Sainson C
Service de rééducation neurologique, centre hospitalier Lacaine, 14260 Aunay-sur-Odon, France.
Ann Readapt Med Phys. 2007 May;50(4):231-9. doi: 10.1016/j.annrmp.2007.01.010. Epub 2007 Feb 9.
Following post-traumatic impairment in executive function, failure to adjust to communication situations often creates major obstacles to social and professional reintegration. The analysis of pathological verbal communication has been based on clinical scales since the 1980s, but that of nonverbal elements has been neglected, although their importance should be acknowledged.
The aim of this research was to study non-verbal aspects of communication in a case of executive-function impairment after traumatic brain injury.
During the patient's conversation with an interlocutor, all nonverbal parameters - coverbal gestures, gaze, posture, proxemics and facial expressions - were studied in as much an ecological way as possible, to closely approximate natural conversation conditions. Such an approach highlights the difficulties such patients experience in communicating, difficulties of a pragmatic kind, that have so far been overlooked by traditional investigations, which mainly take into account the formal linguistic aspects of language.
The analysis of the patient's conversation revealed non-verbal dysfunctions, not only on a pragmatic and interactional level but also in terms of enunciation. Moreover, interactional adjustment phenomena were noted in the interlocutor's behaviour.
The two inseparable aspects of communication - verbal and nonverbal - should be equally assessed in patients with communication difficulties; highlighting distortions in each area might bring about an improvement in the rehabilitation of such people.
创伤后执行功能受损后,无法适应交流情境常常给社交和职业重新融入造成重大障碍。自20世纪80年代以来,病理性言语交流分析一直基于临床量表,但非言语元素的分析却被忽视了,尽管其重要性应该得到承认。
本研究旨在探讨创伤性脑损伤后执行功能受损病例中交流的非言语方面。
在患者与对话者交谈过程中,尽可能以自然的方式研究所有非言语参数——伴随言语的手势、目光、姿势、空间关系和面部表情,以尽可能接近自然对话条件。这种方法突出了此类患者在交流中遇到的困难,即语用方面的困难,而传统研究主要考虑语言的形式语言学方面,至今一直忽视了这些困难。
对患者对话的分析揭示了非言语功能障碍,不仅在语用和互动层面,而且在发音方面。此外,在对话者的行为中还观察到了互动调整现象。
对于有交流困难的患者,应该同等评估交流中言语和非言语这两个不可分割的方面;突出每个领域的偏差可能会改善此类患者的康复情况。