Informal Written Language Analysis Methods: Case Examples of Adults With Traumatic Brain Injury

Abstract

Purpose: Written expression challenges following traumatic brain injury (TBI) in adults have received little clinical attention but can substantially affect quality of life and the success of reintegration efforts. Assessment tools and procedures are lacking despite the likelihood of post-TBI problems with microstructure (e.g., productivity, spelling accuracy) and macrostructure (e.g., topic adherence, organization) aspects of written language. The lack of standardized procedures forces reliance on informal methods to determine writing strengths and challenges. Method: A combination of assessment procedures allowed for evaluation of the productivity and efficiency, adherence to writing conventions (e.g., spelling, sentence structure, punctuation), and macrostructure organization (e.g., story grammar, topic adherence) of written narratives collected from five adults with TBI. Results: Use of multiple assessment methods revealed disparate writing challenges across the five case examples. The differing writing profiles underscore the necessity of evaluating multiple aspects of written narratives. Conclusions: The described analysis methods can help clinicians determine areas of strength and challenge in written work generated by adults with TBI. Examination of multiple aspects of writing is key to garnering a comprehensive appraisal of post-TBI writing.