Article  |   April 2010
Relation of Executive Functioning to Pragmatic Outcome Following Severe Traumatic Brain Injury
Author Notes
  • Contact author: Jacinta M. Douglas, School of Human Communication Sciences, La Trobe University, Bundoora, Victoria 3086, Australia. E-mail: j.douglas@latrobe.edu.au.
Article Information
Language Disorders / Social Communication & Pragmatics Disorders / Attention, Memory & Executive Functions / Traumatic Brain Injury / Language
Article   |   April 2010
Relation of Executive Functioning to Pragmatic Outcome Following Severe Traumatic Brain Injury
Journal of Speech, Language, and Hearing Research, April 2010, Vol. 53, 365-382. doi:10.1044/1092-4388(2009/08-0205)
History: Received October 3, 2008 , Revised February 24, 2009 , Accepted June 1, 2009
Journal of Speech, Language, and Hearing Research, April 2010, Vol. 53, 365-382. doi:10.1044/1092-4388(2009/08-0205)
History: Received October 3, 2008; Revised February 24, 2009; Accepted June 1, 2009
Web of Science® Times Cited: 15

Purpose: This study was designed to explore the behavioral nature of pragmatic impairment following severe traumatic brain injury (TBI) and to evaluate the contribution of executive skills to the experience of pragmatic difficulties after TBI.

Method: Participants were grouped into 43 TBI dyads (TBI adults and close relatives) and 43 control dyads. All TBI participants had sustained severe injury (mean posttraumatic amnesia duration = 45.19 days, SD = 39.15) due to a moving vehicle-related trauma. A minimum of 2 years had elapsed since injury (M = 5.36 years, SD = 3.61). The La Trobe Communication Questionnaire (LCQ; Douglas, O’Flaherty, & Snow, 2000) was administered to all participants. Measures of executive function included the following: the FAS verbal fluency task (Spreen & Benton, 1969), the Speed and Capacity of Language Processing test (Baddeley, Emslie, & Nimmo-Smith, 1992), and the Rey Auditory Verbal Learning Task (Rey, 1964).

Results: Perceptions of TBI participants and their relatives were significantly correlated (r = .63, p < .001) and significantly different from those of controls, F(1, 84) = 37.2, p < .001. Pragmatic difficulties represented violations in 3 domains of Grice’s (1975)  Cooperative Principle (Quantity, Relation, and Manner), and executive function measures predicted 37% (32% adjusted) of the variability in LCQ scores.

Conclusions: The study demonstrates evidence of a significant association between executive impairment and the pragmatic communication difficulties experienced by individuals with TBI.

Acknowledgments
Many thanks to all those who so generously participated in this study.
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