ABSTRACT

Cognitive ability may be masked by communication impairments. This study aimed to assess cognitive functioning using binary choice (i.e., yes/no) neuropsychological tests in patients with communication impairments. Four participants underwent neuropsychological testing. Two participants were in the minimally conscious state (MCS), one participant had locked-in syndrome and was an alternative communication user, and one participant was an augmentative communication user. There was better performance in all cognitive domains for the augmentative and alternative communication (AAC) users (who performed like the non-communication impaired normative data) compared to the MCS participants. However, using established yes/no communication methods, MCS participants performed above chance on a measure of memory and performance on measures of auditory comprehension was variable. Auditory comprehension appeared to be more influenced by working memory demands for the MCS participants than for the AAC users. For emotional functioning, the AAC users endorsed lower mood compared to the MCS participants. The results support the need to assess cognition, communication, as well as capacity in individuals with communication impairments with the consultation of a neuropsychologist and a speech-language pathologist.

摘要

认知能力可能会被沟通障碍所掩盖。本研究旨在使用二元选择（即是/否）神经心理学测试评估有沟通障碍的患者的认知功能。四名参与者接受了神经心理学测试。两名参与者处于最低意识状态（MCS），一名参与者患有锁定综合征并且是替代通信用户，一名参与者是增强通信用户。与 MCS 参与者相比，增强和替代通信 (AAC) 用户（其表现类似于非通信受损规范数据）在所有认知领域都有更好的表现。但是，使用既定的是/否通信方法，MCS 参与者在记忆测量和听觉理解测量上的表现是可变的。与 AAC 用户相比，MCS 参与者的工作记忆需求似乎对听觉理解的影响更大。对于情绪功能，与 MCS 参与者相比，AAC 用户认为情绪较低。结果支持在咨询神经心理学家和语言病理学家的情况下评估有沟通障碍的个体的认知、沟通和能力的必要性。