A new perspective on the relationship between communication impairment and disempowerment following head injury in information exchanges

Communication disorders following closed head injury (CHI) have been described in terms of the impairments that affect the individual's ability to produce words, sentences and discourse. Rather than focusing on impairments, this paper examines the disability experienced by one CHI subject. Comparison is made between M.R., who has sustained a severe CHI, and his brother, S.R. during four telephone calls to their mother, a therapist, the police and the bus timetable information service, using exchange structure analysis. Results indicated that social distance between communication partners, and the nature of the interaction, affected the language choices made by both subjects. The communication partner was found to have a profound impact on the way each subject was able to negotiate each interaction. Results are discussed in terms of the ways in which therapists and society in general view disability and how this shapes social encounters, which in turn affects the outcomes which are made possible for people with CHI.