Affective prosody disorders in adults with neurological conditions: A scoping review

BACKGROUND

Individuals with affective-prosodic deficits have difficulty understanding or expressing emotions and attitudes through prosody. Affective prosody disorders can occur in multiple neurological conditions, but the limited knowledge about the clinical groups prone to deficits complicates their identification in clinical settings. Additionally, the nature of the disturbance underlying affective prosody disorder observed in different neurological conditions remains poorly understood.

AIMS

To bridge these knowledge gaps and provide relevant information to speech-language pathologists for the management of affective prosody disorders, this study provides an overview of research findings on affective-prosodic deficits in adults with neurological conditions by answering two questions: (1) Which clinical groups present with acquired affective prosodic impairments following brain damage? (2) Which aspects of affective prosody comprehension and production are negatively affected in these neurological conditions?

METHODS & PROCEDURES

We conducted a scoping review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. A literature search was undertaken in five electronic databases (MEDLINE, PsycINFO, EMBASE, CINAHL and Linguistics, and Language Behavior Abstracts) to identify primary studies reporting affective prosody disorders in adults with neurological impairments. We extracted data on clinical groups and characterised their deficits based on the assessment task used.

OUTCOMES & RESULTS

The review of 98 studies identified affective-prosodic deficits in 17 neurological conditions. The task paradigms typically used in affective prosody research (discrimination, recognition, cross-modal integration, production on request, imitation and spontaneous production) do not target the processes underlying affective prosody comprehension and production. Therefore, based on the current state of knowledge, it is not possible to establish the level of processing at which impairment occurs in clinical groups. Nevertheless, deficits in the comprehension of affective prosody are observed in 14 clinical groups (mainly recognition deficits) and deficits in the production of affective prosody (either on request or spontaneously) in 10 clinical groups. Neurological conditions and types of deficits that have not been investigated in many studies are highlighted.

CONCLUSIONS & IMPLICATIONS

The aim of this scoping review was to provide an overview on acquired affective prosody disorders and to identify gaps in knowledge that warrant further investigation. Deficits in the comprehension or production of affective prosody are common to numerous clinical groups with various neurological conditions. However, the underlying cause of affective prosody disorders across them is still unknown. Future studies should implement standardised assessment methods with specific tasks based on a cognitive model to identify the underlying deficits of affective prosody disorders.

WHAT THIS PAPER ADDS

What is already known on the subject What is already known on the subjectAffective prosody is used to share emotions and attitudes through speech and plays a fundamental role in communication and social interactions. Affective prosody disorders can occur in various neurological conditions, but the limited knowledge about the clinical groups prone to affective-prosodic deficits and about the characteristics of different phenotypes of affective prosody disorders complicates their identification in clinical settings. Distinct abilities underlying the comprehension and production of affective prosody can be selectively impaired by brain damage, but the nature of the disturbance underlying affective prosody disorders in different neurological conditions remains unclear. What this study adds Affective-prosodic deficits are reported in 17 neurological conditions, despite being recognised as a core feature of the clinical profile in only a few of them. The assessment tasks typically used in affective prosody research do not provide accurate information about the specific neurocognitive processes impaired in the comprehension or production of affective prosody. Future studies should implement assessment methods based on a cognitive approach to identify underlying deficits. The assessment of cognitive/executive dysfunctions, motor speech impairment and aphasia might be important for distinguishing primary affective prosodic dysfunctions from those secondarily impacting affective prosody. What are the potential clinical implications of this study? Raising awareness about the possible presence of affective-prosodic disorders in numerous clinical groups will facilitate their recognition by speech-language pathologists and, consequently, their management in clinical settings. A comprehensive assessment covering multiple affective-prosodic skills could highlight specific aspects of affective prosody that warrant clinical intervention.

The impacts of aging on the comprehension of affective prosody: A systematic review

Recent clinical reports have suggested a possible decline in the ability to understand emotions in speech (affective prosody comprehension) with aging. The present study aims to further examine the differences in performance between older and younger adults in terms of affective prosody comprehension. Following a recent cognitive model dividing affective prosody comprehension into perceptual and lexico-semantic components, a cognitive approach targeting these components was adopted. The influence of emotions' valence and category on aging performance was also investigated. A systematic review of the literature was carried out using six databases. Twenty-one articles, presenting 25 experiments, were included. All experiments analyzed affective prosody comprehension performance of older versus younger adults. The results confirmed that older adults' performance in identifying emotions in speech was reduced compared to younger adults. The results also brought out the fact that affective prosody comprehension abilities could be modulated by the emotion category but not by the emotional valence. Various theories account for this difference in performance, namely auditory perception, brain aging, and socioemotional selectivity theory suggesting that older people tend to neglect negative emotions. However, the explanation of the underlying deficits of the affective prosody decline is still limited.

BEPS: Development, validation, and normative data of a sentence production test in French

Assessing one's sentence production ability can help to identify difficulties experienced by individuals with aphasia and enables targeted intervention. Speech-language pathologists working with the francophone population must contend with the current lack of a sentence production evaluation tool. The aim of this article is to present the development, validation, and normative data of a French-language test used to evaluate the production of sentences: the BEPS (Batterie d'Évaluation de la Production Syntaxique). The BEPS includes four tasks based on Bock and Levelt's model of sentence production, namely (1) Verb Naming Task, (2) Verb Inflection Task, (3) Constituent Assembly Task, and (4) Thematic Role Assignment Task. For each task, various psycholinguistic parameters were controlled or manipulated. The BEPS had good content and construct validity, excellent test-retest reliability and good internal consistency. This battery fulfills the current needs for clinical tool in the francophone population when assessing sentence production capacities. Normative data are presented for individuals 19-79 years of age (n = 191). Raw scores were converted to percentiles for each task. The BEPS represents significant assistance to help clinicians identify the origins of the syntactic production deficits of patients with poststroke and degenerative diseases.

Users' involvement in mental health services: programme logic model of an innovative initiative in integrated care

BACKGROUND

Collaboration and partnership are key issues for modern health systems seeking to implement quality integrated care that meets the needs of the population. The Carrefour Communautaire-Institutionnel-Usagers (Connecting Community organisations-Institutions-Users, CCIU), involving community- and institution-based mental health workers, carers and users, is an innovative normative integrated care group (group for shared values, culture and vision) established by the Canadian Mental Health Association-Montreal Branch. A programme evaluation approach was used to conduct a logic analysis of the CCIU in order to understand the relationships between its resources, activities and outcomes, build a common understanding and, allow for its replication.

METHODS

Five steps were involved in the creation of a programme logic model. A non-exhaustive literature search for similar initiatives, a review of documents related to the CCIU process and direct observations led to the development of a first model. Then, following a participatory and reflexive process, this model was validated with CCIU participants.

RESULTS

A comprehensive model and a simplified model were created. Participants' experiential knowledge and scientific knowledge helped to identify the essential components of the successful operation of the CCIU.

CONCLUSIONS

The CCIU, with its eight essential components, including relations based on equality and mutual respect, corresponds to an essential step in normative integration and integrated care that lead to improved quality services.