Abstract
Everyday discourse is a common context for the difficulties experienced by people
with acquired neurogenic communication disorders. While evidence is present for effective
manualized interventions that directly improve the discourse skills in aphasia, this
remains limited for people with cognitive–communication disorders. This proof of concept
study used an in-depth case series approach to trial the NARNIA discourse intervention
used successfully in aphasia to explore transferability of the protocol and effectiveness
in people with cognitive–communication impairments. Four female participants with
mild to moderate cognitive–communication difficulties (mean age: 52.8 years)—two following
traumatic brain injury and two following vascular episodes—were recruited. Modifications
were made to the protocol to accommodate the participant group. Cognitive-linguistic
abilities, self-perceptions of communicative behavior and psychosocial recovery, and
repeated discourse measures were assessed pre-, immediately post, and at 4 weeks following
intervention, to measure treatment effectiveness. Significant gains were observed
in quantity of output, informativeness, and efficiency of information across both
everyday and narrative discourse genres for all participants. However, in contrast
to previous studies, minimal change was observed in discourse macrostructure elements.
Significant improvements were also observed in memory or working memory for two participants.
This study provides preliminary evidence for the effectiveness of using an adapted
protocol with people with cognitive–communication disorders, highlighting how adaptations
may address the cognitive needs of this diverse clinical group.
Keywords
discourse intervention - multilevel intervention - cognitive–communication - aphasia
