What this paper adds
What is already known on the subject
RHD results in a heterogeneous group of deficits that range in cognitive–communicative complexity. Many of the deficits are subsumed under pragmatics. For example, adults with RHD may demonstrate tangential or verbose communication, insensitivity to others’ needs and feelings, prosodic changes, minimal gesture use and facial expression, and more. While descriptions of pragmatic impairments pervade the literature, there is no consistently used diagnostic label. The clinical consequences of this absence include difficulty with inter‐ and intra‐disciplinary communication about these patients, difficulty consolidating findings across research studies, and challenges in communicating about these pragmatic changes with patients, families and other stakeholders.
What this paper adds to existing knowledge
The term apragmatism is proposed as a diagnostic label to consistently describe pragmatic communication changes after RHD. Apragmatism is characterized using three components of pragmatics: linguistic, paralinguistic and extralinguistic. Descriptions and examples of these three components are provided with supplemental transcripts retrieved from the RHDBank.
What are the potential or actual clinical implications of this work?
Adoption of the term apragmatism by speech and language therapists and other medical and rehabilitation professionals has the potential to provide consistency in describing the abilities and challenges experienced by people following a right hemisphere stroke. Such improvements may help drive the development of evidence‐based assessments and treatments for this population.</abstract><cop>United States</cop><pub>Wiley</pub><pmid>36448626</pmid><doi>10.1111/1460-6984.12807</doi><tpages>16</tpages><orcidid>https://orcid.org/0000-0002-2301-8954</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1368-2822 |
| ispartof | International journal of language & communication disorders, 2023-03, Vol.58 (2), p.651-666 |
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| language | eng |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adult Brain Brain damage Brain Hemisphere Functions Clinical Diagnosis Cognitive impairment cognitive–communication Collaboration Communication Communication Disorders Communication Disorders - diagnosis Communication Disorders - etiology Communication Disorders - rehabilitation Concept Mapping Definitions discourse Families & family life Gestures Humans Labeling (of Persons) Language Disorders linguistic/language disorders Linguistics Neurological Impairments Paralinguistics Patients Pragmatics Prosody Rehabilitation right hemisphere brain damage Speech Language Pathology Speech-language pathologists Stroke Stroke - complications |
| title | Apragmatism: The renewal of a label for communication disorders associated with right hemisphere brain damage |
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