1. Insights into Verbal Planning Total score of core propositions
Executive Dysfunction and Text Processing Measurement –
Insights into Verbal Planning
Julia Büttner
Schön Klinik Bad Aibling, Hospital for Neurology and Rehabilitation
Ludwig Maximilian University of Munich, Ph.D program "LIPP" - Language Theory and Applied Linguistics University
Background
Individuals with traumatic brain injury or with lesions to the (pre)frontal areas do not only exhibit inappropriate discourse behaviour, but also a frequent lack of coherence in the processing of texts. In current research those problems are linked to dysfunction in executive abilities (Lê et al. 2012). A diagnostic measurement for impairments in text processing for this population is still in the offing. The purpose of this study was a) to develop a diagnostic measurement which reveals deficits in the processing of narrative texts, and b) to examine the interaction of executive functions and linguistic abilities on the text level.
Methods
A diagnostic set was developed which focuses on the processing of core propositions and inferences in the comprehension and production of narrative texts (picture stories). The transcripts of the oral narratives were broken into propositions and analysed for story grammar. The performance of the patient group was set in relation to cognitive abilities of the executive system.
Design & Participants
Prospective cohort study
Individuals: mean age: 49 years (range 32-65); patients with dysexecutive symptoms (n=21) + healthy control group (n=20)
Lesions: (pre)frontal both hemispheres, right hemisphere (A. cerebri media) due to vascular diseases + traumatic brain injuries
Exclusion Criteria: Aphasia (Token Test), progredient diseases, severe mnestic and attentional disorders
Measures of Executive Functions: Planning (Tower of London), Working Memory (digit span backward), fluency
(Regensburger fluency test)
Example of a picture story for the oral narratives
© T. Dauenhauer/J.Büttner
Results I – Differences on the text level
Total score of core propositions
The patient group demonstrated a significantly poorer performance on the text level
Text reception: less correct answers (multiple-choice)
Text production: fewer core propositions and inferences,
but no difference in the total number of generated propositions
(4-picture story, t(37) = 0,70, p < 0,48; 8-picture story, t(37) = 0,42, p < 0,67)
 Qualitative but no quantitative differences!
Score in the comprehension task
Control Group Patients
Control Group Patients
Results II – Impact of executive functions
Fluency group 1 group 2
Working Memory group 1 group 2
.372 Tower of London
.431* digit span backward
.491* fluency test
Text comprehension
Interaction effects
.611** Tower of London
.275 digit span backward
.688** fluency test
Text
production
group group 2
Fluency
group group 2
Working Memory
Discussion
The results support the assumption that the parameters core propositions and inferences are sensitive parameters for detecting deficits on the text level. Furthermore, there is strong evidence of a divergent impact of cognitive dysfunction on the reception and production of narrative tests. It can be hypothesized that the difficulties observed in the participants with dysexecutive symptoms may reflect a specific deficit in verbal planning at the interface between linguistic and cognitive processing.
References
Ardila, A The Executive Functions in Language and Communication. In Cognition and Acquired Language Disorders. An Information Processing Approach, R.K. Peach & L.P. Shapiro (eds): St. Louis: Elsevier Mosby.
Boelen D.H., Allain P., Spikman, J.M. & Fasotti, L Script Generation and the Dysexecutive Syndrome in Patients with Brain Injury. Brain Injury 25 (11):
Büttner, J Sprachliche Makrostrukturen und dysexekutive Symptome. Entwicklung eines Diagnostikverfahrens und Evaluierung eines Therapieprogramms bei Störungen der Textverarbeitung. (=Text and dysexecutive symptoms. Assessement and treatment of text processing disorders. Univ. München: Dissertation (= PhD Thesis).
Ferstl, E.C., Walther, K., Guthke, T., & Cramon, D.Y. von Assessment of Story Comprehension Deficits After Brain Damage. Journal of Clinical and Experimental Neuropsychology 27(4):
Graesser, A.C, Singer, M., & Trabasso, T Constructing inferences during narrative text comprehension. Psychological Review, 101(3):
Lê, K., Coelho, C., Mozeiko, J., Krueger, F. & Grafman, J Predicting Story Goodness Performance from Cognitive Measures following Traumatic Brain Injury. American Journal of Speech & Language Patholology 21 (Suppl.):