Story narratives of adults with closed head injury and non-brain-injured adults: influence of socioeconomic status, elicitation task, and executive functioning.

Abstract

Narratives were elicited in two story tasks, retelling and generation, from two groups of adults, 55 with closed head injury (CHI) and 47 non-brain-injured (NBI), recruited from rehabilitation facilities in three northeastern states. Participants were classified, on the basis of their socioeconomic status (SES), as professional, skilled worker, or unskilled worker. Narratives were analyzed using five discourse measures at the levels of sentence production, intersentential cohesion, and story grammar. Discourse performance was then compared across groups, tasks, and SES levels. Discourse performance of the CHI group was also compared with their scores from the Wisconsin Card Sorting Test, a measure of executive functioning. Results indicated that two discourse measures distinguished the groups. The CHI participants produced significantly fewer words per T-unit and fewer T-units within episode structure than did the NBI group, which was attributed to difficulties with content organization. Performance on all five discourse measures differed for the story retelling versus the story generation tasks for both CHI and NBI groups. All participants produced longer and more grammatically complex T-units in the story generation task than in story retelling. However, cohesive adequacy and story grammar were better in the story retelling task than in the story generation task. It was therefore concluded that story generation was a more challenging task than story retelling for both groups. The only significant difference noted for SES involved the measure of intersentential cohesion. The unskilled workers demonstrated poorer cohesive adequacy than either the skilled workers or professionals, regardless of group or story task. Finally, modest correlations were noted between the discourse performance of the CHI group and scores from the Wisconsin Card Sorting Test in both story tasks.