Discourse/RH Damage Flashcards
Why should we investigate discourse?
- affects Social participation
- Personal narrative contribute to self-awareness
- psychosocial adjustment
What does discourse involve?
- establishing coherent relationships between sentences
- imagining situations
- adopting different points of view
- attributing mental states to protagonists
- inferences and gist
What are the types of narrative
- narrative (story)
- procedural (how to make a PB&J)
- conversational (2 people)
- expository (lecture)
One suggestion for discourse structure is
story grammar
What does it mean for a story to be coherent?
it is chronological, logical and causal
What is local coherence?
coherence within a sentence, linking between clauses
What is global coherence?
coherence across discourse- a unified message overall
What cognitive skills are involved in discourse?
language
memory (semantic & episodic)
attention
goal-directed planning
What is the micro level of discourse
- sequence of propositions (information)
- includes lexical-syntactic difficulty, informativeness and cohesion
- corresponds to local coherence
What is the macro level of discourse
- schema/plan of story
- includes coherent, relevance and gist
- corresponds to global coherence
What are the 3 key elements of discourse production
- personnel - 2+ participants
- accumulation of common ground (personal and communal)
- Contributions
What are some ways we can assess discourse impairment
- personal narratives
- picture description
- story telling
- procedural language
- persuasive language
What are some task variables to consider when assessing discourse impairment?
- memory demands
- sequencing/organizational skills
- modality (written/verbal)
- stimulus complexity
- linguistic specificity and complexity
What are ways to assess the micro-structure of discourse?
- length of utterance
- syntactic complexity
- semantic accuracy
- pauses/restarting
- sentence fragments
What are ways to assess the macro-structure of discourse?
- Information content: quantity, quality, efficiency, relevance, manner
- Cookie theft picture: literal information and inferences
What do we look at when looking at supra-structural/conversational analysis of discourse?
- turn taking
- topic manipulation/maintenance
- speech acts
- paralinguistic and non verbal
- repair
Which side of the brain is responsible for understanding metaphors, sarcasm and humour?
right hemisphere
T or F: the left and right hemispheres are functionally different but physically the same
False! they are different both physically and functionally
How are the RH and LH physically different?
- Frontal lobe bigger on RH
- Occipital lobe bigger on LH
- Sylvian fissure longer on RH
- Neuronal and neurochemical differences
How are the RH and LH functionally different
LH: piecemeal (time)
RH: holistic (spatial)
The _______ hemisphere is responsible for fine semantic coding, while the _______ hemisphere is responsible for coarse semantic coding
left
right
RH damage leads to _________ comprehension of implied information, and _________ in comprehension of explicit information
poorer
no difference
Describe the suppression deficits hypothesis
-when the RH activates many meanings of a word, understanding is hampered by ineffective suppression of incorrect meanings
Describe the cognitive resources hypothesis
-demands on attentional resources
Describe the social cognition deficit hypothesis
RH damage can reduce the ability to engage in social relations and understand social information which influence language performance
-reduced complex inferencing in general
Describe right hemisphere damage (RHD) effects on cognition
- anosognosia
- attention
- visuoperceptual/visuospatial processing (neglect)
- memory
- executive functioning
Describe the RHD damage effects on discourse production (macrostructures and microstructures)
- issues generating macrostructures (gist, topic, moral)
- microstructures: words, clauses or turns in conversation
- diminished informational content
- paucity
- production based on scripts with tangential associations
- difficulty telling an integrated, coherent story
- impaired organization on story recall
- inaccurate incomplete main concepts etc.
Describe RHD effects on discourse comprehension
problems abstracting overall meanings, themes or gist
Describe RHD effects on pragmatics
- emotional non-verbal communication
- speech acts
- figurative and implied meaning
- sensitivity to listener needs
- humour
Describe RHD effects on prosody
- aprosodia
- hypermelodic tone
- monotonous voice
Describe RHD effects on reading and writing
- process visual info
- scanning line of print, tracking back to margin to find next line, or scan a page for info
- neglect dyslexia
What information do you need for an initial Ax of RHD?
- identify impairments
- consider patient’s cognitive-communicative activity limitation and participation restrictions
What should you assess in your informal assessment of RHD?
- discourse production
- discourse comprehension
Why do we need to exercise caution when using formal assessment to look at RHD?
a lot of standardized tests were only validated for LH damage
What are some formal tests we can use for RHD?
- Burden of Stroke Scale (BOSS)
- Discourse Comprehension Test (DCT)
- Assessment of language-related functional activities (ALFA)
- Rey complex figure test and recognition trial
