Communication ability following right brain damage: the family perspective

This investigation aimed to determine whether right brain damage affects everyday communication function. Thirty-five subjects with right hemisphere brain damage were evaluated by a family member on the 16 items of the Communicative Effectiveness Index (Lomas et al., 1989) plus 5 additional items, at 1,3,6, and 12 months poststroke. Performance on a set of clinical communication measures indicated clear communication impairment to be present in 23 of these subjects. For these 23 subjects, reduction in communication ability from prestroke level was usually judged by family members to be minimal, but at least 25% identified impairment in aspects of discourse such as conversational participation, topic and referncing, in following directions, understanding writing, and communicating emotions. The family members' assessments indicated improvement in communication skills up to the 6-month stage, followed by reduction to a level not significantly different from the 1-month ratings. Clinical assessments showed steady improvement throughout, with statistically significant changes between 1 and 12 months and 1 and 6 months. Correlation between family and clinical assessment was significant only at the 3-month point.

Family member assessment is a potentially important source of information about naturalistic communication function. To increase its usefulness, future developments in methodology must include the means of gauging the reliability of proxy reports.