Visual Stimulus Materials Used in Spoken Narrative Discourse Elicitation After Traumatic Brain Injury: A Scoping Review

Management of discourse is acknowledged as a critical component of speech-language pathology practice with cognitive communication after traumatic brain injury (TBI). This scoping review aimed to collate the visual materials that are being used in empirical research for spoken narrative elicitation post-TBI, in both assessment and treatment contexts. We aimed to examine the format, structure, and sources for visuals used. Discourse analyses were also investigated. The research was conducted and reported as per the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews between September 26, 2023, and March 1, 2024. Four electronic databases were searched for peer-reviewed original research studies reporting spoken narrative tasks using visual elicitation stimuli after TBI. Secondary searches of backward and forward citations were also undertaken. Of the 1,461 studies found in the search, 60 studies were eligible for data extraction. Eleven visual stimuli were used in 51 of the studies to elicit narratives. The visual stimulus reported in the highest number of studies was The Flowerpot Incident, a six-picture black-and-white picture sequence. Overall, the most frequently used format was a wordless storybook, analyzed most frequently at the macrostructural level. Research studies are using picture sequences or wordless storybooks to elicit discourse samples after TBI. This contrasts with a recent survey of clinical practice with discourse post-TBI, where The Cookie Theft picture was most reported in use (Steel et al., 2024). We discuss the relevance of findings in relation to recent INCOG 2.0 guidelines (Togher et al., 2023) and speech-language pathology practice, and make recommendations for clinical and research future directions. https://doi.org/10.23641/asha.28098113.