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Comprehension of indirect requests by adults with severe traumatic brain injury: Contributions of gestural and verbal information

Kelli J Evans, University of Nebraska - Lincoln


The purpose of this investigation was to determine the extent to which individuals with or without traumatic brain injury (TBI) incorporate gestural and verbal information when interpreting indirect requests. Eighteen adults with severe TBI and eighteen neurologically-intact adults viewed 12 video vignettes depicting actors conversing in everyday communicative contexts. Each vignette concluded with an indirect request. The vignettes were presented in three conditions: verbal information only (VO), gestural information only (GO), and combined verbal and gestural information (VG). Following each vignette, participants answered prediction and interpretation probes to ascertain their understanding of the indirect requests. Responses to both probe questions were combined to form a single comprehension score. Computation of a 2 X 3 mixed-groups factorial ANOVA revealed the same performance pattern across both participant groups, with significantly better performance in the VG condition than either the VO or GO conditions; however, neurologically-intact participants performed significantly better than participants with TBI in all conditions. Further analysis involved categorization of incorrect responses to determine the basis for participant errors. In the VO and VG conditions, most incorrect prediction probe responses provided by members of both participant groups were feasible predictions in that they referenced possible future actions but with no mention of the action implied by indirect request; in contrast, most error responses in the GO condition were contextual in nature, referencing the context but not indirect request. Incorrect interpretation probe responses by neurologically-intact individuals most frequently revealed incorrect interpretation of the indirect request in the VO condition, contextual reference in the GO condition, and literal interpretation in the VG condition. In contrast, most incorrect responses provided by participants with TBI were literal or incorrect in the VO and VG conditions and contextual in the GO condition. The results suggest that survivors of severe TBI with cognitive-communication impairments have poor understanding of indirect requests. Although simultaneous provision of information through gestural and verbal channels results in better comprehension than provision of information through either modality in isolation, survivors of TBI are likely to perform poorly in social situations that require the interpretation of indirect requests.^

Subject Area

Health Sciences, Rehabilitation and Therapy|Health Sciences, Speech Pathology

Recommended Citation

Evans, Kelli J, "Comprehension of indirect requests by adults with severe traumatic brain injury: Contributions of gestural and verbal information" (2008). ETD collection for University of Nebraska - Lincoln. AAI3315879.