A preliminary report of the narrative abilities and verb production among Mandarin-speaking individuals with traumatic brain injury

Abstract

Introduction Discourse in English-speaking individuals with traumatic brain injuries (TBI) has been found to characterize by overall weakness in narrative structure (McDonald, 1993; Snow et al., 1997). Moreover, inappropriate topic shifting and irrelevant answers to questions (Coehlo, 1995), impairments of maintaining a proper discourse, and inappropriate use of cohesive devices such as references and conjunctions (Marini et al., 2011) have also been reported. Narrative production is often used as a tool for assessing language abilities among individuals with TBI. The complex interaction of cognitive, linguistic, and psychosocial skills required to produce a narrative appears to place a sufficient communicative load to enable individual difficulties to be highlighted (Body & Perkins, 2004; Hartley & Jensen, 1992). Narrative Assessment Profile (NAP; Bliss, McCabe, & Miranda, 1998) was designed to evaluate the multidimensional nature of narrative discourse exhibiting communicative impairments. There are six dimensions of narration that are evaluated simultaneously, including topic maintenance, event sequencing, explicitness, referential skill, conjunctive cohesion, and fluency. Each of the six NAP dimensions is scored on a scale from 0 (worst) to 4 (best), totaling the highest achievable score of 24 to reflect the overall quality of a discourse output. Additional lexical analysis will also help complement NAP results by providing data from a different dimension of language (Nicolopoulou & Richner, 2007). Aims The purpose of this study was twofold: (1) to explore the major difficulties in narrative discourse among individuals with TBI using NAP, and (2) to examine the use of verbal predicates in TBI discourse. Methods Four Mandarin-speaking participants with TBI participated and provided a language sample containing two story narratives, including “The tortoise and the hare” and “Cry wolf.” Their mean age and years of education were 38.6 and 11, respectively. Based on the Mandarin version of the Western Aphasia Battery (Peking University Health Science Center, 1988), they were all diagnosed with mild to moderate expressive aphasia, with an average aphasia quotient of 71.06. The orthographic transcriptions were rated using the NAP and the use of three types of verbal predicates was coded: (i) perceptual verbs – predicates that indicate story characters’ perception of the outside world during the narrative, (ii) psychological verbs – predicates that indicate the story characters’ emotional states during the narrative, and (iii) mental verbs – predicates that indicate the story characters’ mental cognitive processing. Results The average NAP overall score was 13.75/24, with the dimension of explicitness being the most impaired. The mean ratings for the six dimensions (in ascending order) were event sequencing (3.5/4), referential skill (3/4), topic maintenance (2.5/4), conjunctive cohesion (2/4), fluency (1.75/4), and explicitness (1/4). Regarding the use of verbal predicates, it was found that the TBI group tended to use a higher proportion of perceptual verbs (such as “to hear” or “to see”) and fewer mental verbs (such as “to believe or “to feel”) when portraying story characters. They seldom used psychological verbs (such as “fear” or “like’) in character representation. Further analyses involving additional TBI cases and comparison between TBI and controls are in progress.