Treatment of Metaphor Interpretation Deficits Subsequent to Traumatic Brain Injury

Objective: To improve oral interpretation of metaphors by patients with traumatic brain injury (TBI). Design: Both single subject experimental design and group analysis. Setting: Patients' homes. Participants: Eight adult patients with moderate to severe traumatic brain injury sustained 3 to 20 years before testing. Intervention: The Metaphor Training Program consisted typically of 10 baseline sessions, 3 to 9 1-hour sessions of structured intervention, and 10 posttraining baseline sessions. Training used extensive practice with simple graphic displays to illustrate semantic associations. Main Outcome Measures: Quality of orally produced metaphor interpretation and accuracy of line orientation judgments served as dependent measures obtained during baseline, training, posttraining, and at a 3- to 4-month follow-up. Untrained line orientation judgments provided a control measure. Results: Group data showed significant improvement in metaphor interpretation but not in line orientation. Six of 8 patients individually demonstrated significant improvement in metaphor interpretation. Gains persisted for 3 of the 6 patients at the 3- to 4-month follow-up. Conclusion: The Metaphor Training Program can improve cognitive-communication performance for individuals with moderate to severe traumatic brain injury. Results support the potential for treating patients' residual cognitive-linguistic deficits.