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This study presents a method for assessing subjective organization (SO) after brain injury and techniques for planning cognitive rehabilitation therapy based on the survivor's SO ability. Eighty-seven college students, 50 persons with traumatic brain injury (TBI), and 30 participants with specific learning disability (SLD) learned two overlapping lists of unrelated nouns in which half of the second list were words that the person had learned on the first list. The study assessed whether different patterns of recall for the overlapping words versus the new words on the second list would discriminate persons with brain injury relative to college students and persons with SLD. The results indicated that college students and the SLD participants showed significantly diminished recall of overlapping words on the second list. However, the TBI participants showed significantly improved recall of the overlapping words. The results indicated that this task provides a simple diagnostic assessment of a participant's SO ability. The results also suggested that a TBI survivor's level of SO may moderate the success of prevocational cognitive rehabilitation therapies.

BACKGROUND: There is a dearth of systematic studies of expressive writing disorder (EWD) in persons with Traumatic Brain Injury (TBI). It is unclear if TBI survivors' written expression differs significantly from that experienced by persons with learning disabilities. It is also unclear which cognitive or neuropsychological variables predict problems with expressive writing (EW) or the EWD. OBJECTIVE: This study investigated the EW skill, and the EWD in adults with mild traumatic brain injuries (TBI) relative to those with learning disabilities (LD). It also determined which of several cognitive variables predicted EW and EWD. METHODS: Principle Component Analysis (PCA) of writing samples from 28 LD participants and 28 TBI survivors revealed four components of expressive writing skills: Reading Ease, Sentence Fluency, Grammar and Spelling, and Paragraph Fluency. RESULTS: There were no significant differences between the LD and TBI groups on any of the expressive writing components. Several neuropsychological variables predicted skills of written expression. The best predictors included measures of spatial perception, verbal IQ, working memory, and visual memory. CONCLUSIONS: TBI survivors and persons with LD do not differ markedly in terms of expressive writing skill. Measures of spatial perception, visual memory, verbal intelligence, and working memory predict writing skill in both groups. Several therapeutic interventions are suggested that are specifically designed to improve deficits in expressive writing skills in individuals with TBI and LD. Language: en