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No AccessAmerican Journal of Speech-Language PathologyResearch Note19 Nov 2019

Microstructural and Fluency Characteristics of Narrative and Expository Discourse in Adolescents With Traumatic Brain Injury

    https://doi.org/10.1044/2019_AJSLP-19-0012

    Abstract

    Purpose

    The purpose of this exploratory study was to identify specific microstructural and fluency differences in expository and narrative summaries produced by students with a traumatic brain injury (TBI) compared to students with typical development (TD).

    Method

    Five adolescents with TBI and 5 matched peers with TD verbally summarized 1 narrative and 2 expository (compare–contrast, cause–effect) lectures, creating 30 summaries. Researchers transcribed summaries and used paired t tests to analyze between-group differences in microstructural measures (productivity, lexical diversity, syntactic complexity), mazing behaviors, and pausing patterns.

    Results

    Youth with TBI produced significantly fewer utterances than teens with TD in both expository contexts, whereas youth with TD produced a significantly greater mean length of C-unit than teens with TBI in the narrative summary only. Youth with TBI produced significantly fewer filled pauses per utterance than did youth with TD during the cause–effect summary only and significantly more pauses per utterance and within-clause pauses per utterance during the compare–contrast summary. Where findings were statistically significant, effect sizes were large. There were no statistically significant between-group differences in mazing or pausing behaviors during narrative summary production.

    Conclusions

    This study is the 1st to compare microstructural and fluency characteristics in teens with TBI and those without when producing verbal summaries of a narrative and 2 types of expository passages. Findings from this study reinforce the need to expand research focusing on expository discourse tasks and identify variables that may be prone to disruption following TBI. Future work is needed to confirm whether identified differences correspond to true discourse difficulties.

    Supplemental Material

    https://doi.org/10.23641/asha.9807812

    References

    • Bauer, P. J., & Zelazo, P. D. (2013). IX. NIH Toolbox Cognition Battery (CB): Summary, conclusions, and implications for cognitive development.Monographs of the Society for Research in Child Development, 78(4), 133–146. https://doi.org/10.1111/mono.12039
      CrossrefMedlineGoogle Scholar
    • Best, R. M., Floyd, R. G., & McNamara, D. S. (2008). Differential competencies contributing to children's comprehension of narrative and expository texts.Reading Psychology, 29(2), 137–164. https://doi.org/10.1080/02702710801963951
      CrossrefGoogle Scholar
    • Biddle, K. R., McCabe, A., & Bliss, L. S. (1996). Narrative skills following traumatic brain injury in children and adults.Journal of Communication Disorders, 29(6), 447–468. quiz 468–469
      CrossrefMedlineGoogle Scholar
    • Boersma, P., & Weenink, D. (2017). Praat: Doing phonetics by computer. [Computer program]. Version 6.0.33.Retrieved from http://www.praat.org/
      Google Scholar
    • Brookshire, B. L., Chapman, S. B., Song, J., & Levin, H. S. (2000). Cognitive and linguistic correlates of children's discourse after closed head injury: A three-year follow-up.Journal of the International Neuropsychological Society, 6(7), 741–751.
      CrossrefMedlineGoogle Scholar
    • Campbell, T. F., & Dollaghan, C. A. (1990). Expressive language recovery in severely brain-injured children and adolescents.Journal of Speech and Hearing Disorders, 55(3), 567–581.
      LinkGoogle Scholar
    • Campbell, T. F., & Dollaghan, C. A. (1995). Speaking rate, articulatory speed, and linguistic processing in children and adolescents with severe traumatic brain injury.Journal of Speech and Hearing Research, 38(4), 864–875.
      LinkGoogle Scholar
    • Catroppa, C., Anderson, V. A., Morse, S. A., Haritou, F., & Rosenfeld, J. V. (2008). Outcome and predictors of functional recovery 5 years following pediatric traumatic brain injury (TBI).Journal of Pediatric Psychology, 33(7), 707–718. https://doi.org/10.1093/jpepsy/jsn006
      CrossrefMedlineGoogle Scholar
    • Chapman, S. B., Culhane, K. A., Levin, H. S., Harward, H., Mendelsohn, D., Ewing-Cobbs, L., … Bruce, D. (1992). Narrative discourse after closed head injury in children and adolescents.Brain and Language, 43(1), 42–65. https://doi.org/10.1016/0093-934X(92)90020-F
      CrossrefMedlineGoogle Scholar
    • Chapman, S. B., Gamino, J. F., Cook, L. G., Hanten, G., Li, X., & Levin, H. S. (2006). Impaired discourse gist and working memory in children after brain injury.Brain and Language, 97(2), 178–188. https://doi.org/10.1016/j.bandl.2005.10.002
      CrossrefMedlineGoogle Scholar
    • Chapman, S. B., Watkins, R., Gustafson, C., Moore, S., Levin, H. S., & Kufera, J. A. (1997). Narrative discourse in children with closed head injury, children with language impairment, and typically developing children.American Journal of Speech-Language Pathology, 6(2), 66–76.
      LinkGoogle Scholar
    • Coelho, C. A. (2007). Management of discourse deficits following traumatic brain injury: Progress, caveats, and needs.Seminars in Speech and Language, 28(2), 122–135. https://doi.org/10.1055/s-2007-970570
      CrossrefMedlineGoogle Scholar
    • Coelho, C. A., Liles, B. Z., & Duffy, R. J. (1991). The use of discourse analyses for the evaluation of higher level traumatically brain-injured adults.Brain Injury, 5(4), 381–392.
      CrossrefMedlineGoogle Scholar
    • Cohen, J. (1988). Statistical power analysis for the behavioral sciences. Hillsdale, NJ: Erlbaum.
      Google Scholar
    • Cook, L. G., DePompei, R., & Chapman, S. B. (2011). Cognitive communicative challenges in TBI: Assessment and intervention in the long term.SIG 2 Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders, 21(1), 33–42. https://doi.org/10.1044/nnsld21.1.33
      LinkGoogle Scholar
    • Davis, G. A., & Coelho, C. A. (2004). Referential cohesion and logical coherence of narration after closed head injury.Brain and Language, 89(3), 508–523. https://doi.org/10.1016/j.bandl.2004.01.003
      CrossrefMedlineGoogle Scholar
    • Ewing-Cobbs, L., Brookshire, B., Scott, M. A., & Fletcher, J. M. (1998). Children's narratives following traumatic brain injury: Linguistic structure, cohesion, and thematic recall.Brain and Language, 61(3), 395–419. https://doi.org/10.1006/brln.1997.1884
      CrossrefMedlineGoogle Scholar
    • Fuentes, M. M., Wang, J., Haarbauer-Krupa, J., Yeates, K. O., Durbin, D., Zonfrillo, M. R., … Rivara, F. P. (2018). Unmet rehabilitation needs after hospitalization for traumatic brain injury.Pediatrics, 141(5), e20172859. Retrieved from https://doi.org/10.1542/peds.2017-2859
      CrossrefMedlineGoogle Scholar
    • Gillam, R. B., Peña, E. D., & Miller, L. (1999). Dynamic assessment of narrative and expository discourse.Topics in Language Disorders, 20(1), 33–47.
      CrossrefGoogle Scholar
    • Glang, A., Todis, B., Thomas, C. W., Hood, D., Bedell, G., & Cockrell, J. (2008). Return to school following childhood TBI: Who gets services?.NeuroRehabilitation, 23(6), 477–486.
      CrossrefMedlineGoogle Scholar
    • Goldman Eisler, F. (1968). Psycholinguistics: Experiments in spontaneous speech. London, England: Academic Press.
      Google Scholar
    • Haarbauer-Krupa, J., Ciccia, A., Dodd, J., Ettel, D., Kurowski, B., Lumba-Brown, A., & Suskauer, S. (2017). Service delivery in the healthcare and educational systems for children following traumatic brain injury: Gaps in care.Journal of Head Trauma Rehabilitation, 32(6), 367–377. https://doi.org/10.1097/HTR.0000000000000287
      CrossrefMedlineGoogle Scholar
    • Hartley, L. L., & Jensen, P. J. (1991). Narrative and procedural discourse after closed head injury.Brain Injury, 5(3), 267–285.
      CrossrefMedlineGoogle Scholar
    • Hay, E., & Moran, C. (2005). Discourse formulation in children with closed head injury.American Journal of Speech-Language Pathology, 14(4), 324–336. https://doi.org/10.1044/1058-0360(2005/031)
      LinkGoogle Scholar
    • Hunt, K. W. (1965). Grammatical structures written at three grade levels (Research Report No. 3). Champaign, IL: National Council of Teachers of English.
      Google Scholar
    • Kingery, K. M., Narad, M. E., Taylor, H. G., Yeates, K. O., Stancin, T., & Wade, S. L. (2017). Do children who sustain traumatic brain injury in early childhood need and receive academic services 7 years after injury?.Journal of Developmental and Behavioral Pediatrics, 38(9), 728–735. https://doi.org/10.1097/DBP.0000000000000489
      CrossrefMedlineGoogle Scholar
    • Kircher, T. T. J., Brammer, M. J., Levelt, W., Bartels, M., & McGuire, P. K. (2004). Pausing for thought: Engagement of left temporal cortex during pauses in speech.NeuroImage, 21(1), 84–90.
      CrossrefMedlineGoogle Scholar
    • Kirsner, K., Dunn, J., Hird, K., Parkin, T., & Clark, C. (2002). Time for a pause.Proceedings of the Ninth Australian International Conference on Speech Science and Technology, Melbourne.
      Google Scholar
    • Levelt, W. J. (1983). Monitoring and self-repair in speech.Cognition, 14(1), 41–104.
      CrossrefMedlineGoogle Scholar
    • Loban, W. (1976). Language development: Kindergarten through grade twelve. Champaign, IL: National Council of Teachers of English.
      Google Scholar
    • Lundine, J. P., Harnish, S. M., McCauley, R. J., Blackett, D. S., Zezinka, A., Chen, W., & Fox, R. A. (2018). Adolescent summaries of narrative and expository discourse: Differences and predictors.Language, Speech, and Hearing Services in Schools, 49(3), 551–568. https://doi.org/10.1044/2018_LSHSS-17-0105
      LinkGoogle Scholar
    • Lundine, J. P., Harnish, S. M., McCauley, R. J., Zezinka, A. B., Blackett, D. S., & Fox, R. A. (2018). Exploring summarization differences for two types of expository discourse in adolescents with traumatic brain injury.American Journal of Speech-Language Pathology, 27(1), 247–257. https://doi.org/10.1044/2017_AJSLP-16-0131
      LinkGoogle Scholar
    • Miller, J. F., & Iglesias, A. (2010). Systematic Analysis of Language Transcripts (Version 16) [Computer software].Retrieved from http://saltsoftware.com/
      Google Scholar
    • Moran, C., Kirk, C., & Powell, E. (2012). Spoken persuasive discourse abilities of adolescents with acquired brain injury.Language, Speech, and Hearing Services in Schools, 43(3), 264–275. https://doi.org/10.1044/0161-1461(2011/10-0114)
      LinkGoogle Scholar
    • Navarro-Ruiz, M. I., & Rallo-Fabra, L. (2001). Characteristics of mazes produced by SLI children.Clinical Linguistics & Phonetics, 15(1–2), 63–66. https://doi.org/10.3109/02699200109167632
      CrossrefMedlineGoogle Scholar
    • Peach, R. K. (2013). The cognitive basis for sentence planning difficulties in discourse after traumatic brain injury.American Journal of Speech-Language Pathology, 22(2), S285–S297. https://doi.org/10.1044/1058-0360(2013/12-0081)
      LinkGoogle Scholar
    • Peach, R. K., & Coelho, C. A. (2016). Linking inter- and intra-sentential processes for narrative production following traumatic brain injury: Implications for a model of discourse processing.Neuropsychologia, 80, 157–164. https://doi.org/10.1016/j.neuropsychologia.2015.11.015
      CrossrefMedlineGoogle Scholar
    • Sullivan, J. R., & Riccio, C. A. (2010). Language functioning and deficits following pediatric traumatic brain injury.Applied Neuropsychology, 17(2), 93–98. https://doi.org/10.1080/09084281003708852
      CrossrefMedlineGoogle Scholar
    • Teasdale, G., & Jennett, B. (1974). Assessment of coma and impaired consciousness. A practical scale.Lancet, 2(7872), 81–84.
      CrossrefMedlineGoogle Scholar
    • Turkstra, L. S., & Holland, A. L. (1998). Assessment of syntax after adolescent brain injury: Effects of memory on test performance.Journal of Speech, Language, and Hearing Research, 41(1), 137–149.
      LinkGoogle Scholar
    • Walz, N. C., Yeates, K. O., Taylor, H. G., Stancin, T., & Wade, S. L. (2012). Emerging narrative discourse skills 18 months after traumatic brain injury in early childhood.Journal of Neuropsychology, 6(2), 143–160. https://doi.org/10.1111/j.1748-6653.2011.02020.x
      CrossrefMedlineGoogle Scholar
    • Ward-Lonergan, J. M. (2010). Expository discourse in school-age children and adolescents with language disorders: Nature of the problem.In M. A. Nippold & C. M. Scott (Eds.), Expository discourse in children, adolescents, and adults: Development and disorders (pp. 155–189). New York, NY: Psychology Press.
      Google Scholar
    • Weintraub, S., Bauer, P. J., Zelazo, P. D., Wallner-Allen, K., Dikmen, S. S., Heaton, R. K., … Gershon, R. C. (2013). I. NIH Toolbox Cognition Battery (CB): Introduction and pediatric data.Monographs of the Society for Research in Child Development, 78(4), 1–15. https://doi.org/10.1111/mono.12031
      CrossrefMedlineGoogle Scholar
    • Wiig, E. H., Semel, E., & Secord, W. A. (2013). Clinical Evaluation of Language Fundamentals–Fifth Edition (CELF-5). Toronto, Ontario, Canada: The Psychological Corporation/A Harcourt Assessment Company.
      Google Scholar
    • Wolfe, M. B. W. (2005). Memory for narrative and expository text: Independent influences of semantic associations and text organization.Journal of Experimental Psychology: Learning, Memory, and Cognition, 31(2), 359–364. https://doi.org/10.1037/0278-7393.31.2.359
      CrossrefMedlineGoogle Scholar
    • Wolfe, M. B. W., & Mienko, J. A. (2007). Learning and memory of factual content from narrative and expository text.The British Journal of Educational Psychology, 77(3), 541–564. https://doi.org/10.1348/000709906X143902
      CrossrefMedlineGoogle Scholar
    • Wolfe, M. B. W., & Woodwyk, J. (2010). Processing and memory of information presented in narrative or expository texts.The British Journal of Educational Psychology, 80(3), 341–362. https://doi.org/10.1348/000709910X485700
      CrossrefMedlineGoogle Scholar
    • Yeates, K. O., Armstrong, K., Janusz, J., Taylor, H. G., Wade, S., Stancin, T., & Drotar, D. (2005). Long-term attention problems in children with traumatic brain injury.Journal of the American Academy of Child & Adolescent Psychiatry, 44(6), 574–584. https://doi.org/10.1097/01.chi.0000159947.50523.64
      CrossrefMedlineGoogle Scholar
    • Yeates, K. O., Swift, E., Taylor, H. G., Wade, S. L., Drotar, D., Stancin, T., & Minich, N. (2004). Short- and long-term social outcomes following pediatric traumatic brain injury.Journal of the International Neuropsychological Society, 10(3), 412–426. https://doi.org/10.1017/S1355617704103093
      CrossrefMedlineGoogle Scholar

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