Document Type

Article

Publication Date

11-30-2022

Abstract

Background

Right hemisphere communication disorders are neither consistently labelled nor adequately defined. Labels associated with right hemisphere brain damage (RHD) are broad and fail to capture the essence of communication challenges needed for stroke-related service provisions. Determination of rehabilitation needs and best-practice guidelines for the education, management and functional improvement of communication disorders after RHD are all predicated on an apt diagnostic label and disorder characteristics.

Aims

In this paper apragmatism is proposed as a potential communication-specific diagnostic label for the impairments in communication that occur after RHD. In particular, the researchers aimed: (1) to establish an operational definition of apragmatism; and (2) to describe the linguistic, paralinguistic and extralinguistic communication deficits under the umbrella term apragmatism.

Methods & Procedures

An international collaborative of researchers with expertise in RHD followed a multilevel approach to consider the utility of apragmatism as a diagnostic label. Adopting the relational approach to concept mapping, the researchers engaged in a series of group meetings to complete four levels of mapping: (1) identify and review, (2) define, (3) expert discussion and (4) label determination.

Main Contribution

Apragmatism was established as a suitable diagnostic label for the impairments in communication associated with RHD. The paper offers an operational definition and description of the linguistic, paralinguistic and extralinguistic features of apragmatism through evidence summaries and examples from people with RHD retrieved from the RHDBank.

Conclusions & Implications

The adoption of the term apragmatism offers an opportunity to capture the hallmark of RHD communication deficits. The use of the term is recommended when referencing the pragmatic language impairments in this population. Apragmatism, which may co-occur with or be exacerbated by cognitive impairments, can interfere with the ability to interpret and convey intended meaning and impact the lives of right hemisphere stroke survivors and their families.

Comments

This is the accepted version of the following article:

Minga J, Sheppard SM, Johnson M, Hewetson R, Cornwell P, Blake ML. Apragmatism: The renewal of a label for communication disorders associated with right hemisphere brain damage. Int J Lang Commun Disord. 2023;58(2):651-666. https://doi.org/10.1111/1460-6984.12807

which has been published in final form at https://doi.org/10.1111/1460-6984.12807. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.

Peer Reviewed

1

Copyright

Royal College of Speech and Language Therapists

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