CHILDRENS NARRATIVES FOLLOWING TRAUMATIC BRAIN INJURY - LINGUISTIC STRUCTURE, COHESION, AND THEMATIC RECALL

Narrative discourse and intellectual functioning were examined 3 years following traumatic brain injury (TBI) in children 1 to 8 years of ag e at the time of injury. The language-impaired TBI group (n = 9) had l anguage deficits during the subacute stage of recovery; their performa nce was contrasted with that of a TBI comparison group equated on neur ologic and demographic variables that did not show subacute language i mpairment (n = 8) and a sibling comparison group (n = 9). The language -impaired TBI group had lower Verbal and Full-Scale IQ scores and prod uced fewer words and utterances than the sibling group on a story rete lling task; their stories were characterized by fewer complete referen tial and lexical ties and more referential errors, indicating difficul ty conjoining meaning across sentences. The language impaired TBI grou p recalled approximately one-third of the propositions needed to maint ain the story theme and made more errors sequencing the propositions t han either the TBI or the sibling comparison groups. Group differences were not obtained on the Performance IQ scores or on measures of rate or fluency of speech production, mazes, use of conjunctives, or namin g errors. The discourse deficiencies of children with TBI and acute la nguage impairment were most pronounced at the level of cognitive organ ization of the text reflecting text macrostructure and were least appa rent at the level of lexical and sentential organization reflecting te xt microstructure. Results are discussed in terms of the vulnerability of developing language abilities to disruption by brain injury. (C) 1 998 Academic Press.