Research
JCPSLP
Volume 16, Number 3 2014
127
KEYWORDS
SOCIAL
COMMUNICATION
TRAUMATIC
BRAIN INJURY
ADOLESCENCE
PRAGMATICS
THIS ARTICLE
HAS BEEN
PEER-
REVIEWED
“Can you speak
English?”
The effects of social communication impairment on the life
of an adolescent with traumatic brain injury
Jessica Drummond, Michael Curtin and Lucie Shanahan
Adolescence is an important period of psychosocial
development involving the interaction of biological, cognitive,
and socio-emotional processes (Santrock, 2010). Adolescents
are developing their own identity and learning the rules of
advanced social interaction as they experience an increase
in communicative contexts and partners (Forgas, Vincze, &
László, 2013; Mikami, Szwedo, Allen, Evans, & Hare, 2010).
The development of advanced social interactions is
underpinned by the four maxims of Grice’s Cooperative
Principle of Conversation (Grice, 1975; Kleinke, 2010):
1. Quantity: the giving of as much information as required
without providing excessive detail;
2. Quality: the provision of information that is believed to be
the truth and for which there is adequate evidence;
3. Relation: a conversation involves all participants making
relevant contributions; and
4. Manner: contributions are given in a brief and orderly
manner, avoiding obscure and ambiguous expressions.
Ciccia and Turkstra (2002) suggested that abnormalities
in cohesion, communication burden, and adequacy
of responses are violations of the maxims of quantity,
relation and manner. These abnormalities are frequently
experienced by people with a traumatic brain injury
(TBI) and can lead to perceptions of these people as
ineffective communicators (Douglas, Bracy, & Snow, 2007;
Marini, Galetto, Zampieri, Vorano, Zettin, & Carlomagno,
2011). Given that the cognitive skills underlying social
communication are still developing during the teenage
years, it follows that adolescents with TBI can have difficulty
mastering effective exchanges of information (Bogart
et al., 2012; Burnett et al., 2011). As a result, they may
ultimately be at a disadvantage when communicating with
their peers because of the reciprocal relationship between
social communication and social competence (Hawley &
Newman, 2010). This could lead to a teenager with TBI
experiencing social isolation (Bogart et al., 2012).
There is a substantial body of research investigating
social communication impairment after a TBI but much of
this has focused on adults. While literature describing the
common sequelae of childhood TBI is now readily available,
there is a relative dearth of empirical literature describing
studies of social communication impairment following
childhood TBI (Anderson, Beauchamp, Rosema, & Soo,
2013). A small number of publications have documented
cognitive and communication impairments post-injury
that result in social dysfunction (e.g: Anderson, Catroppa,
Morse, Haritou, & Rosenfeld, 2009) but the majority of
studies are based on parent and teacher ratings rather
During adolescence teenagers learn the rules
of more sophisticated social interaction. For
teenagers with traumatic brain injury (TBI)
learning these rules is difficult because of the
impairment to cognitive processes underlying
social communication. In the case study
presented in this paper, the social
communication impairment experienced by a
teenage girl with TBI was explored using
semi-structured interviews with the
adolescent, her mother, and a friend. Analysis
revealed that communication breakdown was
a common consequence of the teenager’s
social communication impairment. Strategies
to compensate for the communication
impairment were used by her parents and
friends to limit the extent of the
communication breakdown, but no strategies
were in place to improve the adolescent’s
social communication interactions. It is
proposed that a greater focus on strategies
to develop her social communication skills
would be beneficial, particularly as the
adolescent becomes older and moves on
from the protective environments of her
home and school.
S
ocial communication involves the use of language in
interpersonally appropriate ways to influence people
and interpret events (Olswang, Coggins, & Timler,
2001). According to Turkstra (2000) it is a way to develop
and express identity and to convey information, as well as
provide a medium for the growth of social skills. Successful
social communication requires an understanding of
relationships and people (Togher, Power, Tate, McDonald, &
Rietdijk, 2010). It is also dependent on the co-development
of many cognitive processes, such as memory, planning,
organisation, and perspective-taking (Burnett, Sebastian,
Cohen Kadosh, & Blakemore 2011; Whelan & Murdoch,
2006), which continue to mature during the adolescent
years (Bogart, Togher, Power, & Docking, 2012; Burnett et
al., 2011; Sim, Power, & Togher, 2013; Scherf, Behrmann,
& Dahl, 2012).
Jessica
Drummond (top),
Michael Curtin
(centre) and
Lucie Shanahan
