Performing Cookie Theft Picture Content Analyses to Delineate Cognitive-Communication Impairments.
Cognitive-communication impairments associated with acquired brain injury (ABI) are often identifiable through performance of discourse analyses. Determining appropriate elicitation procedures and having sufficient time to learn procedures, transcribe samples, and perform analyses are factors limiting clinicians’ use of discourse analyses for this purpose, however. The intent of this study was to determine whether a simple and efficient method of using Cookie Theft picture descriptions could be devised to discriminate normal and abnormal language performance and to identify factors contributing to the cognitive-communication impairments of survivors of ABI. Data were language samples generated by 20 adults with and 20 adults without ABI. Sample analysis revealed five patterns distinguishing ABI survivors: (a) generating inefficient discourse, (b) conveying inaccuracies, (c) repeating oneself, (d) generating multiple dysfluencies, and (e) producing a paucity of speech. Seventeen of the 20 participants with ABI displayed behaviors consistent with one or more of these patterns, whereas no participants without ABI demonstrated comparable behaviors. The findings suggest that Cookie Theft picture descriptions yield language samples that are relatively short, have predictable content, can be analyzed in consistent and reliable manners, and can serve to identify specific profiles of factors contributing to cognitive-communication impairments. The communication of people with acquired brain injury (ABI) differs from that of people without neurological injuries. As early as 1984, Milton, Prutting, and Binder stated that survivors of brain injuries “talk better than they communicate” (p. 114), meaning they often speak fluently and without an unusual number of grammatical errors but fail to communicate their intents effectively and efficiently. Professionals label this type of language disorder as cognitive-communication impairment and define it as a decreased ability to perform language-based activities because of a deficit in one or more cognitive functions underlying communication (e.g., attention, executive functioning, memory, etc.) (ASHA, 1991; Coelho, 2007).