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  • Publication
    Accès libre
    Le test de compréhension de l’IRonie et des Requêtes Indirectes – version courte (IRRI-C) : développement, validité de contenu et données normatives préliminaires.
    (2024) ;
    Maud Champagne-Lavau
    ;
    Background: Following a traumatic brain injury or right hemisphere damage, many patients have difficulty understanding non-literal language. However, tools for assessing this disorder are sorely lacking in French. The existing tests (in particular the IRonie and Indirect Request comprehension test - IRRI) also have certain limitations, including the time-consuming administration. Objectives: The present study aims to present (1) the construction, (2) the content validity, and (3) the preliminary normative data of the short version of the Irony and Indirect Requests comprehension test (IRRI-C). Methods: (1) To select the twelve items of each IRRI-C task, difficulty and discrimination indices, item-total score correlations, and differences in correct responses between patients and control participants were calculated from the responses of 33 brain-damaged participants and 102 control subjects to the long version (36 items) of the IRRI test. (2) The tool was then given to seven speech and language therapists and neuropsychologists, who used a questionnaire to assess the clarity and relevance of the IRRI-C in assessing the target construct. (3) Finally, the IRRI-C was administered to 121 control subjects aged between 20 and 65 years to provide preliminary normative data. Results: (1) The twelve stimuli with the best difficulty and discrimination indices, item-total score correlations, and the greatest differences between patients and control participants were selected for each task. A PowerPoint presentation, a scoring sheet, and an introduction and scoring booklet were produced and made available to clinicians on the Internet. (2) Questionnaires on construct validity showed that the IRRI-C was highly relevant for assessing the target construct and that the introductory booklet, instructions, and scoring guide were very clear. (3) Norms stratified according to the variables of interest manipulated in the tasks (context, executive demand, and presence of markers) were calculated as percentiles. Conclusion: The IRRI-C fills an important gap in French-language pragmatics assessment tools. Its shorter format and stratification of norms make it a tool better adapted to clinical reality and conducive to the development of diagnostic hypotheses and therapeutic goals. Future improvements, including validation in different populations and a finer-grained analysis of production during scoring, will further enhance its clinical relevance.
  • Publication
    Accès libre
    Improved comprehension of irony and indirect requests following a severe traumatic brain injury: two case studies
    (2023-11-16) ;
    Maud Champagne-Lavau
    ;
    Background: Following a traumatic brain injury (TBI), people frequently have difficulty understanding nonliteral language, including irony and indirect requests. Despite the handicap that these disorders can represent in daily life, they are rarely treated clinically, and remediation studies are scarce. Aims: The present study thus aimed to evaluate the effectiveness of an explicit metapragmatic therapy targeting nonliteral language comprehension and taking into account cognitive processes likely to underlie this comprehension (i.e., contextual processing, theory of mind, and executive functions). Methods & Procedure: This study was registered on the ClinicalTrials.gov system (ID: NCT04708561) before participant recruitment. Two adults with severe TBI took part in the study. An ABA design with multiple baselines was used to assess the evolution of treated and non-treated written literal and nonliteral story comprehension, as well as ecological tasks and tasks assessing the cognitive processes of interest (theory of mind and executive functions). An interview was also conducted at the end of treatment to assess participant satisfaction. Outcomes & results: Therapy resulted in significant improvement in treated items, with one-month maintenance of gains and generalisation to untreated items in both participants. The generalisation to a working memory task was also observed in one participant. Finally, participant satisfaction with the treatment was high. Conclusions & implications: Our study demonstrated for the first time the potential of a therapy targeting irony and indirect request comprehension in TBI individuals. Clinically, it offers concrete therapeutic avenues and fills a critical gap in the TBI population’s evidence for the remediation of nonliteral language comprehension.