Communicative-pragmatic disorders in traumatic brain injury: The role of theory of mind and executive functions

•We evaluated communicative-pragmatic abilities and cognitive skills in TBI individuals.•We evaluated both linguistic and extralinguistic expressive modalities.•TBI individuals showed deficits in pragmatic tasks, executive function and ToM tests.•We evaluated the role of executive function and ToM in sustaining pragmatic disorders.•Both EF and ToM contributed to explain TBI's pragmatic disorder.

Previous research has shown that communicative-pragmatic ability, as well as executive functions (EF) and Theory of Mind (ToM), may be impaired in individuals with traumatic brain injury (TBI). However, the role of such cognitive deficits in explaining communicative-pragmatic difficulty in TBI has still not been fully investigated. The study examined the relationship between EF (working memory, planning and flexibility) and ToM and communicative-pragmatic impairment in patients with TBI. 30 individuals with TBI and 30 healthy controls were assessed using the Assessment Battery of Communication (ABaCo), and a set of cognitive, EF and ToM, tasks. The results showed that TBI participants performed poorly in comprehension and production tasks in the ABaCo, using both linguistic and extralinguistic means of expression, and that they were impaired in EF and ToM abilities. Cognitive difficulties were able to predict the pragmatic performance of TBI individuals, with both executive functions and ToM contributing to explaining patients' scores on the ABaCo.