Pia Carusone told The Arizona Republic it's difficult to assess Giffords' situation.
"We do a lot of inferring with her because her communication skills have been impacted the most," Carusone said in a report published Thursday. "If you think of it as someone who is able to communicate with you clearly, it is easy to test them. You can ask them a series of questions, and you can get clear answers back. Whereas with Gabby, what we've been able to infer and what we believe is that her comprehension is very good. I don't know about percentage-wise or not, but it's close to normal, if not normal."
Carusone said Giffords, D-Ariz., who sustained critical injuries to the head during the shooting spree that left 13 dead and six wounded, is still unable to communicate in complete sentences.
"She is borrowing upon other ways of communicating. Her words are back more and more now, but she's still using facial expressions as a way to express," Carusone told the newspaper. "Pointing. Gesturing. Add it all together, and she's able to express the basics of what she wants or needs. But, when it comes to a bigger and more complex thought that requires words, that's where she's had the trouble. …
"When she is trying to come up with a word or a sentence and she's clearly struggling, putting everything she's got into it, and sometimes she's not successful. When she is, there's a relief that comes across her face that she has found the word. But when she can't come up with that, it is absolute frustration."
Asked about Giffords' future in politics, Carusone said no decisions will be made in the immediate future.
"The only firm timetable is the legal timetable, and that is May of 2012, when petitions are due for re-election," Carusone said. "That's a firm timetable. Short of that, we'd love to know today what her life will be, what her quality of life will be, which will determine whether she'll be able to run for office and all sorts of other things involving her life. But we just don't know yet. …
"We're about halfway through the process that is the most important time for recovery. Patients recover for the rest of their lives, but it's the first 12 to 14 months that you make the biggest jumps. … In the doctors' minds, it's not even close to when you begin to make the final prognosis for the quality of her life."