The MAKRO Screening – an assessment tool for discourse deficits in adults with dysexecutive symptoms following TBI

ABSTRACT

Introduction

Discourse impairments are common sequelae following TBI. Even though handling discourse is thought to be a basic requirement for social participation and quality of life, few test procedures to assess discourse disorders have been developed so far.

Objective

The main aim of this prospective cohort study was to evaluate the use of the MAKRO Screening for detecting deficits in discourse production and reception in a group of participants with TBI in the post-acute and chronic phase and their relation to executive functions (EF) and severity of brain injury.

Method

Twenty individuals with TBI and a control group of healthy speakers performed on the MAKRO and on tests of EF (Regensburger Verbal Fluency Test; Tower of London; WAIS-IV digit span index). Group performance was evaluated on the basis of a scoring system and qualitative discourse analysis with focus on main concepts and coherence. Further, MAKRO scores were correlated with measures of EF.

Outcomes

Individuals with TBI demonstrated significantly poorer performance within all MAKRO subtests. Discourse analysis revealed fewer main concepts and more frequent use of thematically inappropriate utterances. Performance can be partly explained by severity of initial injury and executive disorders. MAKRO presents a reliable and functional measure for discourse impairments.

KEYWORDS:

• TBI
• discourse assessment
• executive impairments
• cognitive communication disorder
• macrostructural analysis

Disclosure statement

No potential conflict of interest was reported by the author(s).

Declarations of Interests

The authors report no declarations of interests.

Additional information

Funding

This work was supported by the Federal Ministry of Education and Research (BMBF) under Grant number BMBF 01UL1903X.