Discourse assessment following traumatic brain injury: A pilot study examining some demographic and methodological issues

With the shift away from evaluation of isolated aspects of linguistic performance, discourse assessment has become an important tool in assessing the communication skills of individuals who have sustained traumatic brain injury (TBI). Given the substantial evidence that the brain-injured represent a largely preselected population, it would seem relevant that speech pathologists acquire a greater understanding of the role of premorbid sociolinguistic and demographic characteristics in determining the clinical presentation of these patients. This demands that close consideration be given to the selection of control subjects for research with this population. Further, there needs to be clarification about which discourse tasks (by virtue of their cognitive/linguistic demands) are sensitive to brain injury. The pilot study described here compared the discourse skills of three TBI subjects with those of three non-TBI orthopaedic patients, on a range of discourse tasks thought to make differing cognitive and/or linguistic demands on the speaker. The results appear to confirm the need to examine discourse skills within a sociolinguistic context. The importance of examining different discourse parameters is also borne out. Finally, the results suggest that there is some merit in tapping sources other than direct discourse analysis in order to determine how verbal skills have altered as a consequence of brain injury.