Difficulty linking macro- and microlinguistic processes for narrative production following TBI

Peach, Richard K. and Coelho, Carl A. (2014) Difficulty linking macro- and microlinguistic processes for narrative production following TBI. [Clinical Aphasiology Paper]

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Abstract

Substantial evidence has accumulated over the past 35 years suggesting deficient intersentential cohesion in the narrative discourse of many individuals with traumatic brain injury (TBI). Since Mentis and Prutting (1987) reported significantly fewer cohesive ties in the narratives of brain-injured versus normal speakers, a number of reports have replicated and expanded upon these findings (e.g., Coelho, Liles, & Duffy, 1995; Davis & Coelho, 2004; Hartley & Jensen, 1991; Liles, Coelho, Duffy, & Zalagans, 1989; Marini et al., 2011). At the same time, several studies have not found evidence of deficient intersentential cohesion in these adults (Coelho, 2002; Glosser & Deser, 1991; Hough & Barrow, 2003). It can be said then that the narratives produced by at least some speakers with TBI tend to show less adequate intersentential cohesion than that observed in normal speakers (Cannizzaro & Coelho, 2012; Coelho, 2007). Variable microlinguistic impairment has also been observed in narrative discourse following TBI. Sentences produced by speakers with TBI have been reported to include more lexical and syntactic errors, increased mazes, more frequent pausing, and greater reductions in content when compared to normal speakers (Ellis & Peach, 2009; Glosser & Deser, 1991; Hartley & Jensen, 1991; Peach, 2013; Peach & Schaude, 1986; Stout, Yorkston, & Pimenthal, 2000). Such narratives also tend to be less efficient (i.e., lengthier and containing more words per maze) (Erlich, 1988; Hartley & Jensen, 1991; Stout et al., 2000) and less complex (Coelho, Grela, Corso, Gamble, & Feinn, 2005; Peach, Shapiro, Rubin, & Schaude, 1990) than those produced by normal speakers. Nonetheless, other studies have not found few, if any, such microlinguistic disturbances in speakers with TBI (Hough & Barrow, 2003; Marini et al., 2011). It has been suggested that brain injury produces a dissociation between the macrolinguistic and microlinguistic components of narrative production (Glosser & Deser, 1991; Hough & Barrow, 2003) and thus, that the processing of discourse and the processing of sentences are based on different cognitive devices (Consentino, Adornetti, & Ferretti, 2013). Alternatively, it might be that the macrolinguistic structure of narratives produced by brain injured speakers is affected by their microlinguistic impairments (see, e.g., Boyle, 2011; Christiansen, 1995). Given the variable patterns that have been observed in the narratives of speakers with TBI, it may be that narrative production following TBI is the result of an effortful interaction between macrolinguistic and microlinguistic processes rather than dissociation of separate cognitive mechanisms. However, few studies exist that attempt to establish the connections between these different levels of language. As a result, there is little information available to describe how specific changes at either level may influence the processing of narrative discourse. Armstrong (2000) has suggested that cohesion analysis is one of the few methods which directly attempts to link the macro- and microlinguistic aspects of discourse. This study therefore investigated the relationship between intersentential cohesion and microlinguistic impairments in discourse produced by speakers with severe traumatic brain injury (TBI).

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