Interactive Alignment After Communication Partner Training in Adults With Traumatic Brain Injury

Purpose: Adults with moderate–severe traumatic brain injury (TBI) often have significant communication challenges, particularly in interpersonal conversations. Most research aiming to understand these challenges has used static measures of behaviors shown by the person with TBI. Conversation is a dynamic, self-organizing, interactive communication genre, however, and static measures cannot capture those dynamics. We sought to advance understanding of conversational dynamics after TBI by characterizing partners' interactive alignment (IA), wherein two people begin to use the same words, gestures, and other communication features over time. Specifically, we asked how adults with TBI and their communication partners synchronized their word choices with each other and if that synchrony changed after the pair completed communication partner training (CPT). Method: We analyzed de-identified transcripts of purposeful conversation between 18 adults with TBI and their communication partners, pre- and post-CPT, using recurrence quantification analysis. Results: Contrary to our prediction that IA would increase, there was no significant change in IA but a decrease in determinism, as dyads used words and phrases in more diverse ways after training. Conclusion: These results show how IA can be used in treatment studies and suggest ways that CPT could affect dynamics of conversations. Supplemental Material: https://doi.org/10.23641/asha.31445446