Further evidence on topic use following right hemisphere brain damage: Procedural and descriptive discourse

Abstract

Background : In a previous report of topic use in semi-structured conversations (Brady, Mackenzie, & Armstrong, 2003), we did not find the often-described gross topic deficit in participants with right hemisphere brain damage (RHBD) when compared to non-brain-damaged participants (NBD). Discourse genre is known to affect the production of discourse, so topic use was further explored in this population using procedural discourse and picture description tasks. Aims : To explore topic coherence and management in procedural and descriptive discourse in individuals with RHBD as a result of stroke. Methods & Procedures : Four discourse samples (three procedural and one picture description) were elicited from 17 individuals with RHBD at 1 and 6 months post-stroke and from a matched NBD group of 51. The samples were transcribed and analysed in terms of topic coherence and management. T-tests were used to compare the groups on a variety of measures of topic use. Intra-rater, inter-rater, and test–retest reliability were evaluated. Outcomes & Results : As in our study of topic use in semi-structured conversations, no widespread or consistent difference between NBD and RHBD individuals was indicated in their procedural and descriptive discourse data. Some differences in subdivision of topic structure and in the use of fillers may be worthy of further exploration. There was no notable task effect. Conclusions : Again there is little support in our data for the perception that, as a group, people with RHBD experience significant topic use deficits. Over seven discourse tasks, including semi-structured conversation, procedures, and picture description, no consistent topic use deficit was noted among the individuals with RHBD in our analyses. Reasons for this apparent lack of difference/difficulty are discussed. Clinical implications and some indications for possible further experimental study in the area of topic use in people with RHBD post-stroke are described.