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Describing conversations between individuals with traumatic brain injury (TBI) and communication partners following communication partner training: Using exchange structure analysis

Abstract Primary objective: To describe conversational discourse change after joint communication training for individuals with TBI and their everyday communication partners (ECPs), as compared to untrained controls. Hypothesis: Joint training would lead to significantly greater changes in the discourse behaviour of trained participants. Methods and procedures: In this multi-centre non-randomized controlled trial, 29 participants with severe TBI and their ECPs were allocated to either the JOINT training or CONTROL group. Social communication training aimed to train ECPs to better support their partner with TBI to produce more effective conversations. Pre- and post-training casual conversations were compared using exchange structure analysis (ESA) and productivity analysis. Results: ESA and productivity analysis revealed significant change in the use of testing moves by trained ECPs and significant change in productivity by trained participants with TBI. ESA facilitated development of discourse profiles (excessive or impoverished) for participants with TBI, which distinguished the groups at baseline. Conclusions: This study extends one’s understanding of individual discourse styles in people with TBI. The impact of different discourse styles on group outcome studies has been highlighted. These discourse findings may facilitate goal-setting in social skills intervention after TBI, with focus on training ECPs to support people with TBI in conversations.