Longitudinal outcome of verbal discourse in children with traumatic brain injury: Three-year follow-up

Purpose: This study compared changes in discourse ability between two group s of children age 5 to 10 years after brain injury: those with severe traum atic brain injury (TBI) and those with mild/moderate injury over 3-year fol low-up testing. Materials and Methods: Forty-three children with TBI were r ecruited from a larger research project examining cognitive and linguistic recovery after injury. Twenty-two of these patients had severe injuries and 21 sustained mild/moderate injuries. AD children were presented an ordered sequence of pictures and asked to verbally produce a story/narrative disco urse. Each child was then asked to produce a lesson relating to the story. Results: The severe group performed significantly worse than the mild/moder ate group when performance across all four discourse domains was considered . Both groups improved across time on selected discourse measures. Qualitat ive analysis suggested that the severe group showed differential rates of i mprovement across the individual discourse variables over the 3-year interv al. Conclusions: Severe TBI can have a pernicious effect on discourse abili ties in children years after injury compared with children with mild/modera te injuries. The major caveat is that the discourse measures must be suffic iently challenging when used to assess older children and children with mil der forms of TBI.