Question Use in Conversational Discourse Among Individuals With and Without Traumatic Brain Injury

This study investigated patterns of question use in conversation among individuals with traumatic brain injury (TBI) by analyzing the frequency, types, and social actions of the questions.

Questions from conversational discourse transcripts of 54 individuals with TBI and 49 age- and education-matched healthy controls with no brain injury (NBI) were extracted and coded by question type. Coded question types included either formal (polar [yes/no questions], content [wh-questions], alternative [either-or questions]) or functional questions, with additional coding for social actions (e.g., requests for information, repair initiation). Group-level tests (chi-square, Mann-Whitney U); individual-level mixed-effects models controlling for age, education, sex, and employment status; and ordinary least squares regression analyses examining individual differences in question rate at the participant level were conducted.

Both analytical approaches revealed that individuals with TBI showed significantly reduced use of polar questions when compared to individuals with NBI. Individuals with TBI showed higher proportions of content questions (32.5% vs. 20.3%), functional questions (17.6% vs. 10.2%), and questions used to initiate repair in conversations (10.4% vs. 4.2%), although these differences were not statistically significant after correction for multiple comparisons.

Individuals with TBI produced a significantly lower proportion of polar questions than individuals with NBI. Group differences in other question types and the frequency of repair-oriented questions did not remain statistically significant after correction for multiple comparisons. Future experimental study is warranted to confirm the question use patterns and investigate the functional impact of these differences on conversation effectiveness.