Predictors of longitudinal outcome and recovery of pragmatic language and its relation to externalizing behaviour after pediatric traumatic brain injury

Altered resting‐state functional connectivity within the developing social brain after pediatric traumatic brain injury

“…The following ROIs were selected: Bilateral left posterior STS, fusiform gyrus, temporal pole, inferior frontal gyrus, TPJ, amygdala, as well as the dorsomedial PFC (dmPFC), the ventromedial PFC (vmPFC), the rostral ACC and the medial frontal pole. These brain regions have consistently been related to morphological abnormalities and to social difficulties following TBI (Ryan, Catroppa, Beare, et al, , ; Ryan et al, ; Ryan, Catroppa, Cooper, Beare, Ditchfield, Coleman, Silk, Crossley, Rogers, et al, ; Ryan, Catroppa, Godfrey, et al, ; Ryan et al, ; see Table for details on ROIs and MNI coordinates).…”

Introducing the model of cognitive-communication competence: A model to guide evidence-based communication interventions after brain injury

“…International standards for cognitive-communication intervention recommend that rehabilitation of individuals with cognitive-communication disorders be grounded in analysis of an individual's unique characteristics, needs, life contexts, goals, and skills (24). Pre-injury factors that have been found to influence communication outcome include age and stage of neurological and cognitive development (114)(115)(116)(117); education, learning skills, learning disability (118), sex (118-120); mental health concerns, previous brain injury, or substance abuse (118,(121)(122)(123)(124).…”

“…Reported auditory comprehension deficits after ABI include difficulties with accurate or efficient processing of complex vocabulary (14), sarcasm and irony (189), implied information or inference (94,190), hints (155); non-literal or figurative language (metaphor, proverbs, idioms) (14,94,168,191), indirect requests (158), ambiguous sentences (167), and complex semantic or syntactic relationships (14,51,54,78,145,192). Cognitive factors have been shown to play a key role in comprehension deficits including impairments in working memory, attention, speed of processing, organization, reasoning, social cognition or theory of mind, and executive functioning and self-regulation (77,94,114,167,169,190,191,193). A variety of task demands can affect comprehension including syntactic complexity, predictability of stimulus material, amount of contextual support, and the speaking rate of the conversation partner (158,190,193).…”

“…Social communication success is determined by the goals, conventions, boundaries, or expectations of that particular context and can be enhanced or inhibited by the skills of the communication partner (72,133). Social communication impairments after ABI include difficulties with such skills as conversational initiation, fluency (speed, efficiency, revisions, mazes, false starts, repetitions), topic management (maintenance, turn taking, shift), listener-oriented behaviours or perspective taking, self-regulation (of topics, comments, tone, interjections), and adaptation to changing circumstances or distractions in the environment (visual, auditory, interruptions) (29,50,72,114,(215)(216)(217). These deficits can arise as a result of cognitive, communication, emotional, and physical factors including deficient attention, organization, working memory, or executive functions (114,143,159).…”

Social dysfunction after pediatric traumatic brain injury: A translational perspective

“…As depicted in Figure 5, microhemorrhagic lesions were most commonly identified in frontal temporo-limbic regions commonly associated with the SBN, and more diffuse SWI lesions within this network were prospectively associated with poorer cognitive ToM and pragmatic language skills at 6- and 24- months post-injury (Ryan et al, 2015a; Ryan et al, 2015c). In a subsequent sub-study that examined the relation between SWI lesions and higher level aspects of ToM, findings showed that the effect of SWI lesions on ToM may interact with the child’s developmental stage, such that more diffuse acute micro-bleeds may contribute to the time-dependent emergence of social cognitive dysfunction particularly during adolescence (Ryan et al, 2015b).…”