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

Purpose: The researchers sought to determine the extent to which individuals with and without traumatic brain injury (TBI) integrate gestural and verbal information when interpreting indirect requests. Method: Eighteen adults with cognitive-communication impairments secondary to severe TBI and 18 neurologically-intact adults viewed video vignettes depicting actors conversing in everyday contexts and concluding with indirect requests. Indirect requests 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. Results: Statistical analysis revealed comparable performance patterns across 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. Conclusion: Overall, results suggest that individuals with brain injury benefit from a combination of gestural and verbal information when interpreting indirect requests; however, interpretations by individuals with brain injury are less accurate than interpretations made by neurologically-intact individuals. Incorrect responses tend to be abstract rather than literal and inaccurate with regard to a speaker's intended meaning.