Clinical Relevance of Discourse Characteristics After Right Hemisphere Brain Damage

Abstract

Purpose Discourse characteristics of adults with right hemisphere brain damage are similar to those reported for healthy older adults, prompting the question of whether changes are due to neurological lesions or normal aging processes. The clinical relevance of potential differences across groups was examined through ratings by speech-language pathologists. Method A thinking-out-loud task was used to elicit discourse from 8 individuals with right brain damage and 8 healthy older adults. Speech-language pathologists rated discourse transcripts on content and quantity variables and then classified them as belonging to a participant with or without brain damage. Subjective ratings were validated against corroborating measures. Results Discourse produced by adults with right brain damage was rated as more tangential and egocentric than that from healthy older adults. Extreme verbosity or paucity of speech was attributed to people with right brain damage. One third of the speech-language pathologists accurately classified discourse samples according to group, whereas the others displayed biases toward one group or the other. Conclusions Tangentiality, egocentrism, and extremes of quantity are clinically relevant characteristics of discourse produced by adults with right brain damage. Speech-language pathologists must be aware of potential biases that influence their perception of “normal” discourse production.