Language Processing in Context Following Traumatic Brain Injury

创伤性脑损伤后的语言处理

• 批准号: 10307590
• 负责人: Sarah Brown-Schmidt
• 金额: $ 66.51万
• 依托单位: VANDERBILT UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-12-11 至 2024-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10307590
• 关键词: Adult; Affect; Aphasia; Automobile Driving; Basic Science; Brain; Characteristics; Chronic; Clinic; Clinical; Clinical Research; Clinical Trials; Cognition; Cognitive; Communication; Communication impairment; Comprehension; Cues; Failure; Foundations; Future; Goals; Heart; Impairment; Individual; Intervention; Investigation; Knowledge; Language; Lead; Life; Linguistics; Link; Measures; Memory; Methods; Nature; Neuropsychology; Outcome; Participant; Patients; Performance; Physical environment; Production; Published Comment; Questionnaires; Recording of previous events; Rehabilitation therapy; Research; Secondary to; Social Environment; Stretching; Structure; Survivors; Traumatic Brain Injury; Work; behavior measurement; clinical care; clinical prognosis; community reintegration; flexibility; improved; language processing; novel; novel strategies; phrases; poor communities; programs; social; social communication; social group; theories; visual tracking

ABSTRACT Adults with traumatic brain injury (TBI) have chronic deficits in cognitive-communication and these impairments have been linked to negative outcomes and poor community reintegration and independence. A significant challenge in the field is that commonly used methods to detect these deficits in clinical and research settings lack the required sensitivity and have focused on a limited subset of discourse tasks that do not reliably predict communication outcomes. At the heart of our proposal is the idea that current theories of cognitive- communication are too narrow and the methods used to detect deficits are too limiting. In contrast to current conceptualizations which state that cognitive-communication deficits affect discourse and conversation (leaving basic sentence level processing intact), we propose that cognitive-communication impairment is a deficit in the flexible use and processing of language that manifests across the varied and dynamic contexts of everyday language use, whether processing a single sentence or participating in a multiparty conversation. For example, individuals with TBI make inappropriate or irrelevant comments, suggesting a failure to consider the communicative setting and the perspective of their conversational partners, as well as insensitivity to contextual cues (environmental, partner) that guide language use. These are problems using and processing language in context. From this perspective, there is a striking disconnect in the field between clinical observations of impairments in using language in context and the widespread use of decontextualized tasks and measures to capture these deficits in the lab and clinic (e.g., monologue discourse task). Using ecologically valid language tasks and methods sensitive enough to detect even subtle, though meaningful, disruptions in language, the proposed work endeavors to show that deficits in contextual language processing in TBI extend even to the rapid processing of individual phrases and sentences in the moment (i.e., online processing), can be captured in controlled settings, and that such deficits predict communicative outcome. The proposed program of research represents a novel direction in the study of TBI with substantial basic science and clinical translational significance. The proposal is organized around three AIMS: (1) To investigate language processing in context in TBI; (2) To investigate language use in group settings in TBI; (3) To determine the relationship between language processing in context and communicative outcome. This proposal is unique in the field and uniquely promising for understanding the nature of deficits in contextual language processing following TBI and, ultimately, improving rehabilitation intervention outcomes.

抽象的 患有创伤性脑损伤 (TBI) 的成年人存在认知沟通方面的慢性缺陷以及这些障碍 与负面结果以及贫困社区重新融入和独立有关。一个重要的 该领域的挑战是在临床和研究环境中检测这些缺陷的常用方法 缺乏所需的敏感性，并且专注于不能可靠预测的有限的话语任务子集 沟通成果。我们建议的核心是当前的认知理论 沟通太狭窄，用于检测缺陷的方法也太有限。与当前相比 概念化指出认知沟通缺陷会影响话语和对话（留下 基本句子级处理完好无损），我们认为认知沟通障碍是 灵活使用和处理日常各种动态环境中体现的语言 语言使用，无论是处理单个句子还是参与多方对话。例如， 患有 TBI 的人发表不恰当或不相关的评论，表明他们没有考虑到 沟通环境和对话伙伴的观点，以及不敏感 指导语言使用的上下文线索（环境、伙伴）。这些是使用和使用时遇到的问题 在上下文中处理语言。从这个角度来看，两者之间的领域存在着显着的脱节。 上下文使用语言障碍的临床观察以及去上下文化语言的广泛使用 在实验室和临床中捕捉这些缺陷的任务和措施（例如，独白话语任务）。使用 生态有效的语言任务和方法足够敏感，可以检测到即使是微妙的，但有意义的， 语言中断，拟议的工作努力表明上下文语言处理的缺陷 TBI 中的处理甚至可以扩展到当前单个短语和句子的快速处理（即在线 处理），可以在受控环境中捕获，并且这种缺陷可以预测沟通结果。这 拟议的研究计划代表了具有大量基础科学的 TBI 研究的新方向 和临床转化意义。该提案围绕三个目标组织：(1) 调查 TBI 上下文中的语言处理； (2) 调查 TBI 群体环境中的语言使用情况； (3) 至 确定上下文中的语言处理和交际结果之间的关系。这 该提案在该领域是独一无二的，并且对于理解上下文中的赤字性质具有独特的前景 TBI 后的语言处理，并最终改善康复干预结果。