Chapman S B, McKinnon L, Levin H S, Song J, Meier M C, Chiu S
Center for BrainHealth, Department of Human Development, University of Texas at Dallas, Dallas, Texas 45235, USA.
J Head Trauma Rehabil. 2001 Oct;16(5):441-55. doi: 10.1097/00001199-200110000-00004.
This study compared changes in discourse ability between two groups of children age 5 to 10 years after brain injury: those with severe traumatic brain injury (TBI) and those with mild/moderate injury over 3-year follow-up testing.
Forty-three children with TBI were recruited from a larger research project examining cognitive and linguistic recovery after injury. Twenty-two of these patients had severe injuries and 21 sustained mild/moderate injuries. All children were presented an ordered sequence of pictures and asked to verbally produce a story/narrative discourse. Each child was then asked to produce a lesson relating to the story.
The severe group performed significantly worse than the mild/moderate group when performance across all four discourse domains was considered. Both groups improved across time on selected discourse measures. Qualitative analysis suggested that the severe group showed differential rates of improvement across the individual discourse variables over the 3-year interval.
Severe TBI can have a pernicious effect on discourse abilities in children years after injury compared with children with mild/moderate injuries. The major caveat is that the discourse measures must be sufficiently challenging when used to assess older children and children with milder forms of TBI.
本研究比较了两组5至10岁脑损伤儿童在3年随访测试后的话语能力变化：重度创伤性脑损伤（TBI）儿童和轻度/中度损伤儿童。
从一个研究损伤后认知和语言恢复的大型研究项目中招募了43名TBI儿童。其中22例患者为重伤，21例为轻/中度损伤。向所有儿童展示一组有序的图片，并要求他们口头讲述一个故事/叙述性话语。然后要求每个儿童讲述与该故事相关的一课。
当考虑所有四个话语领域的表现时，重度组的表现明显比轻度/中度组差。两组在选定的话语测量指标上均随时间有所改善。定性分析表明，重度组在3年期间各个话语变量的改善率存在差异。
与轻度/中度损伤儿童相比，重度TBI在损伤数年之后对儿童的话语能力可能产生有害影响。主要需要注意的是，当用于评估年龄较大的儿童和轻度TBI儿童时，话语测量指标必须具有足够的挑战性。
