Contributions of Linguistics to the Study of Aphasias: Focus on Discursive Approaches

The chapter aims to present and discuss the contributions of Linguistics to the study of aphasias, especially regarding the power of discursive theories to subsidize language assessment and therapeutic follow-up with aphasic individuals. Jakobson, in 1956, based on Saussure’s approach and on Luria’s neuropsychological theory, was the first scholar to call for the participation of linguists in this field, once “aphasia is a problem of language”. Nonetheless, aphasia does not disturb only linguistic formal levels – phonetical-phonological, syntactic, lexical-semantic –, but also pragmatic and discursive aspects of language that are constitutive of meaning processes involved in the social use of language. Unfortunately, more traditional approaches to language assessment and to the follow-up work are exclusively based on metalinguistic tasks, which do not take into consideration the subjective and contextual aspects of language functioning. The experience we have acquired over more than thirty years within the field of Neurolinguistics has shown that qualitative longitudinal researches – mainly case studies – are a privileged locus to seek for evidences of how the linguistic levels are impacted in the several forms of aphasia. Such understanding, in turn, favor the therapeutic work towards more contextualized activities, in order to help the individuals to reorganize their linguistic-cognitive processes.

Experiences of age-related declining navigation abilities and impact on use of outdoor environments: A qualitative study of older adults with self-reported memory difficulties

Laboratory-based experiments show ageing negatively impacts navigation abilities, yet a paucity of research explores lived experience. This exploratory study examined older people with self-reported memory difficulties experiences of declining navigation abilities during sixteen semi-structured telephone interviews. Findings reveal: (i) ‘Behavioural drivers’ that underpinned the participants’ experiences and actions when engaging with their environments (ii) ‘Avoidance’ and (iii) ‘Active’ strategies that were adopted by the participants. Declining cognitive function appeared to have a negative impact on participants perceived abilities and confidence to navigate unfamiliar outdoor environments, which in turn influenced the strategies they chose to adopt. Future psychosocial interventions should draw on neuropsychological theory to ensure retention of navigation skills and confidence for as long as possible.

Right frontal anxiolytic-sensitive EEG ‘theta’ rhythm in the stop-signal task is a theory-based anxiety disorder biomarker

Psychiatric diagnoses currently rely on a patient’s presenting symptoms or signs, lacking much-needed theory-based biomarkers. Our neuropsychological theory of anxiety, recently supported by human imaging, is founded on a longstanding, reliable, rodent ‘theta’ brain rhythm model of human clinical anxiolytic drug action. We have now developed a human scalp EEG homolog—goal-conflict-specific rhythmicity (GCSR), i.e., EEG rhythmicity specific to a balanced conflict between goals (e.g., approach-avoidance). Critically, GCSR is consistently reduced by different classes of anxiolytic drug and correlates with clinically-relevant trait anxiety scores (STAI-T). Here we show elevated GCSR in student volunteers divided, after testing, on their STAI-T scores into low, medium, and high (typical of clinical anxiety) groups. We then tested anxiety disorder patients (meeting diagnostic criteria) and similar controls recruited separately from the community. The patient group had higher average GCSR than their controls—with a mixture of high and low GCSR that varied with, but cut across, conventional disorder diagnosis. Consequently, GCSR scores should provide the first theoretically-based biomarker that could help diagnose, and so redefine, a psychiatric disorder.

‘We go for a homely feel … not the clinical dementia side’: care home managers’ experiences of supporting residents with dementia to orientate and navigate care environments

Living with dementia can adversely affect people's spatial (orientation and navigation) and reality (time, date and place) orientation, which can detrimentally impact on their sense of social inclusion and wellbeing. This is an important challenge to address within United Kingdom (UK) care homes where around 70 per cent of the residents are living with dementia or severe memory problems. Care home managers have some autonomy in decision-making that impacts on the daily functioning of residents and are key in enacting the orientation and navigation agenda within a care home environment. Yet a paucity of literature explores their understanding and experiences of this issue. Contributing to this knowledge gap, our exploratory study examined managers’ current practice of supporting residents with dementia to minimise disorientation and their knowledge of dementia-friendly design principles, guidelines and audit tools. Semi-structured telephone interviews with 12 UK care home managers were conducted. Questions started generally targeting residents’ orientation and navigation abilities, followed by specific questions to draw out strategies used to support residents. Thematic analysis identified three higher-order themes: aligning strategies with needs, intuitive learning and managing within the wider business context. The findings demonstrated that managers perceive dementia to impact on a person's spatial and reality orientation. Consequently, the strategies they chose to adopt were tailored towards alleviating both challenges. However, although managers were aware of some design principles, they frequently relied on intuitive learning and past experiences to inform their choice of interventions, reporting a lack of knowledge and/or time to seek out orientation-specific training and guidance, resulting in a low uptake of guidelines and audit tools in practice. This gap between theory and practice highlights a need for accessible guidelines that integrate strategies with neuropsychological theory, and appropriate training to improve orientation and navigation in care home environments. Managers, staff, business owners, architects and designers all play a key role in implementing orientation guidelines into practice and ensuring dementia-friendly care home environments for residents.

SmartPrompt Reminder Application Improves Everyday Task Completion and Reduces Inefficient Behaviors

The SmartPrompt phone-based reminder application was designed according to neuropsychological theory and pilot testing to facilitate everyday functioning. A laboratory-based pilot of ten participants with MCI and mild dementia showed significantly greater task completion with significantly fewer checking behaviors when using the SmartPrompt versus a control condition. Younger individuals and those who engaged in more checking behaviors completed more tasks in the control condition, but these relations were not significant when using the SmartPrompt. After 15 minutes of training, caregivers achieved near perfect scores on a SmartPrompt configuration quiz. Participant and caregiver usability ratings were strong, even though participants reported relatively low computer proficiency and neutral/unfavorable attitudes towards technology. Piloting informed modifications of the SmartPrompt to enhance personalization (e.g., customized alarms/rewards) and improved human-computer-interaction for in-home testing. Preliminary in-home test data on individually-owned smartphones and conclusions regarding barriers and facilitators to the effectiveness of the modified SmartPrompt will be discussed.

Moderating Role of Stress, Anxiety, and Depression in the Relationship Between Tinnitus and Hearing Loss Among Patients

Adaptation level theory of tinnitus and neuropsychological theory of tinnitus are extensively used frameworks for understanding emotional and psychological distress among tinnitus sufferers. Objective of the present study was to investigate potential associations between hearing loss, tinnitus, anxiety, depression, and stress. The Tinnitus Handicap Inventory (Newman, Jacobson, & Spitzer, 1996) and the Depression, Anxiety, Stress Scale (Lovibond & Lovibond, 1995)scales were administered to a sample of 110 tinnitus outpatients recruited from Audiology departments of Lahore and Rawalpindi hospitals. Results revealed tinnitus was positively linked with psychological problems. Additionally, it was established that tinnitus is a positive significant predictor for anxiety, stress and depression. The moderation models related to the interactions between psychological problems and hearing loss were negative significant predictors for tinnitus symptoms. Moreover, the comparative analysis between gender differences revealed a significant diversity in the levels of stress, anxiety, and depression. Results also elucidated that patients at initial stages of hearing loss were more prone towards reporting tinnitus symptoms along with emerging psychological problems.

Testing the interhemispheric deficit theory of dyslexia using the visual half-field technique

A deficit in interhemispheric transfer has been proposed as a neuropsychological theory of dyslexia. Interactions between the hemispheres during word recognition can be studied using the visual half-field paradigm. The well-established recognition advantage for right visual field (RVF) words over left visual field (LVF) words is thought to reflect the additional processing costs associated with callosal transfer of LVF word representations to the language-specialised left hemisphere. In addition, a further gain in recognition for bilateral presentation of a word has been attributed to cooperative interactions between the hemispheres. These recognition advantages can therefore be seen as behavioural indices of the efficiency of callosal transfer. This study aimed to replicate the finding of an absence of the bilateral advantage in developmental dyslexia, previously reported by Henderson et al. In all, 47 dyslexic and 43 control adult participants were tested, and no significant difference was found in the size of the bilateral advantage between the two groups. Our data did however replicate the previous finding of an increased RVF-LVF difference in dyslexic participants caused by poorer accuracy for LVF words (i.e., a greater LVF cost). This evidence is compatible with the interhemispheric deficit theory of dyslexia, suggesting an impairment in the transfer of visual word information from the right to the left hemisphere during reading.