Date of Award

Spring 2020

Project Type

Thesis

Program or Major

Communication Sciences and Disorders

Degree Name

Master of Science

First Advisor

Kathryn J Greenslade

Second Advisor

Kathryn J Greenslade

Third Advisor

Amy E Ramage

Abstract

Background & Aims: Narrative discourse, or storytelling, is critical to assess in adults with traumatic brain injury (TBI) as many of them present with deficits in accuracy, completeness, and logical sequencing of story content as well as in story grammar organization. Richardson and Dalton (2016) and Greenslade et al. (in submission) created Main Concept, Sequencing, and Story Grammar (MSSG) to analyze these variables in Cinderella narratives, with preliminary data revealing age-related declines in neurologically healthy control (NHC) performance. To extend these findings, the present study sought to evaluate MSSG’s clinical utility in identifying narrative deficits in adults with TBI. Research questions asked whether 1) adults with TBI would receive poorer scores across analyses compared to NHCs, and 2) more adults with TBI would show consistently poor or discrepant performance across the accuracy, completeness, and sequencing of story content and story grammar organization.

Methods: Seventy-six Cinderella narrative transcripts were downloaded from the online database, TalkBank, with equal numbers of participants with TBI and NHCs. MSSG analyses were applied to examine five measures: 1) main concept (MC; presence, accuracy, and completeness of story content), 2) sequencing, 3) MC + sequencing, and 4 & 5) two story grammar measures: episodic complexity and total episodic components.

Outcomes/Results: MSSG analyses detected statistically significant between-group differences across all measures, documenting how adults with TBI told less accurate, complete, and logically sequenced story content while including fewer complex episodes and fewer episodic components. More adults with TBI demonstrated consistently poor performance across MC + sequencing and total episodic components as compared to NHC.

Conclusions: The present study provides preliminary construct validity for using MSSG analyses to detect differences in the narrative discourse of adults with TBI. Results revealed that half of the TBI sample demonstrated consistently poor narrative discourse performance, producing less accurate, complete, well-sequenced, and complex narratives. These data provide initial evidence supporting the use of MSSG to quantify the narratives of adults with TBI in research and clinical settings.

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