JCPSLP Vol 16 no 3 2014_FINAL_WEB

Research

“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

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).

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

KEYWORDS SOCIAL COMMUNICATION TRAUMATIC BRAIN INJURY ADOLESCENCE PRAGMATICS THIS ARTICLE HAS BEEN PEER- REVIEWED

Jessica Drummond (top), Michael Curtin (centre) and Lucie Shanahan

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JCPSLP Volume 16, Number 3 2014

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