Mild traumatic brain injuries (mTBIs), or concussions, account for 87% of all traumatic brain injuries (TBIs) in the United States and are a public health concern affecting an estimated 69 million people worldwide. MTBIs are often associated with cognitive impairments, such as attention deficits, but may also play a detrimental role in verbal language skills. Considering the importance of verbal language for everyday social interactions, including education and employment, there is a need for greater understanding of how it is impacted by mTBI.
Verbal language is generally used in two ways. Expressive verbal language refers to spoken or written words. Receptive verbal language refers to words that one hears or reads. To further explore differences in expressive and receptive verbal language skills in individuals with TBI, a research team conducted a study of people recovering from mTBI, moderate to severe TBI, or orthopedic injury (OI). The study included 70 adult participants, using OI group as a control to account for the physical distress accompanied with brain trauma. Participants were tasked with reading the children’s book, “Cinderella,” and retelling the story from their own words. Researchers evaluated each retelling for participants’ macrolinguistic understanding of the story’s main concepts, and microlinguistic productivity for measures including words per minute, total words, and fluency.
Individuals in the moderate to severe TBI group were able to retell significantly fewer main story concepts than all other groups and individuals with mTBI and OI showed a nonsignificant but downward trend. While the “Cinderella” task may not have been robust enough to distinguish language deficits between mTBI and OI groups, results showed significantly shorter story durations for mTBI patients than healthy and OI groups—on average, the mTBI patient’s story was 10 seconds shorter than that of the OI group.
These findings suggest that both physical trauma and mild brain trauma may result in comparable verbal language deficits that may act as a mechanism for communication barriers. Impaired communication of TBI patients remains a pressing clinical issue and there are no clinical practice guidelines for assessing verbal language in mTBI. It is therefore essential that research continues to investigate the role of TBI in language. Additionally, the role of speech and language pathology in mTBI treatment should continue to expand, allowing those recovering from traumatic injuries to recover their communication skills.
Norman RS, Mueller KD, Huerta P, et al. Discourse Performance in Adults With Mild Traumatic Brain Injury, Orthopedic Injuries, and Moderate to Severe Traumatic Brain Injury, and Healthy Controls. American Journal of Speech-Language Pathology. (January 2022).