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Hill E, Whitworth A, Boyes M, Claessen M. An international survey of assessment and treatment practice for discourse in paediatric Acquired Brain Injury. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 25:577-588. [PMID: 35642559 DOI: 10.1080/17549507.2022.2079724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE Guidelines recommend routine discourse assessment and treatment in paediatric acquired brain injury (ABI) but provide little guidance for clinical practice. The degree to which this has influenced the nature of discourse assessment and treatment in clinical practice has not been examined in detail. METHOD Speech-language pathologists working in paediatric ABI (clients aged <18 years) in Australia, New Zealand, the UK, the USA, Canada, and the Asia Pacific region were invited to complete a survey of discourse assessment and intervention practices (n = 77). RESULT Clinicians from Australia and New Zealand comprised over half of a responses (53%). The largest proportion had over 10 years' experience (60%), worked in the metropolitan area (58%), and with secondary school-age children (64%). Routine discourse assessment was undertaken by 80% of respondents, focussing on a limited range of genres. No preferred intervention approach was identified. One-quarter of clinicians routinely considered holistic factors during clinical decision-making. Limited normative data and treatment evidence, insufficient time and training were identified as clinical barriers. CONCLUSION Assessment practices were consistent with guidelines, yet interventions were highly variable, reflecting limited evidence, client heterogeneity, time constraints, and limited training. A biopsychosocial approach to practice was evident, yet a focus on impairment level factors was prominent. Findings support the need for standardised discourse assessment and discourse intervention methods. Translation into practice guidelines would promote consistency and confidence in clinical practice.
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Affiliation(s)
- Elizabeth Hill
- Curtin School of Allied Health, Curtin University, Perth, Western Australia
| | - Anne Whitworth
- College of Health and Medicine, University of Tasmania, Launceston, Tasmania, and
| | - Mark Boyes
- School of Population Health, Curtin University, Perth, Western Australia
| | - Mary Claessen
- Curtin School of Allied Health, Curtin University, Perth, Western Australia
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Crumlish L, Wallace SJ, Copley A, Rose TA. Exploring the measurement of pediatric cognitive-communication disorders in traumatic brain injury research: A scoping review. Brain Inj 2022; 36:1207-1227. [PMID: 36303459 DOI: 10.1080/02699052.2022.2111026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To synthesize information about the constructs measured, measurement instruments used, and the timing of assessment of cognitive-communication disorders (CCDs) in pediatric traumatic brain injury (TBI) research. METHODS AND PROCEDURES Scoping review conducted in alignment with Arksey and O'Malley's five-stage methodological framework and reported per the PRISMA extension for Scoping Reviews. Inclusion criteria: (a) cohort description, case-control, and treatment studies; (b) participants with TBI aged 5-18 years; (c) communication or psychosocial outcomes; and (d) English full-text journal articles. The first author reviewed all titles, abstracts, and full-text articles; 10% were independently reviewed. OUTCOMES AND RESULTS Following screening, a total of 687 articles were included and 919 measurement instruments, measuring 2134 unique constructs, were extracted. The Child Behavior Checklist was the most used measurement instrument and 'Global Outcomes/Recovery' was the construct most frequently measured. The length of longitudinal monitoring ranged between ≤3 months and 16 years. CONCLUSIONS AND IMPLICATIONS We found considerable heterogeneity in the constructs measured, the measurement instruments used, and the timing of CCD assessment in pediatric TBI research. A consistent approach to measurement may support clinical decision-making and the efficient use of data beyond individual studies in systematic reviews and meta-analyses.
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Affiliation(s)
- Lauren Crumlish
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Sarah J Wallace
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.,Queensland Aphasia Research Centre, Australia
| | - Anna Copley
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Tanya A Rose
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.,Queensland Aphasia Research Centre, Australia
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Evidence-Based Practice for the Use of Internal Strategies as a Memory Compensation Technique After Brain Injury: A Systematic Review. J Head Trauma Rehabil 2016; 31:E1-E11. [DOI: 10.1097/htr.0000000000000181] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Schaffer Y, Geva R. Memory outcomes following cognitive interventions in children with neurological deficits: A review with a focus on under-studied populations. Neuropsychol Rehabil 2015; 26:286-317. [PMID: 25730385 DOI: 10.1080/09602011.2015.1016537] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Given the primary role of memory in children's learning and well-being, the aim of this review was to examine the outcomes of memory remediation interventions in children with neurological deficits as a function of the affected memory system and intervention method. Fifty-seven studies that evaluated the outcome of memory interventions in children were identified. Thirty-four studies met the inclusion criteria, and were included in a systematic review. Diverse rehabilitation methods for improving explicit and implicit memory in children were reviewed. The analysis indicates that teaching restoration strategies may improve, and result in the generalisation of, semantic memory and working memory performance in children older than 7 years with mild to moderate memory deficits. Factors such as longer protocols, emotional support, and personal feedback contribute to intervention efficacy. In addition, the use of compensation aids seems to be highly effective in prospective memory tasks. Finally, the review unveiled a lack of studies with young children and the absence of group interventions. These findings point to the importance of future evidence-based intervention protocols in these areas.
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Affiliation(s)
- Yael Schaffer
- a Department of Psychology , The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University , Ramat Gan , Israel
| | - Ronny Geva
- a Department of Psychology , The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University , Ramat Gan , Israel
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Turkstra LS, Politis AM, Forsyth R. Cognitive-communication disorders in children with traumatic brain injury. Dev Med Child Neurol 2015; 57:217-22. [PMID: 25283953 DOI: 10.1111/dmcn.12600] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/10/2014] [Indexed: 11/28/2022]
Abstract
Children with moderate to severe traumatic brain injury (TBI) are at risk of developing cognitive-communication disorders that have devastating effects on their school life, family life, and social life. These problems can be difficult for families to describe and may be overlooked by community-based providers who are unfamiliar with TBI sequelae. To support the identification and management of cognitive-communication disorders, we review the common signs and symptoms of these disorders in children with TBI and discuss principles of assessment and intervention.
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Affiliation(s)
- Lyn S Turkstra
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI, USA
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Limond J, Adlam AL, Cormack M. A Model for Pediatric Neurocognitive Interventions: Considering the Role of Development and Maturation in Rehabilitation Planning. Clin Neuropsychol 2014; 28:181-98. [DOI: 10.1080/13854046.2013.873083] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Haslam C, Bazen-Peters C, Wright I. Errorless learning improves memory performance in children with acquired brain injury: a controlled comparison of standard and self-generation techniques. Neuropsychol Rehabil 2012; 22:697-715. [PMID: 22672015 DOI: 10.1080/09602011.2012.686820] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The principle of errorless learning has proven efficacy in helping adults and older adults with acquired memory impairment learn novel information. However, surprisingly few studies have investigated its efficacy in children. The present study addresses this omission in the literature, investigating the effectiveness of two forms of errorless learning - the established method, in which the examiner provides responses during learning, and a self-generation method, in which learners produce their own responses - each relative to the standard baseline of trial-and-error learning, in young people with acquired brain injury (ABI, n = 15) and non-injured controls (n = 15). Participants learned different word lists in each condition and their memory was tested after distraction and, subsequently, after a 20-minute delay. Not surprisingly, controls performed better than the ABI group. However, while there was no effect of learning condition for controls, in the ABI group memory performance was significantly better under errorless conditions. In contrast to findings in the adult literature, there was no difference in the efficacy of the two errorless methods, suggesting that self-generation was no better than standard examiner-generation. This study extends upon previous research to provide the first demonstration of the effectiveness of errorless methods in a group of young people with ABI.
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Ho J, Epps A, Parry L, Poole M, Lah S. Rehabilitation of everyday memory deficits in paediatric brain injury: Self-instruction and diary training. Neuropsychol Rehabil 2011; 21:183-207. [DOI: 10.1080/09602011.2010.547345] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Sullivan JR, Riccio CA. Language Functioning and Deficits Following Pediatric Traumatic Brain Injury. ACTA ACUST UNITED AC 2010; 17:93-8. [DOI: 10.1080/09084281003708852] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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A Controlled Treatment Study of Internal Memory Strategies (I-MEMS) Following Traumatic Brain Injury. J Head Trauma Rehabil 2010; 25:43-51. [DOI: 10.1097/htr.0b013e3181bf24b1] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Slomine B, Locascio G. Cognitive rehabilitation for children with acquired brain injury. ACTA ACUST UNITED AC 2009; 15:133-43. [PMID: 19489085 DOI: 10.1002/ddrr.56] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Cognitive deficits are frequent consequences of acquired brain injury (ABI) and often require intervention. We review the theoretical and empirical literature on cognitive rehabilitation in a variety of treatment domains including attention, memory, unilateral neglect, speech and language, executive functioning, and family involvement/education. Because there are more well-designed studies examining the efficacy of cognitive rehabilitation in adults with brain injury, the major findings from this body of literature are also highlighted. In addition, given that similar cognitive and behavioral concerns are often apparent in children with certain neurodevelopmental disorders, selected literature focusing on interventions for these groups of children is included. Limitations and challenges inherent in examining cognitive interventions in children with ABI are also discussed. Overall, despite the growing body of literature examining the efficacy of cognitive rehabilitation in children with ABI, there continues to be a great need to develop well-designed studies to examine the efficacy of these interventions.
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Affiliation(s)
- Beth Slomine
- Department of Neuropsychology, Kennedy Krieger Institute, 707 North Broadway, Baltimore, MD 21205, USA.
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Snow P, Powell M. Developmental language disorders and adolescent risk: A public-health advocacy role for speech pathologists? ACTA ACUST UNITED AC 2009. [DOI: 10.1080/14417040400010132] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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de Riesthal M. Treatment of Cognitive-Communicative Disorders Following Blast Injury. ACTA ACUST UNITED AC 2009. [DOI: 10.1044/nnsld19.2.58] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Abstract
Purpose: Mild traumatic brain injury (mTBI) following exposure to a blast is the signature injury of Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF). The purposes of this article are to describe the characteristics of the service members who experience blast injuries, the cognitive-communicative deficits they present, and the role of the speech-language pathologist (SLP) in managing these deficits.
Method: Demographic data for the service members who have experienced blast injuries in OIF/OEF are reviewed and reported. The literature on treating cognitive-communicative disorders following mTBI is reviewed and is discussed in the context of managing the deficits reported by service members returning from Iraq and Afghanistan.
Results and conclusions: Information regarding the effects of blast exposure on the human body continues to emerge. Data regarding the most effective treatment for cognitive-communicative deficits following blast injury are needed. For now, SLPs must rely on the best evidence from the civilian mTBI literature, clinical expertise, and the personal values of the individual with TBI to develop effective treatment programs targeting the cognitive-communicative disorders experienced by these individuals.
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Laatsch L, Harrington D, Hotz G, Marcantuono J, Mozzoni MP, Walsh V, Hersey KP. An Evidence-based Review of Cognitive and Behavioral Rehabilitation Treatment Studies in Children With Acquired Brain Injury. J Head Trauma Rehabil 2007; 22:248-56. [PMID: 17667068 DOI: 10.1097/01.htr.0000281841.92720.0a] [Citation(s) in RCA: 100] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to complete a systematic evidence-based review of published cognitive and behavioral treatment studies with pediatric subjects who have a history of an acquired brain injury (ABI). DATA SOURCES We utilized PubMed and EMBASE to search peer-reviewed journals from 1980 to 2006. DATA SELECTION Terms such as cognitive rehabilitation, speech therapy, language therapy, and behavior therapy were employed in the search and 28 studies met established criteria. DATA EXTRACTION The data extracted from each study included specific details about the cognitive or behavioral treatment, subjects, study design, outcome measurements, and treatment effectiveness. DATA SYNTHESIS The studies, involving 366 children and youth with ABI, were classified as 1 Class I study, 5 Class II studies, 6 Class III studies, and 16 Class IV studies. CONCLUSIONS Despite a limited number of studies, 2 treatment recommendations and 1 option were developed from this systematic literature search.
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Affiliation(s)
- Linda Laatsch
- Department of Neurology and Rehabilitation, University of Illinois College of Medicine, Chicago 60612, and Children's Specialized Hospital, Mountainside, NJ, USA.
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Kennedy M. Managing Memory and Metamemory Impairments in Individuals with Traumatic Brain Injury. ACTA ACUST UNITED AC 2006. [DOI: 10.1044/leader.ftr2.11142006.8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Anderson V, Catroppa C. Advances in Postacute Rehabilitation After Childhood-Acquired Brain Injury. Am J Phys Med Rehabil 2006; 85:767-78. [PMID: 16924189 DOI: 10.1097/01.phm.0000233176.08480.22] [Citation(s) in RCA: 81] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Despite traditional views, children do not necessarily recover well from brain injury. Residual functional impairments are commonly documented in physical, cognitive, educational, behavioral, and social domains and result in a significant, ongoing social and economic burden for the child's family and for the broader community. More recent acknowledgment of the serious, and often permanent, consequences of acquired brain injury in childhood has been paralleled by rapid advances in evidence-based, acute medical care and diagnostic technology. In contrast, child-based postacute rehabilitation and long-term interventions are less well developed. To date, child services have borrowed substantially from adult models, combining both direct therapies and interdisciplinary approaches. Despite their proliferation, and strong clinical support, such services are rarely the subject of rigorous evaluation and have given little acknowledgment to the important developmental factors that need to be considered when working with children. Using a developmental framework, this review aims to consider the nature of functional impairments that result from childhood traumatic brain injury, the recovery process postinjury, and the scope and role of child-based rehabilitation. In addition, the relatively scarce body of literature describing the evaluation of child rehabilitation models are reviewed with an emphasis on identifying approaches that provide evidence of enhanced function in the child's everyday life and, in particular, in the home and school contexts.
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Affiliation(s)
- Vicki Anderson
- Australian Centre for Child Neuropsychology Studies, Murdoch Children's Research Institute, Melbourne, Australia
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Abstract
BACKGROUND The need to address acquired cognitive impairments is increasing in child populations seen across a range of settings. However, current clinical practice following brain injury in children does not necessarily incorporate the use of cognitive rehabilitation models or techniques. The aim of this paper is to review the literature in this area. METHODS All published interventions targeting the cognitive domains of attention, memory and/or executive function that could be identified were reviewed. Different cognitive rehabilitation techniques are briefly described and the clinical and research implications of the findings are discussed. RESULTS Eleven papers, involving 54 children and adolescents receiving intervention, were identified. This literature describes generalised cognitive rehabilitation programmes as well as more specific strategies targeting focal deficits. CONCLUSIONS There is an absence of randomised controlled trials and a very limited number of studies using other methodological approaches, providing at this time no conclusive evidence for the efficacy of cognitive rehabilitation for children with acquired brain injury, but a clear need to address a range of methodological difficulties in this field of enquiry.
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Affiliation(s)
- Jenny Limond
- Paediatric Psychology, Southampton General Hospital, Southampton, UK
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Turkstra LS, Flora TL. Compensating for executive function impairments after TBI: a single case study of functional intervention. JOURNAL OF COMMUNICATION DISORDERS 2002; 35:467-482. [PMID: 12443048 DOI: 10.1016/s0021-9924(02)00118-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
UNLABELLED The purpose of this study was to demonstrate the effectiveness of compensatory strategies for impairments in executive function. The strategies were designed to enable a client with traumatic brain injury (TBI) to obtain professional employment. In a series of individual speech-language therapy sessions, compensatory strategies were developed, refined, and trained in mock-interview situations. Significant improvements were noted in report-writing accuracy and self-reported stress during report-writing. The client was able to obtain and maintain competitive employment in his chosen profession. The results support the use of strategies aimed at supporting executive function to improve performance on verbal tasks, and were informative regarding the effects of self-perceived efficacy and stress on performance after TBI. They illustrate that intervention based on real-life supports may be effective even many years post-TBI. LEARNING OUTCOMES At the conclusion of this article, readers will: (1) identify aspects of executive function that relate to communication in the workplace, (2) describe the steps in considering intervention within a single subject research design framework, and (3) consider the effects of stress and perceived self-efficacy on performance of communication tasks.
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Affiliation(s)
- Lyn S Turkstra
- Department of Communication Sciences, Case Western Reserve University, Cleveland, OH 44106, USA.
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Dirette DK, Hinojosa J, Carnevale GJ. Comparison of remedial and compensatory interventions for adults with acquired brain injuries. J Head Trauma Rehabil 1999; 14:595-601. [PMID: 10671705 DOI: 10.1097/00001199-199912000-00008] [Citation(s) in RCA: 68] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To examine the effects of a compensatory intervention versus a remedial intervention for deficits in visual processing of adults with acquired brain injuries (ABI). SETTING A cognitive rehabilitation program at a large comprehensive rehabilitation hospital in the New York City metropolitan area. PATIENTS Thirty adults with ABI were matched according to severity of injury, gender, age, and time post-injury, and randomly assigned to the remedial or compensatory group. INTERVENTIONS The remedial intervention consisted of four 45-minute sessions (once weekly) of participation in computer tasks without instruction in compensatory strategies. The compensatory intervention consisted of four 45-minute sessions of instruction in the use of three internal compensatory strategies, including verbalization, chunking, and pacing. MAIN OUTCOME MEASURES Pretest/posttest measures included three functional computer tasks. Weekly measures included a computerized version of the Paced Auditory Serial Addition Task (PASAT) and two computerized matching tasks. RESULTS Both groups exhibited statistically significant improvement of comparable degree on posttests and weekly measures. Further analysis revealed that 80% of both groups used compensatory strategies, regardless of intervention method. Those who used strategies demonstrated better performance than those who did not. CONCLUSION The ability to use internal compensatory strategies may be a significant confound in research examining the effects of the various cognitive rehabilitation intervention methods.
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Affiliation(s)
- D K Dirette
- Occupational Therapy Department, Western Michigan University, Kalamazoo, Michigan 49008-5051, USA
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