Procedural discourse performance in adults with severe traumatic brain injury at 3 and 6 months post injury.
Elin Stubbs, Leanne Togher, Belinda Kenny and 7 others
PMID 29281420WHAT IT FOUND
Adults with severe TBI did not show clear change in sandwich description output or structure from 3 to 6 months.
They still spoke more slowly and gave fewer essential and optional steps than controls, with more irrelevant content at 3 months.
Key findings
01Between 3 and 6 months, optional steps increased but not significantly, and the change in optional steps was significantly greater than the change in low content elements.
02At 3 and 6 months, controls mentioned all essential steps and more optional steps than the TBI group.
03The TBI group had a significantly slower speech rate than controls at both intervals and more low content elements at 3 months.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study included 43 participants with TBI, which is larger than previous procedural discourse studies but still limited. Many participants had aphasia or dysarthria, so it is hard to know whether poor procedural description came from discourse planning, word retrieval, or motor speech. Some participants were receiving speech therapy during the interval, so the study cannot separate natural recovery from treatment. The controls described a peanut butter and jelly sandwich, while the TBI group described a cheese and Vegemite sandwich, which may have affected the details. The sandwich task was the last discourse task, so fatigue may have affected output. The significant within-group result was a comparison of change scores, not a significant change in optional steps or low content elements on their own. Follow-up was only 12 weeks, which the authors note may be too short to detect macrostructural change.
Declared interests
The authors report no declarations of interest.
The easy way to misread this
Do not conclude that procedural communication recovers substantially between 3 and 6 months, or that speech therapy caused the change. Most within-group changes were not significant, and the significant finding was only that optional-step change was larger than low-content change. Some participants were also receiving speech therapy, so the study cannot separate treatment from natural recovery.