title: The development of pragmatic skills in children after hemispherotomy: Contribution from left and right hemispheres.
abstract: OBJECTIVE
  Hemispherotomy (H) is the standard treatment used to cure hemispheric epileptic syndromes in childhood. The postoperative linguistic profile involves hemispheric specialization processes and developmental cognitive plasticity. This research concerns pragmatic aspects of language as a tool for communication which involves both linguistic and extralinguistic communication in context. Our aim was to analyze whether any correlation exists with age at surgery and side of surgery on pragmatic skills following H.
  
  
  METHODS
  Forty children who underwent H (23 females, 16 right H) were evaluated at a mean age of 12.8 years (±2.6) with two receptive tasks (oral comprehension and syntactic judgment), the Children's Communication Checklist (CCC) rating scale, and the Behavioral Rating Inventory of Executive Function (BRIEF) questionnaire in order to evaluate the role of executive functions on pragmatic skills. Children operated on before the age of 18 months were considered the "early" group (5 right H and 9 left H), while those operated on later were called the "late" group (11 right H and 15 left H).
  
  
  RESULTS
  The whole group had significant deficits in all three measures. We demonstrated a statistically significant crossed interaction between the side of H and the age at H with pragmatic language impairments (F(1,36)=17.48; p=.0002) and disorders in executive function (F(1,36)=5.80; p=.021) in left early H and in right late H patients. These findings are consistent with the previous studies of pragmatic language impairments concerning adolescents and adults with right hemisphere damage and emphasize the contribution of structural language in the early stage of verbal communication.
  
  
  CONCLUSIONS
  These results emphasize for the first time that hemispherotomized children have pragmatic language impairments that are independent of receptive language. Our findings are congruent with the recent theory on pragmatic language development in childhood with evidence of a participation of the left hemisphere at the early age followed by right hemispheric specialization and involvement of executive functions, independently of receptive language.
authors.affiliation: INSERM U1129 "Infantile Epilepsies and Brain Plasticity", Paris, France; Université Paris Descartes, Sorbonne Paris Cité, France; CEA, Gif sur Yvette, France; Rothschild Foundation Hospital, Pediatric Neurosurgery Department, Paris, France.
authors.forename: Jessica
authors.initials: J
authors.lastname: Save-Pédebos
authors.affiliation: CHArt-P10 (EA4004) (Human and Artificial Cognition), Department of Psychology, University Paris Ouest Nanterre La Défense, France.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Pinabiaux
authors.affiliation: Rothschild Foundation Hospital, Pediatric Neurosurgery Department, Paris, France.
authors.forename: Georg
authors.initials: G
authors.lastname: Dorfmuller
authors.affiliation: Rothschild Foundation Hospital, Pediatric Neurosurgery Department, Paris, France.
authors.forename: Sarah Ferrand
authors.initials: SF
authors.lastname: Sorbets
authors.affiliation: Rothschild Foundation Hospital, Pediatric Neurosurgery Department, Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Delalande
authors.affiliation: INSERM U1129 "Infantile Epilepsies and Brain Plasticity", Paris, France; Université Paris Descartes, Sorbonne Paris Cité, France; CEA, Gif sur Yvette, France; Rothschild Foundation Hospital, Pediatric Neurosurgery Department, Paris, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Jambaqué
authors.affiliation: INSERM U1129 "Infantile Epilepsies and Brain Plasticity", Paris, France; Université Paris Descartes, Sorbonne Paris Cité, France; CEA, Gif sur Yvette, France; Rothschild Foundation Hospital, Pediatric Neurosurgery Department, Paris, France. Electronic address: cbulteau@fo-rothschild.fr.
authors.forename: Christine
authors.initials: C
authors.lastname: Bulteau
mesh_terms: D000293:Adolescent; D002648:Child; D003142:Communication; D032882:Comprehension / Q000502:physiology; D004292:Dominance, Cerebral / Q000502:physiology*; D004827:Epilepsy / Q000601:surgery*; D005260:Female; D006801:Humans; D007802:Language; D007806:Language Disorders / Q000209:etiology*; D007807:Language Tests; D008297:Male; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D013060:Speech / Q000502:physiology*
keywords: Development; Hemispheric specialization; Hemispherotomy; Pragmatic language