Research Article Attentional Orienting and Disfluency-Related Memory Boost Are Intact in Adults With Moderate-Severe Traumatic Brain Injury

Purpose: Traumatic brain injury (TBI) is associated with a range of cognitivecommunicative deficits that interfere with everyday communication and social interaction. Considerable effort has been directed at characterizing the nature and scope of cognitive-communication disorders in TBI, yet the underlying mechanisms of impairment are largely unspecified. The present research examines sensitivity to a common communicative cue, disfluency, and its impact on memory for spoken language in TBI. Method: Fifty-three participants with moderate-severe TBI and 53 noninjured comparison participants listened to a series of sentences, some of which contained disfluencies. A subsequent memory test probed memory for critical words in the sentences. Results: Participants with TBI successfully remembered the spoken words (b = 1.57, p < .0001) at a similar level to noninjured comparison participants. Critically, participants with TBI also exhibited better recognition memory for words preceded by disfluency compared to words from fluent sentences (b = 0.57, p = .02). Conclusions: These findings advance mechanistic accounts of cognitivecommunication disorder by revealing that, when isolated for experimental study, individuals with moderate-severe TBI are sensitive to attentional orienting cues in speech and exhibit enhanced recognition of individual words preceded by disfluency. These results suggest that some aspects of cognitive-communication disorders may not emerge from an inability to perceive and use individual communication cues, but rather from disruptions in managing (i.e., attending, weighting, integrating) multiple cognitive, communicative, and social cues in complex and dynamic interactions. This hypothesis warrants further investigation.