Abstract

Background: Previous research has suggested that individuals with closed head injury (CHI) have difficulty with the communication skills required for a successful conversational exchange. A variety of analysis paradigms have been used with this population and provide evidence to support that conversational discourse deficits do exist in individuals with CHI. However, the use of various analytical procedures renders it difficult for researchers to draw consistent conclusions and hinders the development of evidence-based practice guidelines for conversational discourse evaluation or treatment for individuals with CHI. Aims: The purpose of this study was to evaluate two conversational discourse analysis procedures. It was hypothesised that modifying a Conversational Appropriateness paradigm used successfully in previous research would provide additional information about conversational ability ultimately leading to more conclusive results. Methods & Procedures: A series of conversations elicited from one individual with CHI were analysed using two analysis schemes: Conversational Appropriateness (e.g., Blank & Franklin, 1980; Coelho, Youse, & Le, 2002) and a Modified Conversational Appropriateness paradigm designed for this study. Outcomes & Results: The results supported the hypothesis suggesting the original Conversational Appropriateness paradigm may not be completely representational of conversation ability of individuals with CHI. A Modified Conversational Appropriateness procedure may be more appropriate for the CHI population, as it appears to capture the nuances that are known to affect conversational performance in individuals with CHI revealing greater detail regarding deficits in conversational participation. Conclusions: Comparing two conversational discourse analysis paradigms provided valuable insight into measures that may more adequately define the conversation ability of individuals with CHI. Modifying a discourse analysis procedure that has been shown to be successful in the past can provide additional detail for therapists to utilise when assessing and designing therapy goals for an individual with CHI. Although further research is needed, if a reliable, valid procedure can be developed for clinical use the possibility of developing evidence-based practice guidelines for discourse assessment and treatment may be more attainable.

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