An examination over time of language and discourse production abilities following right hemisphere brain damage

Although it is common for descriptions of communication ability in people with right hemisphere brain damage (RHBD) to include discourse deficits that affect pragmatic effectiveness, reports of these deficits are often made from subjective observations based on single cases. To date there is also very little objective information about spontaneous change over time in a representative clinical population in either discourse-specific or other aspects of language ability. In this study a group of eight individuals with post-stroke RHBD were assessed at 1 month and 6 months post-onset. The Discourse Comprehension Test was administered and seven discourse samples were elicited (three conversational, three procedural and a picture description). Detailed analyses of these samples included length, syntactic complexity, physical and illustrative gestures, verbal disruption, cohesion and topic coherence. A high level of intra-rater reliability was achieved in the analyses. Very few significant differences were evident over time in the language and discourse features measured and there were no apparent task effects. Reasons for this lack of ‘spontaneous recovery’ are discussed and some research implications drawn from this exploratory study.