Comprehension of Spoken Narrative Discourse by Adults With Aphasia, Right-Hemisphere Brain Damage, or Traumatic Brain Injury

Abstract

This paper reviews the literature concerning auditory comprehension of discourse by adults with and without brain damage. It also reports the results of an investigation of comprehension of spoken narrative discourse by adults with left-hemisphere brain damage and aphasia, right-hemisphere brain damage, or traumatic brain injury (20 subjects per group), as well as that of 40 adults without brain damage. These subjects were tested with the 10 narratives from the Discourse Comprehension Test (Brookshire & Nicholas, 1993). Test questions assess comprehension and retention of stated and implied main ideas and details. The performance of the groups with brain damage was qualitatively similar to that of the group with no brain damage, but quantitatively inferior. The performance of the groups with aphasia, right-hemisphere damage, and traumatic brain injury was both qualitatively and quantitatively similar. The performance of the four groups was strongly affected by the salience of information in the stories. All 100 subjects responded correctly to main idea questions more often than to detail questions. The effect of directness was less strong than that of salience, but all four groups produced more correct responses when questions assessed stated information than when they assessed implied information. The effect of directness was greater for detail questions than for main idea questions. Although this study was not designed to assess the validity of any discourse comprehension model, the performance pattern of both subjects with no brain damage and those with brain damage is consistent with a resource allocation model of discourse comprehension.