ABS 052: Investigating the Relationship Between Cognition and Written Discourse in Adolescents with Mild Traumatic Brain Injury

Tejaswani Datla ¹, Dr. Manaswita Dutta ²

¹ Rice University
² Portland State University

The Van Wickle Journal (2026) Volume 2, ABS052

Introduction: The consequences of mild traumatic brain injuries (mTBI) are often underestimated, yet their effects can persist long after the initial injury, leading to cognitive, communicative, emotional, psychosocial, and physical impairments. Assessment of mTBI-related symptoms becomes particularly critical for adolescents and young adults as this can have debilitating consequences on their academic performance and life success. Individuals aged 16 and older engage in jobs and activities that heavily depend on cognition and communication skills, such as time management, conversation, negotiation, attention, and executive functioning. Recently, there has been increasing interest in using ecologically valid tasks such as discourse analysis to improve the assessment of cognitive-communication skills in individuals with mTBI. However, most research has focused primarily on spoken language with nominal research on the utility of written language production even though discourse production in both modalities are critical for successful life participation. Written discourse analysis offers a valuable means of evaluating naturalistic language use and the underlying cognitive processes that support discourse execution.

This study aimed to examine differences in written discourse and cognitive performances between young adults diagnosed with mTBI and age-matched peers without brain injury. Additionally, it investigated the relationship between cognitive performance and written discourse production in both groups. Based on evidence from prior TBI research, it was hypothesized that persons with a history of mTBI will perform significantly differently in terms of their cognitive and discourse performances compared to those without a history of brain injury. Further, given that cognition is intricately linked with discourse abilities, we expected to see significant correlations between cognitive scores and written discourse performances of persons with mTBI compared to less relevant correlations among those without mTBI.

Methods: The study included data from 23 individuals with a history of mTBI (mean age = 20.5 ± 3.1 years; time post injury = 2.4 ± 3.65 years) and age-matched 18 healthy controls (mean age = 23.5 ± 6.8 years) from the TBIBank English Stockbridge Corpus database (tbi.talkbank.org; MacWhinney et al., 2011; Stockbridge, & Newman, 2019). All participants completed: (1) a cognitive task battery assessing executive functioning, including letter fluency, backward digit span, and flanker tasks, and (2) a written discourse storytelling task based on the Cinderella picture book. From the downloaded discourse transcripts, microlinguistic (i.e., productivity, lexical, semantic, and syntactic) and macrolinguistic (i.e., local and global coherence) variables were extracted and analyzed. Parametric statistics were employed to evaluate group differences and correlations between cognitive and discourse outcomes.

Results: There was a significant positive relationship between FAS score and total communication units for individuals with mTBI. Interestingly, although the accuracy on the Flanker task was comparable for both groups, individuals in the mTBI group took much longer (avg. 116.43s) to complete the task compared to controls (avg. 68.31s). Within the mTBI group, better local coherence of narratives significantly linked to higher Flanker task accuracy and response times. In contrast, the NHCs showed a positive correlation between their Flanker accuracy scores and global coherence, mTBI group showed a negative relationship, demonstrating a need for a more comprehensive tests.

Discussion: These preliminary results call for future research with a larger sample size to validate these considerations. Initial findings from our study suggest that cognitive skills, in particular, executive functioning, are closely associated with written discourse performance in both individuals with and without brain injury (e.g. coherence being a measurement for inhibition from the Flanker task). Furthermore, this study emphasizes the need to routinely incorporate complex cognitive and language tasks in both research and clinical practice to more accurately and sensitively assess the higher-level challenges faced by individuals with mTBIs, thus improving diagnostic accuracy and treatment effectiveness for this population.