Management of discourse deficits following traumatic brain injury: progress, caveats, and needs.

Currently, there is substantial evidence to support the assessment of communication, following traumatic brain injury (TBI), beyond what is included in standardized aphasia or child language batteries. The sensitivity of discourse analyses for delineating subtle cognitive-communicative deficits is well established in the research literature. A variety of useful monologic and conversational discourse measures have been identified including productivity, efficiency, content accuracy and organization, story grammar and coherence, and topic management. Disruption of discourse may persist for years after TBI and appears to have a negative impact on quality of life. Although discourse analyses have great potential for clinical application for individuals with TBI, their widespread use has been limited by time and training constraints. A further limitation is that there is no empirical evidence to guide the treatment of discourse deficits. There is need for the development and investigation of theoretically based interventions.