Abstract
<p>Background: Social communication impairments after traumatic brain injury (TBI) affect a range of skills required for effective conversation. We examined how adults with TBI adjust their communication when speaking to multiple communication partners with variable shared knowledge (i.e., multiparty audience design).Method: 30 adults with moderate-severe TBI and 30 non-injured comparison (NC) participants played a referential communication game to assess multiparty audience design. In the Sorting phase, participants (the “Director”), described abstract images to two trained research assistant “Matchers” who sorted the same images in a matching order. They sorted the images four times, establishing shared labels for the images. In a later Test phase, we manipulated Matcher knowledge across three conditions: participants described the images again to groups of two Matchers who were either a) both knowledgeable about the image labels, b) both naïve, or c) mixed. We examined participants’ adjustments in expression length, definite reference, and disfluency across Sorting phase rounds and Test phase conditions.Results: In the Sorting phase, the TBI group showed reduced gains in referential efficiency over the four rounds of the game compared to non-injured peers. At Test phase, the TBI group significantly adjusted their spoken language for groups with one or more naïve listeners (i.e., longer expressions, more disfluencies, and fewer definite references), but the magnitude of these effects was significantly smaller than the NC group.Conclusions: Participants with TBI showed reduced spoken language adjustment for multiparty audience design, increasing risk for disruptions in navigating group communication in work, school, and interpersonal relationships.</p>