Can high-level inferencing be predicted by Discourse Comprehension Test performance in adults with right hemisphere brain damage?

BACKGROUND: Adults with right hemisphere brain damage (RHD) can have considerable difficulty in drawing high-level inferences from discourse. Standardised tests of language comprehension in RHD do not tap high-level inferences with many items or in much depth, but nonstandardised tasks lack reliability and validity data. It would be of great clinical value if a standardised test could predict performance on high-level inferencing measures. AIMS: This study addressed whether performance of adults with RHD on the Discourse Comprehension Test (DCT; Brookshire & Nicholas, 1993) could predict their performance on a nonstandardised measure of high-level inference in narrative comprehension. METHODS #ENTITYSTARTX00026; PROCEDURES: This study used a within-group correlational design. Participants were 32 adults with damage limited to the right cerebral hemisphere, as a result of cerebrovascular accident. Half of the participants were male and half female. Participants averaged 64.5 years of age and 14.2 years of education. Participants listened to narrative stimuli and to yes/no questions about each narrative. Each DCT narrative was followed by the standard 8 questions about stated or implied main ideas or details. The high-level inferencing task contained 6 narrative scenarios from Winner, Brownell, Happé, Blum, and Pincus (1998). Each scenario describes a character who commits a minor transgression and later denies it. Two versions of each story are designed to induce different interpretations of the character's denial. In one version, the character tells a white lie when he is unaware that he was seen committing the transgression. In the other versions, when aware of being seen, the character makes an ironic joke. The narratives were interrupted periodically by comprehension questions. Four Pearson correlation coefficients were computed, between each of two DCT predictor variables (total accuracy for all comprehension questions; accuracy on questions about implied information) and two indicators of high-level inferencing (total accuracy to answer experimental questions in Joke stories; total accuracy to answer experimental questions in Lie stories). OUTCOMES #ENTITYSTARTX00026; RESULTS: Correlation coefficients were low-to-moderate, and nonsignificant. CONCLUSIONS: Performance on the DCT by adults with RHD did not predict their high-level inferencing performance, as measured in this study. The issue that motivated this study should be pursued further in light of the potential advantages to be gained, for both clinical and research purposes. It may be, however, that specific measures of various types of high-level inferencing will need to be developed and validated.