Ewing-Cobbs L, Brookshire B, Scott M A, Fletcher J M
Department of Pediatrics, University of Texas, Houston Health Science Center 77030, USA.
Brain Lang. 1998 Feb 15;61(3):395-419. doi: 10.1006/brln.1997.1884.
Narrative discourse and intellectual functioning were examined 3 years following traumatic brain injury (TBI) in children 1 to 8 years of age at the time of injury. The language-impaired TBI group (n = 9) had language deficits during the subacute stage of recovery; their performance was contrasted with that of a TBI comparison group equated on neurologic and demographic variables that did not show subacute language impairment (n = 8) and a sibling comparison group (n = 9). The language-impaired TBI group had lower Verbal and Full-Scale IQ scores and produced fewer words and utterances than the sibling group on a story retelling task; their stories were characterized by fewer complete referential and lexical ties and more referential errors, indicating difficulty conjoining meaning across sentences. The language-impaired TBI group recalled approximately one-third of the propositions needed to maintain the story theme and made more errors sequencing the propositions than either the TBI or the sibling comparison groups. Group differences were not obtained on the Performance IQ scores or on measures of rate or fluency of speech production, mazes, use of conjunctives, or naming errors. The discourse deficiencies of children with TBI and acute language impairment were most pronounced at the level of cognitive organization of the text reflecting text macrostructure and were least apparent at the level of lexical and sentential organization reflecting text microstructure. Results are discussed in terms of the vulnerability of developing language abilities to disruption by brain injury.
对受伤时年龄在1至8岁的儿童创伤性脑损伤（TBI）3年后的叙述性话语和智力功能进行了研究。语言受损的TBI组（n = 9）在恢复的亚急性期存在语言缺陷；将他们的表现与在神经学和人口统计学变量上匹配但未表现出亚急性语言损伤的TBI对照组（n = 8）以及同胞对照组（n = 9）的表现进行了对比。在故事复述任务中，语言受损的TBI组的言语智商和全量表智商得分较低，说出的单词和话语比同胞组少；他们的故事特点是完整的指称和词汇联系较少，指称错误较多，这表明在跨句子连接意义方面存在困难。语言受损的TBI组回忆起维持故事主题所需命题的约三分之一，并且在对命题进行排序时比TBI对照组或同胞对照组犯的错误更多。在操作智商得分、言语产生的速度或流畅性测量、迷宫测试、连词使用或命名错误方面未发现组间差异。TBI和急性语言损伤儿童的话语缺陷在反映文本宏观结构的文本认知组织层面最为明显，而在反映文本微观结构的词汇和句子组织层面最不明显。根据发育中的语言能力易受脑损伤干扰的脆弱性对结果进行了讨论。
