2.2 Interpretation of narrative discourse in individuals with Traumatic Brain Injury (TBI) by naïve listeners and Speech Language Pathologists (SLPs): A pilot study

Amanda Sinagra & Hia Datta, PhD, Molloy University

Mild traumatic brain injuries (TBI) often result from closed brain injuries. Cognitive impairments derived from such mild TBIs are often unnoticed. This study investigates the discourse skills of individuals with mild traumatic brain injuries. Healthy naïve listeners and Speech Language Pathologists (SLPs) had to rate and evaluate macrostructure (i.e., how one conveys their ideas in an organized coherent manner) in audio recorded narratives from healthy individuals and patients with mild TBI. We hypothesized that the naïve listeners but not the SLPs would have difficulty detecting the difference between typical narratives and mild TBI narratives. Ten SLPs and ten naïve listeners were asked to listen to story retells and rate each story. They heard audio recordings from two mild TBI narrators and two healthy speakers talking about the Cinderella story and recounting a personal experience after being given the same prompt. Cognitive and linguistic skills were rated by all listeners through a Likert scale. The narratives from the individuals with mild TBI were less coherent and more tangential than those from the individuals with no known impairments. Narratives by the individuals with mild TBI were judged to be vague, focused on unnecessary detail, and it was difficult to understand the main idea in them. Contrary to our predictions, naïve listeners found distinct differences between the mild TBI cases and the normal narratives. However, SLPs were able to also distinguish the difference as predicted. In summary, micro linguistic aspects of the narratives (i.e., the grammatical structure of language) from the individuals with mild TBI, were not perceived as impaired. Macro linguistic aspects that involve  the overall gist of stories were found to be impaired. This study contributes to the field of speech language pathology regarding assessment of mild traumatic brain injuries, using discourse microstructure alone, and provides awareness to other multidisciplinary fields. The findings from the SLPs can be used to inform treatment.