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Updated: Mar 29, 2026

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 16, 2011
Linking inter- and intra-sentential processes for narrative production following traumatic brain injury: Implications
Richard K Peach1, Carl A Coelho2
1Rush University Medical Center, Departments of Communication Disorders & Sciences, Neurological Sciences, and Otolaryngology/Head & Neck Surgery, 1018B Armour Academic Center, 600 South Paulina Street, Chicago, IL, 60612 USA.
Abstract:
Some suggest that traumatic brain injury (TBI) produces dissociation between the macrolinguistic and microlinguistic levels of discourse production. This assumption is based primarily on studies that have found preserved intersentential cohesion and/or intra-sentential processing in narratives produced by these individuals. However, few studies exist, if any, that have investigated the relationship between these processes in TBI speakers who do demonstrate such microlinguistic impairments. This study investigated the relationship between impairments of intersentential cohesion and intra-sentential processing in the discourse of 15 speakers with severe TBI. The results demonstrated a significant relationship between the production of cohesive ties and instances of intra-sentential impairment that suggests that utilization of resources for adequate cohesion appears to negatively affect intra-sentential processing following TBI. We propose that macrolinguistic and microlinguistic processes are not independent of one another, as has been proposed, but share cognitive resources that support the planning and production of both local (microlinguistic) and long-distance (macrolinguistic) relationships expressed through discourse.
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