New ways to analyze word generation performance in brain injury: A systematic review and meta-analysis of additional performance measures

Introduction. The investigation of word generation performance is an accepted, widely used, and well-established method for examining cognitive, language, or communication impairment due to brain damage. The performance measure traditionally applied in the investigation of word generation is the number of correct responses. Previous studies, however, have suggested that this measure does not capture all potentially relevant aspects of word generation performance and hence its underlying processes, so that its analytical and explanatory power of word generation performance might be rather limited. Therefore, additional qualitative or quantitative performance measures have been introduced to gain information that goes beyond the deficit and allows for therapeutic implications. Method. We undertook a systematic review and meta-analysis of original research that focused on the application of additional measures of word generation performance in adult clinical populations with acquired brain injury. Results. Word generation tasks are an integral part of many different tests, but only few use additional performance measures in addition to the number of correct responses in the analysis of word generation performance. Additional measures, which showed increased or similar diagnostic utility relative to the traditional performance measure, regarded clustering and switching, error types, and temporal characteristics. Conclusions. The potential of additional performance measures is not yet fully exhausted in patients with brain injury. The temporal measure of response latencies in particular is not adequately represented, though it may be a reliable measure especially for identifying subtle impairments. Unfortunately, there is no general consensus as of yet on which additional measures are best suited to characterizing word generation performance. Further research is needed to specify the additional parameters that are best qualified for identifying and characterizing impaired word generation performance

Emotion Recognition, Empathy, or ToM? The Influence of Social Cognition on Communication in Traumatic Brain Injury A Systematic Review

Communication disorders following traumatic brain injury have been attributed to social-cognitive dysfunctions. However, this relationship is not always clearly demonstrated in empirical research. This systematic review seeks to clarify the relationship by considering different subcomponents of social cognition and communication. The results show that, for the social-cognitive subcomponents of emotion recognition and empathy, evidence is available mainly for a relationship to global communication abilities. However, we did find a systematic relationship between Theory of Mind and individual aspects of pragmatics (i.e., the processing of irony/sarcasm, insincerity, indirect speech acts). To strengthen the evidence for the role of social-cognitive subcomponents concerning communication, future research could implement a core outcome set based on the present findings

Kurzfassung und interdisziplinäre Kommentierung der internationalen INCOG-2.0-Leitlinie „Kognitive Kommunikationsstörungen nach Schädelhirntrauma“

<jats:p> Zusammenfassung: Kognitive Kommunikationsstörungen (Cognitive Communication Disorders = CCDs) bezeichnen kommunikative Beeinträchtigungen, die v. a. die kommunikativ-pragmatischen Fähigkeiten betreffen und primär durch begleitende kognitive Störungen, z. B. der Gedächtnis-, Aufmerksamkeits-, und exekutiven Planungsfunktionen bedingt sind. Eine besondere Rolle spielen außerdem Beeinträchtigungen Sozialer Kognition (z. B. Empathie, Theory of Mind). Somit fällt die Diagnostik und Behandlung der CCDs interdisziplinär in den Zuständigkeitsbereich der Klinischen Neuropsychologie und der Sprachtherapie. Ein internationales, interdisziplinäres Netzwerk, die sog. INCOG-Arbeitsgruppe, hat im Jahre 2023 aktualisierte, evidenzbasierte Empfehlungen zur Diagnostik und Behandlung von CCDs und begleitender soziokognitiver Störungen spezifisch nach mittelschweren bis schweren Schädel-Hirn-Traumata veröffentlicht. Diese sollen im vorliegenden Artikel zusammenfassend vorgestellt und kommentiert werden. Es werden erste Vorschläge zur konkreten interdisziplinären Zusammenarbeit von Klinischer Neuropsychologie und Sprachtherapie abgeleitet. </jats:p&gt

Measuring Verbal Reasoning and Executive Strategies in German Speaking People with Cognitive-Communication Disorders: Cross-Cultural Adaptation and Pilot Testing of the FAVRES-DE

Quinting J, Stenneken P, Mahlke A, et al. Measuring Verbal Reasoning and Executive Strategies in German Speaking People with Cognitive-Communication Disorders: Cross-Cultural Adaptation and Pilot Testing of the FAVRES-DE. Aphasiology . 2022.Background Cognitive communication disorders (CCDs) are a hallmark of traumatic brain injury (TBI). Difficulties may be relatively subtle, becoming especially evident in complex communication situations which place a higher cognitive demand on the person affected. To date, no standardised, ecologically valid assessment tool for detecting these subtle CCDs exists for German. The Functional Assessment of Verbal Reasoning and Executive Strategies (FAVRES; (MacDonald, 2005)), available in English and Canadian-French, is designed to detect subtle CCDs after acquired brain-injury (ABI) using real-life scenarios. Aims This study aims to translate and adapt the FAVRES into German as well as to gather reference data on the performance of neurologically healthy adults. Furthermore, the study conducts a first evaluation of age- and education-specific performance trends and interrater-reliability. Results are compared with the normative data of the original English version and the French-Canadian translation. In addition, an exploratory multiple case analysis of the feasibility of the FAVRES-DE and its capability to detect subtle CCDs on a sample of four adults with TBI is conducted. Methods & Procedures The original version of the FAVRES was translated and adapted based on the ITC-Guidelines for Translating and Adapting Tests (2016). The resulting German version, the FAVRES-DE, was completed by 60 neurologically healthy adults (32 women) and four adults with chronic CCD after TBI (>= 6 months post onset) in a pilot cross-sectional study. Results The FAVRES-DE was feasible with all participants. Age and education had significant influence on the performance of the neurologically healthy group, whose results were comparable to the original version and to the French-Canadian normative study, but analyses revealed differences in several subscores. Two of the four participants with TBI exhibited a significantly lower performance than the control group. Analyses of interrater-reliability revealed a high level of agreement between three independent raters. Discussion The FAVRES-DE seems to be a sensitive measure to identify CCDs after TBI. The challenges of detecting subtle CCDs are exemplified by one of the TBI cases. Further validation and psychometric testing of the FAVRES-DE on a representative dataset is warranted

Measuring Verbal Reasoning and Executive Strategies in German Speaking People with Cognitive-Communication Disorders: Cross-Cultural Adaptation and Pilot Testing of the FAVRES-DE

Background Cognitive communication disorders (CCDs) are a hallmark of traumatic brain injury (TBI). Difficulties may be relatively subtle, becoming especially evident in complex communication situations which place a higher cognitive demand on the person affected. To date, no standardised, ecologically valid assessment tool for detecting these subtle CCDs exists for German. The Functional Assessment of Verbal Reasoning and Executive Strategies (FAVRES; (MacDonald, 2005)), available in English and Canadian-French, is designed to detect subtle CCDs after acquired brain-injury (ABI) using real-life scenarios. Aims This study aims to translate and adapt the FAVRES into German as well as to gather reference data on the performance of neurologically healthy adults. Furthermore, the study conducts a first evaluation of age- and education-specific performance trends and interrater-reliability. Results are compared with the normative data of the original English version and the French-Canadian translation. In addition, an exploratory multiple case analysis of the feasibility of the FAVRES-DE and its capability to detect subtle CCDs on a sample of four adults with TBI is conducted. Methods & Procedures The original version of the FAVRES was translated and adapted based on the ITC-Guidelines for Translating and Adapting Tests (2016). The resulting German version, the FAVRES-DE, was completed by 60 neurologically healthy adults (32 women) and four adults with chronic CCD after TBI (>= 6 months post onset) in a pilot cross-sectional study. Results The FAVRES-DE was feasible with all participants. Age and education had significant influence on the performance of the neurologically healthy group, whose results were comparable to the original version and to the French-Canadian normative study, but analyses revealed differences in several subscores. Two of the four participants with TBI exhibited a significantly lower performance than the control group. Analyses of interrater-reliability revealed a high level of agreement between three independent raters. Discussion The FAVRES-DE seems to be a sensitive measure to identify CCDs after TBI. The challenges of detecting subtle CCDs are exemplified by one of the TBI cases. Further validation and psychometric testing of the FAVRES-DE on a representative dataset is warranted

Measuring communication as a core outcome in aphasia trials: Results of the ROMA-2 international core outcome set development meeting

BackgroundEvidence-based recommendations for a core outcome set (COS; minimum set of outcomes) for aphasia treatment research have been developed (the Research Outcome Measurement in Aphasia-ROMA, COS). Five recommended core outcome constructs: communication, language, quality of life, emotional well-being and patient-reported satisfaction/impact of treatment, were identified through three international consensus studies. Constructs were paired with outcome measurement instruments (OMIs) during an international consensus meeting (ROMA-1). Before the current study (ROMA-2), agreement had not been reached on OMIs for the constructs of communication or patient-reported satisfaction/impact of treatment. AimTo establish consensus on a communication OMI for inclusion in the ROMA COS. Methods & ProceduresResearch methods were based on recommendations from the Core Outcome Measures in Effectiveness Trials (COMET) Initiative. Participants with expertise in design and conduct of aphasia trials, measurement instrument development/testing and/or communication outcome measurement were recruited through an open call. Before the consensus meeting, participants agreed on a definition of communication, identified appropriate OMIs, extracted their measurement properties and established criteria for their quality assessment. During the consensus meeting they short-listed OMIs and participants without conflicts of interest voted on the two most highly ranked instruments. Consensus was defined a priori as agreement by >= 70% of participants. Outcomes & ResultsIn total, 40 researchers from nine countries participated in ROMA-2 (including four facilitators and three-panel members who participated in pre-meeting activities only). A total of 20 OMIs were identified and evaluated. Eight short-listed communication measures were further evaluated for their measurement properties and ranked. Participants in the consensus meeting (n = 33) who did not have conflicts of interest (n = 29) voted on the top two ranked OMIs: The Scenario Test (TST) and the Communication Activities of Daily Living-3 (CADL-3). TST received 72% (n = 21) of 'yes' votes and the CADL-3 received 28% (n = 8) of 'yes' votes. Conclusions & ImplicationsConsensus was achieved that TST was the preferred communication OMI for inclusion in the ROMA COS. It is currently available in the original Dutch version and has been adapted into English, German and Greek. Further consideration must be given to the best way to measure communication in people with mild aphasia. Development of a patient-reported measure for satisfaction with/impact of treatment and multilingual versions of all OMIs of the COS is still required. Implementation of the ROMA COS would improve research outcome measurement and the quality, relevance, transparency, replicability and efficiency of aphasia treatment research. WHAT THIS PAPER ADDSWhat is already known on this subjectInternational consensus has been reached on five core constructs to be routinely measured in aphasia treatment studies. International consensus has also been established for OMIs for the three constructs of language, quality of life and emotional well-being. Before this study, OMIs for the constructs of communication and patient-reported satisfaction/impact of treatment were not established. What this paper adds to existing knowledgeWe gained international consensus on an OMI for the construct of communication. TST is recommended for inclusion in the ROMA COS for routine use in aphasia treatment research. What are the potential or actual clinical implications of this work?The ROMA COS recommends OMIs for a minimum set of outcomes for adults with post-stroke aphasia within phases I-IV aphasia treatment research. Although not intended for clinical use, clinicians may employ the instruments of the ROMA COS, considering the quality of their measurement properties. The systematic inclusion of a measure of communication, such as TST, in clinical practice could ultimately support the implementation of research evidence and best practices