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Christensen I, Power E, Togher L, Brassel S, Elbourn E, Folder N, Jensen LR. Communication between rehabilitation staff and people with traumatic brain injury: A systematic review. Neuropsychol Rehabil 2024; 34:1071-1109. [PMID: 37944003 DOI: 10.1080/09602011.2023.2274625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 10/04/2023] [Indexed: 11/12/2023]
Abstract
This systematic review aimed to synthesize barriers and facilitators in communicative interactions between staff and people with traumatic brain injury (TBI) in the rehabilitation context. Searches captured published evidence up to November 2022 in MEDLINE, Embase, SCOPUS, Web of Science, CINAHL, AMED, and PsycINFO. Eligible studies reported on the communicative interaction between rehabilitation staff and adults with TBI. In total, 31 studies were included in the review; including quantitative, qualitative, and mixed-methods designs. Quality assessment was carried out using standard checklists. Quantitative studies and quantitative components of mixed-method studies were synthesized descriptively according to reported communication barriers and facilitators. Qualitative studies and qualitative components of mixed-method studies were analysed through an inductive thematic meta-synthesis; generating six main themes with four subthemes. Themes were categorized as barriers or facilitators to communicative interaction. Findings demonstrated that cognitive-communication disorders of people with TBI challenge the communicative interaction between rehabilitation staff and people with TBI. However, the extent to which these disorders create a communicative barrier is closely related to staff's communicative approach. While staff holding a collaborative and acknowledging approach and using supportive strategies may facilitate successful communicative interactions, staff using the opposite approach may exacerbate communication barriers.
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Affiliation(s)
- Iben Christensen
- Department of Nordic Studies and Linguistics, University of Copenhagen, Copenhagen South, Denmark
| | - Emma Power
- Department of Speech Pathology, University of Technology Sydney, Ultimo, Australia
| | - Leanne Togher
- Discipline of Speech Pathology, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
| | - Sophie Brassel
- Discipline of Speech Pathology, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
| | - Elise Elbourn
- Discipline of Speech Pathology, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
| | - Naomi Folder
- Department of Speech Pathology, University of Technology Sydney, Ultimo, Australia
| | - Lise Randrup Jensen
- Department of Nordic Studies and Linguistics, University of Copenhagen, Copenhagen South, Denmark
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Howell S, Hoskin J, Eaton D, Holloway M, Varley R. Stakeholder views on cognitive communication assessment and intervention for a person living independently in the community with severe traumatic brain injury. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2024; 59:483-495. [PMID: 36595483 DOI: 10.1111/1460-6984.12839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 12/08/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Cognitive communication disorder (CCD) following traumatic brain injury (TBI) is well documented and these communication problems impede successful re-integration into community living. While there is growing evidence for intervention to both detect and treat the impact of these deficits across the rehabilitation continuum, there are barriers to accessing services. Cognitive communication impairments may be missed because the person can talk, and this may mask the subtle but debilitating impact of a CCD. Referral to a speech and language therapist (SLT) may be overlooked or not timely, which prevents the individual accessing evidence-based interventions. Inadequate treatment provision and an under- or overestimation of communication capability can potentially undermine the effectiveness of wider team assessment and intervention. AIMS To report stakeholder views on specialist SLT input for CCD within a multidisciplinary team intervention for a community-dwelling individual with severe TBI. The investigation explored perspectives on understanding of CCD, on practice and on outcomes, in order to inform professional groups on perceived impacts of the evidence-to-practice gap. METHODS AND PROCEDURES A semi-structured interview methodology was employed with 11 stakeholder participants involved in a single case. Data were evaluated using a thematic framework method. Themes were inductively derived from the stakeholder narratives. OUTCOMES Stakeholders reported the following outcomes from specialist SLT input for CCD within a collaborative team approach: improved engagement with rehabilitation and support teams, improved health-related quality of life and well-being, and increased client participation in community activities of personal relevance. Stakeholders also reported inequities in wider service provision where limitations in professional understanding of CCD and knowledge of best practice recommendations preclude access to specialist SLT services. CONCLUSIONS CCDs are under-recognised and this can have a devastating effect on people with CCD and on those around them. Stakeholder reports provide evidence for the effectiveness of SLT practice recommendations for the treatment of CCD following TBI. They also provide additional evidence of persisting barriers to accessing treatment. Future research to explore ways to close this evidence-to-practice gap is required. WHAT THIS PAPER ADDS What is already known on this subject Cognitive communication difficulties are a well-documented consequence of TBI. There is evidence for the effectiveness of person-centred interventions for CCD across the recovery continuum. International evidence-based practice recommendations are in place for CCD assessment and management. Barriers to accessing SLT expertise for CCD have previously been reported. What this paper adds to existing knowledge This investigation explores the views of a diverse group of stakeholders involved in a single case of a community-dwelling individual with severe TBI. Stakeholders report positive real-world outcomes from SLT interventions for CCD within a coordinated multidisciplinary rehabilitation team. Stakeholder reports also indicate inequities in wider service provision and CCD knowledge gaps amongst professional groups providing rehabilitation services for people with TBI. What are the potential or actual clinical implications of this work? CCDs are under-recognised, with devastating effect for people with CCD and those around them. These findings underscore the importance of raising professional awareness of CCD and best practice recommendations, in order to improve access to SLT expertise for people with CCD following TBI.
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Affiliation(s)
- Susan Howell
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Joanna Hoskin
- Division of Language and Communication Science, City, University of London, London, UK
| | | | - Mark Holloway
- Head First, Assessment and Case Management, Hawkhurst, UK
| | - Rosemary Varley
- Division of Psychology and Language Sciences, University College London, London, UK
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Kelly C, Cornwell P, Copley A, Hewetson R. Speech pathologists' perspectives when managing adults following traumatic brain injury in community-based rehabilitation settings: A qualitative investigation. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 25:787-796. [PMID: 35996961 DOI: 10.1080/17549507.2022.2110940] [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: Across Australia and New Zealand, speech-language pathologists (SLPs) routinely assess and treat adults with cognitive-communication disorders following traumatic brain injury (TBI). Despite their regular involvement, little is known about how clinicians provide management to this client group, particularly in community-based contexts. Therefore the aim of this study is to explore the clinical practices of SLPs who have experience working in community-based rehabilitation services with adults with cognitive-communication disorders following TBI.Method: A qualitative descriptive study using one-on-one semi-structured interviews was conducted as part of an explanatory sequential mixed-methods design. Fourteen SLPs with experience working with individuals with TBI completed an interview with content analysis used to explore the data.Result: The overarching theme identified was that a "Client-centred and inclusive approach to community-based rehabilitation services" is required. The three subthemes to emerge from the data included the importance of utilising a (1) "flexible service delivery approach", with (2) "meaningful therapy focus", and (3) "collaboration" with multidisciplinary team members and significant others when managing this client group.Conclusion: SLPs play a crucial role in client-centred inclusive rehabilitation for community-dwelling adults with cognitive-communication disorders following TBI. The complexity of working with this population requires current and future models of care to incorporate an interdisciplinary approach that is flexible in its delivery and meaningful in focus.
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Affiliation(s)
- Crystal Kelly
- School of Health Sciences and Social Work, Griffith University, Brisbane, Australia and
| | - Petrea Cornwell
- School of Health Sciences and Social Work, Griffith University, Brisbane, Australia and
| | - Anna Copley
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Ronelle Hewetson
- School of Health Sciences and Social Work, Griffith University, Brisbane, Australia and
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Avramović P, Rietdijk R, Kenny B, Power E, Togher L. Developing a Digital Health Intervention for Conversation Skills After Brain Injury (convers-ABI-lity) Using a Collaborative Approach: Mixed Methods Study. J Med Internet Res 2023; 25:e45240. [PMID: 37556179 PMCID: PMC10448295 DOI: 10.2196/45240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 04/14/2023] [Accepted: 05/03/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND People with acquired brain injury (ABI) experience communication breakdown in everyday interactions many years after injury, negatively impacting social and vocational relationships. Communication partner training (CPT) is a recommended intervention approach in communication rehabilitation after ABI. Access to long-term services is essential, both in rural and remote locations. Digital health has potential to overcome the challenges of travel and improve cost efficiencies, processes, and clinical outcomes. OBJECTIVE We aimed to collaboratively develop a novel, multimodal web-based CPT intervention (convers-ABI-lity) with key stakeholders and evaluate its feasibility for improving conversation skills after brain injury. METHODS This mixed methods study consisted of 3 key stages guided by the Integrate, Design, Assess, and Share (IDEAS) framework for developing effective digital health interventions. Stage 1 included the integration of current end-user needs and perspectives with key treatment and theoretical components of existing evidence-based interventions, TBI Express and TBIconneCT. Stage 2 included the iterative design of convers-ABI-lity with feedback from end-user interviews (n=22) analyzed using content analysis. Participants were individuals with ABI, family members, health professionals, and paid support workers. Stage 3 included the evaluation of the feasibility through a proof-of-concept study (n=3). A total of 3 dyads (a person with ABI and their communication partner [CP]) completed 7 weeks of convers-ABI-lity, guided by a clinician. The outcome measures included blinded ratings of conversation samples and self-report measures. We analyzed postintervention participant interviews using content analysis to inform further intervention refinement and development. RESULTS Collaborative and iterative design and development during stages 1 and 2 resulted in the development of convers-ABI-lity. Results in stage 3 indicated positive changes in the blinded ratings of conversation samples for the participants with traumatic brain injury and their CPs. Statistically reliable positive changes were also observed in the self-report measures of social communication skills and quality of life. Intervention participants endorsed aspects of convers-ABI-lity, such as its complementary nature, self-guided web-based modules, clinician sessions, engaging content, and novel features. They reported the intervention to be relevant to their personal experience with cognitive-communication disorders. CONCLUSIONS This study presents the outcome of using the IDEAS framework to guide the development of a web-based multimodal CPT intervention with input from key stakeholders. The results indicate promising outcomes for improving the conversation skills of people with ABI and their CPs. Further evaluation of intervention effectiveness and efficacy using a larger sample size is required.
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Affiliation(s)
- Petra Avramović
- Discipline of Speech Pathology, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
| | - Rachael Rietdijk
- Discipline of Speech Pathology, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Belinda Kenny
- Discipline of Speech Pathology, School of Health Sciences, Western Sydney University, Sydney, Australia
| | - Emma Power
- Discipline of Speech Pathology, Graduate School of Health, University of Technology Sydney, Sydney, Australia
| | - Leanne Togher
- Discipline of Speech Pathology, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Christensen I, Power E, Togher L, Norup A. "Communication Is Not Exactly My Field, but It Is Still My Area of Work": Staff and Managers' Experiences of Communication With People With Traumatic Brain Injury. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:827-847. [PMID: 36455235 DOI: 10.1044/2022_ajslp-22-00074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
PURPOSE Communication between people with traumatic brain injury (TBI) and rehabilitation staff can be impacted by cognitive-communication disorders. Communication partner training (CPT) programs hold potential to improve communication between people with TBI and their communication partners. To tailor CPT programs to the rehabilitation environment, it is critical to understand the nature of communicative interactions for staff members. This study explores staff and managers' experiences of communication with people with TBI in the rehabilitation setting. METHOD Individual semistructured videoconference interviews were carried out with staff members (n = 22) and managers (n = 4) varying in terms of professions and length of work experience. Interviews were guided by a phenomenological approach to gain comprehensive knowledge of staff and managers' lived experiences of communication with people with TBI. RESULTS Four themes with nine subthemes were generated: (a) cognitive-communication disorders challenge interaction (communication is socially inappropriate, the diversity of presenting symptoms associated with TBI is demanding), (b) staff struggle in communication (there is a breakdown of communicative collaboration, communication increases staff's workload, emotional well-being of staff is at risk), (c) communication context is crucial (tasks affect communication, extending the professional roles), and (d) staff want communication knowledge and skills (needs vary according to work experience, access to tailored strategies, and feedback). CONCLUSIONS Staff and managers experienced communication with people with TBI as highly demanding. The socially inappropriate communication in people with TBI was perceived to disturb the collaborative aspects of communication and create negative emotional impacts for staff. Staff experiences varied according to discipline, work experience, rehabilitation tasks, and facility. Consequently, staff and managers expressed a need for specific communication strategies to help them overcome the communicative challenges. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.21579159.
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Affiliation(s)
- Iben Christensen
- Department of Nordic Studies and Linguistics, University of Copenhagen, Denmark
| | - Emma Power
- University of Technology Sydney, Department of Speech Pathology, Ultimo, New South Wales, Australia
| | - Leanne Togher
- Department of Speech Pathology, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Anne Norup
- Neurorehabilitation Research and Knowledge Centre, Rigshospitalet, Copenhagen, Denmark
- Department of Psychology, University of Southern Denmark, Odense, Denmark
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Nielsen AI, Jensen LR, Power E. Meeting the confused patient with confidence: perceived benefits of communication partner training in subacute TBI. Brain Inj 2022; 37:1-14. [PMID: 36571429 DOI: 10.1080/02699052.2022.2158224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 08/11/2022] [Accepted: 12/09/2022] [Indexed: 12/27/2022]
Abstract
OBJECTIVE This study aims to explore health professionals' perceived benefits of implementing Communication Partner Training (CPT) using Supported Conversation for Adults with Aphasia (SCA™) in a subacute rehabilitation setting with patients in post-traumatic confusional state (PTCS) after TBI. METHOD The study was conducted in a clinical setting using a pre-post questionnaire design to explore change. One hundred and four interdisciplinary clinicians attended CPT in the SCA™ method and subsequent implementation support. Participants completed a questionnaire with both quantitative and qualitative questions before and after the training and implementation period. Data were analyzed using descriptive and inferential statistics and qualitative content analysis. RESULTS Participants' perceived confidence and self-assessed ability to communicate with patients in PTCS significantly increased after CPT (p = 0.006). While participants still experienced communication challenges, they reported using CPT-related tools and strategies in their interactions. Participants found they could apply strategies to improve patients' comprehension of information and to confirm their understanding of patients' communication. However, using strategies to enhance patients' expressive abilities was perceived as more challenging. CONCLUSIONS Training health professionals in CPT increase their confidence in managing communication with patients in PTCS. Further research is needed to evaluate the efficacy of CPT within a more rigorous research design.
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Affiliation(s)
- Annesofie Ishøy Nielsen
- Department of Brain and Spinal Cord Injury, The Neuroscience Centre, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Lise Randrup Jensen
- Department of Nordic Studies and Linguistics, University of Copenhagen, Postal address: Emil Holms Kanal 2, DK-2300 København S, Copenhagen, Denmark
| | - Emma Power
- Department of Speech Pathology, University of Technology Sydney, Speech Pathology, Graduate School of Health, Postal address: PO Box 123 Broadway NSW 2007 Australia, Sydney, Australia
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Powell LE, Gau J, Glang A, Corrigan JD, Ramirez M, Slocumb J. Staff Traumatic Brain Injury Skill Builder: Evaluation of an Online Training Program for Paraprofessional Staff Serving Adults With Moderate-Severe TBI. J Head Trauma Rehabil 2021; 36:E329-E336. [PMID: 33656483 PMCID: PMC8380254 DOI: 10.1097/htr.0000000000000661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To evaluate the online, self-guided, interactive Staff TBI Skill Builder training program for paraprofessional staff. DESIGN A within-subjects, nonexperimental evaluation involving 79 paraprofessionals and professionals working across a range of settings. Participants completed a pretest (T1), a posttest immediately upon program completion (T2), and follow-up (T3) 60 days after program completion. MEASURES (1) Knowledge of basic traumatic brain injury facts; (2) knowledge application; (3) self-efficacy in responding to text-based application scenarios; (4) self-report of skill utilization and effectiveness; and (5) program satisfaction (ease-of-use and usefulness). RESULTS Participants demonstrated high levels of knowledge, knowledge application, and self-efficacy at pretest. Despite the high pretest levels, participants showed significant improvements in knowledge application (d = 0.50) after using the program. Nonsignificant gains in knowledge (d = 0.13) and self-efficacy (d = 0.02) were found. The use of selected skills significantly increased from posttest to follow-up. Participants reported high program satisfaction; 99% of the participants indicated that they would recommend the program to others. CONCLUSION These results demonstrate the feasibility of providing interactive, online training for paraprofessionals serving adults with moderate-severe traumatic brain injury.
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Affiliation(s)
- Laurie E Powell
- The Center on Brain Injury Research and Training, University of Oregon, Eugene (Drs Powell and Glang, Mr Gau, and Mss Ramirez and Slocumb); and Ohio Valley Center for Brain Injury Prevention and Rehabilitation, The Ohio State University, Columbus (Dr Corrigan)
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Kagan A, Simmons-Mackie N, Shumway E, Victor JC, Chan L. Development and evaluation of the Basic Outcome Measure Protocol for Aphasia (BOMPA). INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 23:258-264. [PMID: 32693622 DOI: 10.1080/17549507.2020.1784278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE The Basic Outcome Measure Protocol for Aphasia (BOMPA) is a practical tool that allows for a quick self-report on quality of life from the perspective of the person with aphasia, as well as a clinical evaluation of aphasia severity and the ability to participate in conversation. The primary aim of this paper is to describe development of BOMPA and report on results of an inter-rater reliability study involving speech-language pathology raters. METHOD The inter-rater reliability study utilised a fully crossed design and included independent ratings of 12 videos by 20 speech-language pathologists. RESULT Results indicate moderate to strong inter-rater reliability among participant speech-language pathology raters (0.65-0.96), as well as when comparing these participant ratings with an expert rater's gold standard (0.59-0.86). CONCLUSION BOMPA may be a useful outcome measurement tool for time-pressed clinicians in clinical settings.
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Hoepner JK, Sievert A, Guenther K. Joint Video Self-Modeling for Persons With Traumatic Brain Injury and Their Partners: A Case Series. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:863-882. [PMID: 33784468 DOI: 10.1044/2021_ajslp-20-00074] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose Individuals with traumatic brain injury (TBI) experience impairments to self-regulation and social communication that strain relationships. Video self-modeling (VSM) provides visible and audible, tangible evidence of what they do well and what could improve. Conducting such training in the context of authentic exchanges with their everyday partners may support positive change in social communication. The present investigation sought to evaluate indices of improved social communication. Method A mixed-methods design was employed for this case series investigation. Quantitative measures include pre- and postoutcomes on goal attainment scales (GASs) and measures of conversational effectiveness. Qualitative measures include responsiveness to video-supported prompts, conversational behaviors, and metacognitive statements. Results Participants perceived gains on GAS of 3-4 SDs, as well as perceived improvements on the La Trobe Communication Questionnaire. Those gains were validated by gains on the adapted Measure of Participation in Conversation and Measure of Skill in Supported Conversation. Individuals with TBI and their partners reached consensus on most goals and postintervention La Trobe Communication Questionnaire ratings. Participants made accurate judgments about their behaviors at a high rate, given video review. Conversational behaviors and use of metacognitive statements varied across participants and conversational contexts. Field notes and session transcripts provide evidence that both dyads increased internalization of VSM goals and purpose. Conclusions Joint VSM shows promise as a method for eliciting accurate self-assessments among individuals with TBI and their close partners. Both dyads perceived positive gains in interactions within and outside their dyads. Furthermore, joint VSM and GAS appear to improve self-awareness and internalization of VSM goals and purpose.
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Affiliation(s)
- Jerry K Hoepner
- Department of Communication Sciences and Disorders, University of Wisconsin-Eau Claire
| | - Alexis Sievert
- Department of Communication Sciences and Disorders, University of Wisconsin-Eau Claire
| | - Kaitlin Guenther
- Department of Communication Sciences and Disorders, University of Wisconsin-Eau Claire
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Mach H, Baylor C, Burns M, Yorkston K. Training students from rehabilitation professions on communicating with patients with communication disorders. PM R 2021; 14:58-67. [PMID: 33611858 DOI: 10.1002/pmrj.12580] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 11/24/2020] [Accepted: 02/12/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND FRAME, a mnemonic referring to a program for helping health care providers adapt patient-provider communication when working with patients with communication disorders, improves the knowledge, confidence, and communication skills of medical students for working with this population. However, the impact of the FRAME program for preparing students from the rehabilitation disciplines to work with patients with communication disorders is unknown. OBJECTIVE To examine the effects of the FRAME program on the knowledge, confidence, and communication skills of students in physical therapy (PT), occupational therapy (OT), and prosthetics and orthotics (P&O) in terms of how to communicate effectively with patients with communication disorders. DESIGN An exploratory, quasi-experimental pretest-posttest design. SETTING PT, OT, and P&O clinical education programs at the University of Washington's Department of Rehabilitation Medicine. PARTICIPANTS Twenty rehabilitation students (PT = 12; OT = 7; and P&O = 1) participated in the FRAME training. INTERVENTIONS The FRAME program, delivered in a single, 2-hour session teaches students communication skills to use with patients with various types of communication disorders. MAIN OUTCOME MEASURES A quiz of students' knowledge about communication disorders and a self-rating of confidence for interacting with this patient population were used. Speech-language pathology graduate clinicians rated students' use of communication strategies from each area of the FRAME training during interactions with standardized patients portraying aphasia and dysarthria. Student qualitative feedback were also collected. RESULTS Students' knowledge, confidence, and use of communication strategies improved significantly following training. Greatest gains were observed in students' ability to familiarize themselves with how a patient communicates and establish a method of communication before proceeding with the interview. Qualitative feedback aligned with these findings. CONCLUSIONS The FRAME program increases the knowledge, confidence, and use of communication strategies in rehabilitation students in order to communicate more effectively with patients with communication disorders in their future careers.
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Affiliation(s)
- Helen Mach
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA.,College of Health Sciences, Newark, Delaware, USA
| | - Carolyn Baylor
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
| | - Michael Burns
- Department of Speech and Hearing Sciences, University of Washington, Seattle, Washington, USA
| | - Kathryn Yorkston
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
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Agrela N, Santos ME, Guerreiro S. Communication skills training pilot programme after traumatic brain injury: short and medium-term benefits. Brain Inj 2021; 35:304-314. [PMID: 33464934 DOI: 10.1080/02699052.2021.1872096] [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: 10/22/2022]
Abstract
Objective: The study aimed to evaluate whether a pilot communication rehabilitation programme improves different communicative modalities in people who have sustained a moderate to severe TBI immediately following the training and at 3 months follow up.Methods: We have recruited 12 participants who had moderate-to-severe TBI. Subjects were randomly divided into two groups, EG and CG. We have assessed the groups before and after treatment and we have performed a follow-up three months later, through of the ABaCo. The EG followed a very structured programme. In the CG, a programme to stimulate communication through free conversation was carried out. Each programme consisted of 24 group sessions, of 1h30 min, twice a week, for 12 weeks.Results: Improvements were observed in both groups, although more evident in the EG. Both groups had better results in extralinguistic production. In the EG, there was still an improvement in the paralinguistic production and extralinguistic comprehension, after ending the training. These improvements persisted 3 months after ending the programme.Conclusion: The results demonstrated the effectiveness of the intervention of a structured pragmatic rehabilitation programme. However, the existence of a communication group based solely on conversation can also have positive results and should be implemented whenever a more specific intervention is not possible. In future research, it will be important to increase the sample size and involve caregivers in person and regularly in the EG programme.
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Affiliation(s)
- Nicole Agrela
- Instituto de Ciências da Saúde, Universidade Católica Portuguesa, Lisbon, Portugal
| | - Maria Emília Santos
- Center for Interdisciplinary Research in Health (CIIS), Instituto de Ciências da Saúde, Universidade Católica Portuguesa, Lisbon, Portugal
| | - Sandra Guerreiro
- Centro de Reabilitação Profissional de Gaia (CRPG), Gaia, Portugal
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Mok Z, Steel G, Russell C, Conway E. Measuring the interactions of people with dementia and their conversation partners: a preliminary adaption of the Kagan measures of support and participation in conversation. Aging Ment Health 2021; 25:13-21. [PMID: 31591908 DOI: 10.1080/13607863.2019.1671314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE While dementia can negatively affect communication, positive interactions can be facilitated by the conversation partners of people with dementia. There are few assessment tools designed to evaluate the support provided by the conversation partner and the resulting participation of the person with dementia. This study reports on an adaptation of the Measure of Support in Conversation (MSC) and Measure of Participation in Conversation (MPC) scales for use with people with dementia and their conversation partners (the MSC Dementia and MPC Dementia, respectively) and investigates the inter-and intra-rater reliability of these adapted measures. METHOD The MSC-D and MPC-D scales were adapted from the original MSC and MPC scales to reflect current knowledge of communication and interaction involving people with dementia. Audio recordings of a total of 25 casual conversations, lasting 5-10 min, between a person with dementia and familiar aged care staff were independently rated by two raters to investigate inter-rater reliability and by one rater on two separate occasions to investigate intra-rater reliability. RESULTS ICC analyses on the MSC-D indicated good inter-rater reliability (ICC = 0.718-0.812) and intra-rater reliability (ICC = 0.628-0.760). The MPC-D had excellent inter-rater reliability (ICC = 0.904-0.945) and intra-rater reliability (ICC = 0.925-0.957). 93.6% of all ratings were within 0.5 of each other on a nine point scale from 0 to 4. CONCLUSION The results provide preliminary support for the use of these adapted scales. Further research is required to investigate the validity and reliability of these scales using video recordings and across a wider range of communication genres.
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Affiliation(s)
- Zaneta Mok
- School of Allied Health, Australian Catholic University, Melbourne, Australia
| | - Gillian Steel
- School of Allied Health, Australian Catholic University, Melbourne, Australia
| | - Cailey Russell
- School of Allied Health, Australian Catholic University, Melbourne, Australia
| | - Erin Conway
- School of Allied Health, Australian Catholic University, Brisbane, Australia
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Behn N, Francis J, Togher L, Hatch E, Moss B, Hilari K. Description and Effectiveness of Communication Partner Training in TBI: A Systematic Review. J Head Trauma Rehabil 2021; 36:56-71. [PMID: 32472837 DOI: 10.1097/htr.0000000000000580] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To evaluate the current evidence on communication partner training and its effectiveness on outcomes for people with traumatic brain injury (TBI) and/or their communication partners. METHODS Information sources: Systematic searches of 9 databases (AMED, CINAHL, EMBASE, Medline/EBSCOHOST, PsycINFO, PsycBITE, PsycARTICLES, PubMed, and Scopus) from database inception to February 2019. Eligibility criteria: Empirical studies on interventions for adult communication partners where the primary focus of the program (>50%) was on improving communication skills of people with TBI and/or communication partners. Data: Participants, characteristics of the training, outcome measures, and findings. Risk of bias: Standard checklists were used for methodological quality (PEDro, ROBiN-T) and intervention description (TIDieR). Synthesis: Narrative synthesis and effect sizes (Cohen's d) for group-level studies. OUTCOMES Ten articles (describing 8 studies) met eligibility criteria: 3 randomized controlled trials, 2 nonrandomized controlled trials, and 3 single-case experimental designs. Studies included a total of 258 people with TBI and 328 communication partners; however, all but one study had fewer than 65 participants. Methodological quality varied and intervention description was poor. Three studies in the final synthesis (n = 41 communication partners, n = 36 people with TBI) reported positive intervention effects. Effect sizes in group studies were d = 0.80 to 1.13 for TBI and d = 1.16 to 2.09 for communication partners. CONCLUSIONS The articles provided encouraging, though limited, evidence for training communication partners. Greater methodological rigor, more clearly described interventions, and consistent use of outcome measures and follow-up after treatment are needed. Further research on this topic is warranted.
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Affiliation(s)
- Nicholas Behn
- Divisions of Language and Communication Science (Drs Behn, Moss, and Hilari and Ms Hatch) and Health Services Research and Management (Dr Francis), School of Health Sciences, City, University of London, England; and Speech Pathology, Faculty of Medicine and Health, The University of Sydney, Australia (Dr Togher)
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Paice L, Aleligay A, Checklin M. A systematic review of interventions for adults with social communication impairments due to an acquired brain injury: Significant other reports. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2020; 22:537-548. [PMID: 32135070 DOI: 10.1080/17549507.2019.1701082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose: To determine the most effective intervention for adults with social communication impairments due to an Acquired Brain Injury (ABI), using standardised outcome measures completed by significant others.Method: A systematic literature review was conducted. Four electronic databases relevant to the field of speech-language pathology or brain injury were searched: Medline, CINAHL, AMED and Embase. Grey literature, reference lists and citation indexes were also hand searched for additional research. Studies that met the broad inclusion and exclusion criteria were initially screened to determine articles for full text reviews by two independent reviewers. Reviewers independently extracted data from full-text reviews using a data extraction form and performed bias analysis using the Downs and Black quality checklist (Downs, S.H., & Black, N. (1998). The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. Journal of Epidemiology & Community Health, 52, 377-384.). Studies were categorised using a five-phase model of evidence (Robey, R.R., & Schultz, M.C. (1998). A model for conducting clinical-outcome research: An adaptation of the standard protocol for use in aphasiology. Aphasiology, 12, 787-810.).Result: 681 articles were identified after duplicates were removed. 15 articles were reviewed for full-text analysis. Six studies were ultimately included in the review. Of these, three were randomised controlled trials and three others were not. Four studies delivered intervention solely to the individual with an ABI, one to the communication partner only, and one delivered intervention both to the individual and their communication partner. Intervention programmes ranged from four to 12 weeks and from 12 to 48 hours total contact time. The reviews studies were heterogeneous, which made comparisons difficult. Risk of bias was also present to varying degrees in all studies. The current level of evidence has focussed on efficacy of treatments and effectiveness of treatment is not yet established.Conclusion: The current level of evidence is not yet established to make clear clinical guidelines on which interventions are most effective, based on significant others' reports. Further research is required, incorporating more rigorous study designs and larger sample sizes to enable accurate conclusions to be drawn.
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Behn N, Francis JJ, Power E, Hatch E, Hilari K. Communication partner training in traumatic brain injury: a UK survey of Speech and Language Therapists' clinical practice. Brain Inj 2020; 34:934-944. [PMID: 32521171 DOI: 10.1080/02699052.2020.1763465] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PRIMARY OBJECTIVE To explore the clinical practice of communication partner training by Speech and Language Therapists for people with traumatic brain injury in the UK. STUDY DESIGN Online 97-item survey which addressed the practice of training both familiar and unfamiliar communication partners, and barriers and facilitators to implementation informed by the Theoretical Domains Framework. PARTICIPANTS 169 Speech and Language Therapists from private and public settings in the UK. RESULTS While 96% reported training familiar communication partners, only 58% reported training unfamiliar communication partners. Therapists reported providing communication partner training consistent with best practice 43% of the time. Evidence-based published programmes were used by 13.8% and 19.9% of participants for training familiar and unfamiliar partners, respectively. Therapists reported using outcomes for familiar and unfamiliar communication partners 83% and 78% of the time. The most frequently reported barrier was lack of behavioral regulation (e.g., planning). Most frequent perceived facilitators were clinicians wanting to deliver communication partner training and that training was part of therapists' professional role (social professional role and identity). CONCLUSIONS Therapists were motivated to deliver communication partner training but reduced capability affected implementation. Further support to clinicians on outcome measurement with materials to develop workplace systems to monitor implementation is needed.
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Affiliation(s)
- Nicholas Behn
- Division of Language and Communication Science, School of Health Sciences, City, University of London , London, UK
| | - Jill J Francis
- Division of Health Services Research and Management, School of Health Sciences, City, University of London , London, UK
| | - Emma Power
- Graduate School of Health, University Technology Sydney, Speech Pathology , Ultimo, Australia
| | - Ellie Hatch
- Division of Language and Communication Science, School of Health Sciences, City, University of London , London, UK
| | - Katerina Hilari
- Division of Language and Communication Science, School of Health Sciences, City, University of London , London, UK
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Rietdijk R, Power E, Attard M, Togher L. Acceptability of telehealth-delivered rehabilitation: Experiences and perspectives of people with traumatic brain injury and their carers. J Telemed Telecare 2020; 28:122-134. [PMID: 32460583 DOI: 10.1177/1357633x20923824] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Communication skills training for people with traumatic brain injury (TBI) and their carers is recommended best practice. Delivery via telehealth could improve access to this training. This paper focuses on the acceptability of telehealth delivery of communication skills training. METHODS A mixed-methods investigation of acceptability of telehealth to people with TBI and their carers was incorporated into a clinical trial. Thirty-six people with TBI (23 metropolitan and 13 regional) and their carers were recruited. Metropolitan participants were randomly allocated to telehealth or in-person intervention at a 1:3 ratio. Regional participants were allocated to telehealth. Telehealth and in-person participants were compared on retention, time to complete the programme, home practice completion and therapeutic alliance ratings. Participants completed semi-structured interviews regarding their views on telehealth, which were analysed using thematic analysis. RESULTS There were no significant differences between telehealth and in-person participants in retention rate, time to complete the programme, degree of home practice completion or therapeutic alliance ratings. Three themes were identified: 'telehealth delivery opens a window for access to rehabilitation in the context of my daily life', 'in-person delivery offers rehabilitation based on natural human interaction' and 'weighing telehealth against in-person delivery'. DISCUSSION Participants found telehealth delivery acceptable, as indicated by the similarity between groups in the quantitative process measures, and as reported in interviews. Some reported a preference for in-person delivery if there had been a choice of delivery mode. Participants described characteristics of the two delivery modes which were relevant to their attitudes towards telehealth.
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Affiliation(s)
- Rachael Rietdijk
- The University of Sydney, Faculty of Medicine and Health, Australia
| | - Emma Power
- The University of Technology Sydney, Graduate School of Health, Australia.,The University of Sydney, Faculty of Medicine and Health, Australia
| | - Michelle Attard
- The University of Sydney, Faculty of Medicine and Health, Australia
| | - Leanne Togher
- The University of Sydney, Faculty of Medicine and Health, Australia
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Howell S, Beeke S, Pring T, Varley R. Measuring outcomes of a peer-led social communication skills intervention for adults with acquired brain injury: A pilot investigation. Neuropsychol Rehabil 2020; 31:1069-1090. [PMID: 32408795 DOI: 10.1080/09602011.2020.1760892] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Reduced social competence following severe acquired brain injury (ABI) is well-documented. This pilot study investigated a peer-led group intervention based on the claim that peer models may be a more effective mechanism for behaviour change than clinician-led approaches. Twelve participants with severe ABI were recruited from a post-acute neurorehabilitation setting and randomly assigned to either a peer-led intervention or a staff-led activity group (usual care) (Clinicaltrials.gov: NCT02211339). The groups met twice a week for 8 weeks. A peer was trained separately to facilitate interaction in the intervention group. Training comprised 16 individual sessions over 4 weeks. Group behaviour was measured twice at baseline, after intervention and at maintenance (4 weeks), using the Adapted Measure of Participation in Conversation (MPC) and the Interactional Network Tool (INT), a newly devised measure of group conversational interaction. Outcome measures showed differential sensitivity. The groups did not differ in baseline behaviour. Findings showed a significant improvement in the treated group on the MPC transaction scale post-intervention (p = .02). The intervention group showed more balanced interaction post-intervention on the INT and at follow-up. Findings show preliminary evidence of the advantage for peer-led groups. The INT shows promise as a method to detect a change in group communication behaviour.Trial registration: ClinicalTrials.gov identifier: NCT02211339.
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Affiliation(s)
- Susan Howell
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Suzanne Beeke
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Tim Pring
- Division of Language and Communication Science, City, University of London, London, UK
| | - Rosemary Varley
- Division of Psychology and Language Sciences, University College London, London, UK
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Wiseman-Hakes C, Ryu H, Lightfoot D, Kukreja G, Colantonio A, Matheson FI. Examining the Efficacy of Communication Partner Training for Improving Communication Interactions and Outcomes for Individuals With Traumatic Brain Injury: A Systematic Review. Arch Rehabil Res Clin Transl 2020; 2:100036. [PMID: 33543065 PMCID: PMC7853340 DOI: 10.1016/j.arrct.2019.100036] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE To describe the evidence regarding communication partner training (CPT) interventions for individuals with traumatic brain injury (TBI) and their conversation partners. DATA SOURCES Eleven key databases-PubMed, CINAHL, Cochrane Registry of Controlled Trials, Embase, Linguistic and Language Behavior Abstracts, ProQuest, Scopus, Web of Science, PsycBITE, SpeechBITE, and ERIC-were searched from inception through 2019. STUDY SELECTION Selected articles had to be peer reviewed, written in English, experimental or quasiexperimental design, report on TBI communication partners, and describe interventions or strategies targeting communication partners. DATA EXTRACTION Of 1088 articles identified, 12 studies were selected for data extraction, critical appraisal, and analysis with considerations of sex and gender. The Oxford Centre for Evidence-Based Medicine's guideline was used to critically appraise Levels of Evidence. Assessment of bias was conducted using the Cochrane Collaboration tools for randomized controlled trials and risk of bias in nonrandomized studies of interventions for nonrandomized controlled trials and the risk of bias in N-of-1 trials scale. DATA SYNTHESIS A systematic review with a qualitative meta-analysis of themes and findings across the selected studies identified 3 major categories: (1) benefits of the training for those with TBI, (2) risks of CPT, and (3) suggestions to improve its efficacy. CONCLUSION Most of the evidence comes from 1 research group, which may be viewed as a weakness in the current body of literature. However, although the evidence to date is modest, CPT may help to increase accessibility and reduce participation inequities in the community for individuals with TBI.
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Affiliation(s)
- Catherine Wiseman-Hakes
- Department of Speech Language Pathology, School of Rehabilitation Science, McMaster University, Institute for Applied Health Sciences, Hamilton, Ontario, Canada
- KITE Toronto Rehab, University Health Network, Toronto, Ontario, Canada
| | - Hyun Ryu
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, Ontario, Canada
| | - David Lightfoot
- St. Michael’s Hospital Health Sciences Library, Unity Health Toronto, Toronto, Ontario, Canada
| | - Gazal Kukreja
- Acquired Brain Injury, Ontario Neurotrauma Foundation, Toronto, Ontario, Canada
| | - Angela Colantonio
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Flora I. Matheson
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health and Centre for Criminology and Sociolegal Studies, University of Toronto, Toronto, Ontario, Canada
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Rietdijk R, Power E, Attard M, Heard R, Togher L. Improved Conversation Outcomes After Social Communication Skills Training for People With Traumatic Brain Injury and Their Communication Partners: A Clinical Trial Investigating In-Person and Telehealth Delivery. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2020; 63:615-632. [PMID: 32078409 DOI: 10.1044/2019_jslhr-19-00076] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose The aim of the study was to investigate the effectiveness of social communication skills training (TBIconneCT) for people with traumatic brain injury (TBI) and their communication partners, delivered in-person or via telehealth, on quality of conversations. Method This study is a clinical trial, including an in-person intervention group (n = 17), a telehealth intervention group (n = 19), and a historical control group (n = 15). Participants were adults at least 6 months post moderate-to-severe TBI with social communication skills deficits and their usual communication partners. Participants completed a casual and purposeful conversation task at pre-intervention, postintervention, and a follow-up assessment. A blinded assessor evaluated conversations using the Adapted Measure of Participation in Conversation and the Adapted Measure of Support in Conversation. Treatment effects were examined by comparing groups on change in ratings between pre- and posttraining. Maintenance of effects was examined using change between posttraining and follow-up assessment. The trial protocol was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12615001024538). Results Trained participants with TBI had significant improvements in participation in casual conversation compared to controls. Trained communication partners also had significant improvements compared to controls on ratings of support in casual conversations. However, treatment effects were not maintained at follow-up for two of eight measures. Comparisons between outcomes of in-person and telehealth groups found negligible to small effect sizes for six of eight measures. Conclusions The findings reinforce previous studies demonstrating the efficacy of communication partner training after TBI. Telehealth delivery produced similar outcomes to in-person delivery.
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Affiliation(s)
- Rachael Rietdijk
- The University of Sydney, Sydney School of Health Sciences, New South Wales, Australia
| | - Emma Power
- The University of Sydney, Sydney School of Health Sciences, New South Wales, Australia
- The University of Technology Sydney, Graduate School of Health, New South Wales, Australia
| | - Michelle Attard
- The University of Sydney, Sydney School of Health Sciences, New South Wales, Australia
| | - Robert Heard
- The University of Sydney, Sydney School of Health Sciences, New South Wales, Australia
| | - Leanne Togher
- The University of Sydney, Sydney School of Health Sciences, New South Wales, Australia
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Nielsen AI, Power E, Jensen LR. Communication with patients in post-traumatic confusional state: perception of rehabilitation staff. Brain Inj 2020; 34:447-455. [DOI: 10.1080/02699052.2020.1725839] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Annesofie Ishøy Nielsen
- Department of Neurorehabilitation, TBI Unit, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Emma Power
- University of Technology Sydney, Graduate School of Health, Ultimo, Australia
- University of Sydney, Faculty of Medicine and Health, School of Health Sciences, Lidcombe, Australia
| | - Lise Randrup Jensen
- Department of Nordic Studies and Linguistics, University of Copenhagen, Copenhagen, Denmark
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A Clinical Trial Investigating Telehealth and In-Person Social Communication Skills Training for People With Traumatic Brain Injury: Participant-Reported Communication Outcomes. J Head Trauma Rehabil 2020; 35:241-253. [DOI: 10.1097/htr.0000000000000554] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Tessier A, Power E, Croteau C. Paid worker and unfamiliar partner communication training: A scoping review. JOURNAL OF COMMUNICATION DISORDERS 2020; 83:105951. [PMID: 31751831 DOI: 10.1016/j.jcomdis.2019.105951] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 10/02/2019] [Accepted: 10/23/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Communication partner training could be employed to train people working in the community to facilitate interaction with individuals who live with a variety of communication disorders. However, current evidence syntheses are limited to a single disorder (e.g., aphasia) and focus on a variety of familiar and unfamiliar communication partners. An understanding of the scope of literature across the evidence-base of acquired neurological populations may provide a better basis to develop interventions and future research tailored for community workers. AIMS To explore the scope of literature on paid worker and unfamiliar partner communication training for acquired neurogenic communication disorders with a focus on describing: 1) the types of communication disorders addressed by interventions; 2) the types of learners who received the interventions; 3) the nature of the interventions; and 4) the reported effects on trainees and people with a communication disorder. METHODS & PROCEDURES A scoping review was conducted. Studies were selected by a systematic keyword search, undertaken through four databases. Eligibility criteria included studies that: (i) reported an intervention directed at paid workers or unfamiliar partners where the primary goal was to improve communication with people with acquired neurogenic communication disorders, (ii) reported original results, (iii) contained quantitative or qualitative data on the effects of the intervention, (iv) were written in English or French and (v) were published in a peer-reviewed journal. The PRISMA-ScR was used to guide design and reporting of the scoping review. RESULTS Seventy publications met the inclusion criteria. Interventions were mostly disorder-specific and addressed communication with people with dementia, aphasia or traumatic brain injury. 15/70 studies examined training programs that were not restructured to a specific population (e.g., aphasia). Learners were mostly working or studying in the healthcare field and only 2/70 studies included community workers without primarily health training. Sixty different interventions were reported and were mostly delivered by speech-language pathologists. Training varied in terms of duration (a few minutes to 46 h) and content, but many shared training methods (e.g., presentation of theory on communication disorders). Nearly all studies demonstrated positive results, 23/26 studies suggested that paid worker and unfamiliar partner communication training may increase the knowledge of trainees, 24/26 studies suggested that it could improve their confidence when interacting with people with a communication disorder and 44/46 studies suggested that it could improve the trainees' communication abilities. CONCLUSION A small developing evidence-base exists for communication training programs for paid and unfamiliar communications partners that focuses beyond a single diagnosis or disorder. However, there is very limited knowledge on interventions for community workers from non-health professions. Future research should focus on the evaluation of existing programs tailored to, or explicitly designed for this context with the aim of identifying active ingredients that lead to improved and sustainable outcomes.
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Affiliation(s)
- Alexandra Tessier
- Université de Montréal, Faculté de médecine, École d'orthophonie et d'audiologie, C.P. 6128, succursale Centre-ville, Montréal, Québec H3C 3J7, Canada; Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, 6363 chemin Hudson (Pavillon Lindsay), bureau 061, Montréal, Québec H3S 1M9 Canada.
| | - Emma Power
- University of Technology Sydney, Graduate School of Health, The Graduate Research School, University of Technology Sydney, PO Box 123, Broadway, NSW 2007, Sydney, Australia.
| | - Claire Croteau
- Université de Montréal, Faculté de médecine, École d'orthophonie et d'audiologie, C.P. 6128, succursale Centre-ville, Montréal, Québec H3C 3J7, Canada; Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, 6363 chemin Hudson (Pavillon Lindsay), bureau 061, Montréal, Québec H3S 1M9 Canada.
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Elbourn E, Kenny B, Power E, Togher L. Psychosocial Outcomes of Severe Traumatic Brain Injury in Relation to Discourse Recovery: A Longitudinal Study up to 1 Year Post-Injury. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2019; 28:1463-1478. [PMID: 31487472 DOI: 10.1044/2019_ajslp-18-0204] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose The interrelationship between psychosocial outcomes and discourse after severe traumatic brain injury remains largely unknown. This study examines outcomes relating to work, relationships, and independence within the context of discourse recovery across the 1st year post-injury. Method An inception cohort comprising 57 participants with severe traumatic brain injury was assessed at 3, 6, 9, and 12 months post-injury. Outcomes were measured with the Sydney Psychosocial Reintegration Scale-2 (Tate et al., 2012; Tate, Simpson, Loo, & Lane-Brown, 2011), and discourse was evaluated with Main Concept Analysis of a narrative retell. Correlation and linear regression analyses were utilized. Results Significant correlations were found between psychosocial outcomes reported by relatives and discourse performance across the 1st year. The 6-month discourse scores significantly predicted the 12-month psychosocial outcomes reported by relatives. Initial discourse severity and recovery pattern also informed outcomes. Conclusions Discourse disorders have a strong relationship with everyday outcomes relating to work, relationships, and independence as reported by relatives. Six months post-injury is a beneficial time for assessment, education, and service planning. Age, years of education, and aphasia may mediate recovery and outcomes. A clinical decision tree is offered to support goal setting. Supplemental Material https://doi.org/10.23641/asha.9755444.
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Affiliation(s)
- Elise Elbourn
- Discipline of Speech Pathology, The University of Sydney, New South Wales, Australia
| | - Belinda Kenny
- Discipline of Speech Pathology, The University of Sydney, New South Wales, Australia
| | - Emma Power
- Graduate School of Health, University of Technology Sydney, New South Wales, Australia
| | - Leanne Togher
- Discipline of Speech Pathology, The University of Sydney, New South Wales, Australia
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Powell L, Gomez D, Gau J, Glang A, Perez A, Slocumb J, Beck L, Dawson M. A survey of the training experiences and needs of paraprofessionals serving adults with brain injury. Brain Inj 2019; 34:281-289. [DOI: 10.1080/02699052.2019.1686773] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Laurie Powell
- Center on Brain Injury Research and Training, University of Oregon, Eugene, OR, USA
| | - Doug Gomez
- Center on Brain Injury Research and Training, University of Oregon, Eugene, OR, USA
| | - Jeff Gau
- Center on Brain Injury Research and Training, University of Oregon, Eugene, OR, USA
| | - Ann Glang
- Center on Brain Injury Research and Training, University of Oregon, Eugene, OR, USA
| | - Amanda Perez
- Center on Brain Injury Research and Training, University of Oregon, Eugene, OR, USA
| | - Jody Slocumb
- Center on Brain Injury Research and Training, University of Oregon, Eugene, OR, USA
| | - Laura Beck
- Center on Brain Injury Research and Training, University of Oregon, Eugene, OR, USA
| | - Matthew Dawson
- Center on Brain Injury Research and Training, University of Oregon, Eugene, OR, USA
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Behn N, Marshall J, Togher L, Cruice M. Setting and achieving individualized social communication goals for people with acquired brain injury (ABI) within a group treatment. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2019; 54:828-840. [PMID: 31250537 DOI: 10.1111/1460-6984.12488] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 05/24/2019] [Accepted: 06/05/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Cognitive-communication disorders are common following an acquired brain injury (ABI). Remediation should involve individualized goal-setting, yet few reports describe the effectiveness of setting communication goals in a group setting. AIMS To describe a process for setting and achieving goals for people with ABI. METHODS & PROCEDURES A total of 21 participants with ABI participated in a group treatment (triads and dyads) over 6 weeks (20 h in total). Specific social communication goals were set using goal attainment scaling (GAS) with the participant and their communication partner. Goals targeted strategy use that accounted for existing cognitive abilities. The participant and their communication partner evaluated the goals post-treatment and 6-8 weeks later. Data were analysed using Friedman's test to identify the achievement of GAS goals. OUTCOMES & RESULTS A total of 20 participants recalled goals independently post-treatment. Significant improvement post-treatment on GAS goals was rated by both the participant (p < 0.001) and their communication partner (p < 0.001). This improvement was maintained at follow-up. No significant differences in ratings were found between participants and their communication partners at either time point. CONCLUSIONS & IMPLICATIONS Individualized social communication goals can be set and achieved for people with ABI in group treatment, even when participants are several years post-injury. GAS offers a method for structuring and quantifying goal progress. Involving communication partners and cognitive strategies were effective in improving communication.
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Affiliation(s)
- Nicholas Behn
- Division of Language and Communication Science, School of Health Sciences, City, University of London, London, UK
| | - Jane Marshall
- Division of Language and Communication Science, School of Health Sciences, City, University of London, London, UK
| | - Leanne Togher
- Speech Pathology, Faculty of Health Sciences, The University of Sydney, Lidcombe, NSW, Australia
| | - Madeline Cruice
- Division of Language and Communication Science, School of Health Sciences, City, University of London, London, UK
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Behn N, Marshall J, Togher L, Cruice M. Reporting on novel complex intervention development for adults with social communication impairments after acquired brain injury. Disabil Rehabil 2019; 43:805-814. [PMID: 31361164 DOI: 10.1080/09638288.2019.1642964] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE Interventions are often poorly described in published controlled trials, with relatively little information regarding intervention development, content and fidelity. This makes it difficult to conduct replication studies, interpret and compare findings across studies and for therapists to deliver the intervention in clinical practice. Complete reporting of interventions (including fidelity) is now recommended for treatment studies, and this standardized approach is achieved using the Template for Intervention Description and Replication (TIDieR). The aim of this article is to describe the multi-phase process of developing a novel intervention for adults with acquired brain injury (ABI) and report on the findings from involving practicing therapists in this process. METHODS Phase 1 involved a review of relevant literature and specifying the intervention as a prototype intervention manual. Phase 2 comprised a focus group with eight practicing therapists exploring their experiences and perceptions of the intervention, potential active components, and essential elements; it also included a review of the prototype manual. Data from the focus group discussion was transcribed and analyzed thematically. Phase 3 investigated actual fidelity of the intervention undertaken, achieved by observers viewing videoed sessions and appraising against the fidelity checklist, which was then analyzed using Cohen's kappa. RESULTS Project-based intervention was defined as having six essential elements: a project or tangible end product focus; group-based intervention; individualized communication-based goals; communication partner involvement; acknowledgement and support of participants' cognitive ability; and consideration and plan to address impaired awareness. Analysis of focus group data revealed four themes of essential elements; group context; therapeutic skills; and manual core components and informed the development of a fidelity checklist with 13 essential and 6 desirable criteria. Fidelity assessed using percent agreement was acceptable for almost all rater pairs; where significant, Kappa coefficients had values ranging from poor to excellent (k = 0.34-1.0) depending on rater pair and session. DISCUSSION The TIDieR framework provided a clear systematic approach for the complete description and reporting of a complex communication intervention for people with ABI. This article comprehensively described the development and manualisation of intervention in collaboration with practicing therapists which can be used for future testing. In addition, the process undertaken has the potential to inform rehabilitation researchers in other fields on the development of complex interventions.Implications for rehabilitationThe results of this study detail the steps needed to describe an intervention, from the identification of the essential elements through to the creation of a manual and checklist to show fidelity. The process provides a starting point for other rehabilitation researchers developing complex interventions.This article provides a clear and comprehensive description of a novel intervention containing six essential elements for people with acquired brain injury presenting with communication impairments.Project-based intervention is one intervention, which intends to help improve communication skills and quality of life in people with acquired brain injury.This study highlights the important role practicing therapists can play in the creation of an intervention manual and fidelity checklist and in ensuring that sufficient detail is provided to help therapists implement the intervention into clinical practice.
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Affiliation(s)
- Nicholas Behn
- Division of Language and Communication Science, School of Health Sciences, City, University of London, London, UK
| | - Jane Marshall
- Division of Language and Communication Science, School of Health Sciences, City, University of London, London, UK
| | - Leanne Togher
- Speech Pathology, Faculty of Health Sciences, The University of Sydney, Lidcombe, Australia
| | - Madeline Cruice
- Division of Language and Communication Science, School of Health Sciences, City, University of London, London, UK
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Protocol for a clinical trial of telehealth-based social communication skills training for people with traumatic brain injury and their communication partners. BRAIN IMPAIR 2019. [DOI: 10.1017/brimp.2019.9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractBackground: A previous clinical trial of training communication partners of people with traumatic brain injury (TBI) demonstrated positive outcomes [Togher, Power, McDonald, Tate, & Rietdijk (2009). Brain Impairment, 10(2), 188-204]. Adapting communication partner training for delivery via telehealth could improve access to this intervention.Objectives: To compare outcomes across in-person communication partner training, telehealth communication partner training and a control groupMethod: Protocol for a partially randomised controlled trial. People with moderate-severe TBI will be allocated to either an in-person or telehealth-based training program. Comparison data will be drawn from the original trial control group, which was recruited using the same eligibility criteria as this protocol. Outcomes after training will be compared between the in-person training group, the telehealth training group and the historical control group.Discussion: This protocol uses specific design features with the aim of maximising the study’s power, including a partially randomised allocation process and a historical control group. The results will inform about the feasibility and effectiveness of delivering TBI rehabilitation via telehealth.Trial registration: Australian and New Zealand Clinical Trials Registry: ACTRN12615001024538.
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Behn N, Marshall J, Togher L, Cruice M. Feasibility and initial efficacy of project-based treatment for people with ABI. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2019; 54:465-478. [PMID: 30693611 DOI: 10.1111/1460-6984.12452] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Revised: 11/02/2018] [Accepted: 12/10/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Communication impairments are common and pervasive for people a long time following acquired brain injury (ABI). These impairments have a significant impact on a person's quality of life (QOL) post-injury. Project-based treatment is a treatment approach that could have an impact on communication skills and QOL for people with ABI a long-term post-injury. This treatment is embedded in a context of meaningful activities chosen by people with ABI, whereby, as a group, they work collaboratively to achieve a tangible end product. AIMS To evaluate the feasibility and initial efficacy of project-based treatment on improving the communication skills and QOL for people with ABI. METHODS & PROCEDURES An exploratory controlled trial with alternate allocation of groups, and follow-up at 6-8 weeks, was completed. Twenty-one people with chronic ABI were recruited in groups of two to three from community settings, allocated to either a TREATMENT (n = 11) or WAITLIST group (n = 10). Participants attended a 20-h group-based treatment over 6 weeks where they worked towards achieving a project that helped others. To determine feasibility, four criteria were used: demand, implementation, practicality and acceptability. A range of communication and QOL outcomes was used to determine a fifth feasibility criterion, initial efficacy. Some of these criteria were additionally used to evaluate the feasibility of the outcomes. OUTCOMES & RESULTS All participants received the treatment as allocated with high attendance and no dropouts. The treatment was feasible to deliver as intended and was highly acceptable to participants. Medium and large effect sizes were found from pre- to post-treatment, and from pre-treatment to follow-up for measures of conversation, perceived communicative ability and QOL. CONCLUSIONS & IMPLICATIONS Project-based treatment is feasible with indications of initial efficacy for both communication skills and QOL. The treatment provides a promising new approach for improving communication skills and QOL in people with chronic acquired brain injuries in the community setting.
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Affiliation(s)
- Nicholas Behn
- Division of Language and Communication Science, School of Health Sciences, City, University of London, London, UK
| | - Jane Marshall
- Division of Language and Communication Science, School of Health Sciences, City, University of London, London, UK
| | - Leanne Togher
- Speech Pathology, Faculty of Health Sciences, The University of Sydney, Lidcombe, NSW, Australia
| | - Madeline Cruice
- Division of Language and Communication Science, School of Health Sciences, City, University of London, London, UK
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Chia AA, Power E, Kenny B, Elbourn E, McDonald S, Tate R, MacWhinney B, Turkstra L, Holland A, Togher L. Patterns of early conversational recovery for people with traumatic brain injury and their communication partners. Brain Inj 2019; 33:690-698. [DOI: 10.1080/02699052.2019.1571632] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- An An Chia
- Discipline of Speech Pathology, Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia
| | - Emma Power
- Discipline of Speech Pathology, Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia
- Discipline of Speech Pathology, UTS Graduate School of Health, University of Technology, Sydney, Australia
| | - Belinda Kenny
- Discipline of Speech Pathology, Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia
- NHMRC Centre of Research Excellence in Brain Recovery, Sydney, NSW, Australia
| | - Elise Elbourn
- Discipline of Speech Pathology, Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia
- NHMRC Centre of Research Excellence in Brain Recovery, Sydney, NSW, Australia
| | - Skye McDonald
- NHMRC Centre of Research Excellence in Brain Recovery, Sydney, NSW, Australia
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Robyn Tate
- NHMRC Centre of Research Excellence in Brain Recovery, Sydney, NSW, Australia
- Faculty of Medicine, University of Sydney, Sydney, NSW, Australia
| | - Brian MacWhinney
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Lyn Turkstra
- Department of Communicative Disorders, University of Wisconsin-Madison, Madison, WI, USA
| | - Audrey Holland
- Department of Speech, Language and Hearing Sciences, University of Arizona, Tucson, AZ, USA
| | - Leanne Togher
- Discipline of Speech Pathology, Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia
- NHMRC Centre of Research Excellence in Brain Recovery, Sydney, NSW, Australia
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Rietdijk R, Power E, Brunner M, Togher L. The reliability of evaluating conversations between people with traumatic brain injury and their communication partners via videoconferencing. Neuropsychol Rehabil 2018; 30:1074-1091. [DOI: 10.1080/09602011.2018.1554533] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Rachael Rietdijk
- The University of Sydney, Faculty of Health Sciences, Sydney, NSW, Australia
| | - Emma Power
- The University of Sydney, Faculty of Health Sciences, Sydney, NSW, Australia
- The University of Technology Sydney, Graduate School of Health, Sydney, NSW, Australia
| | - Melissa Brunner
- The University of Sydney, Faculty of Health Sciences, Sydney, NSW, Australia
- The University of Technology Sydney, Graduate School of Health, Sydney, NSW, Australia
| | - Leanne Togher
- The University of Sydney, Faculty of Health Sciences, Sydney, NSW, Australia
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Elbourn E, Kenny B, Power E, Honan C, McDonald S, Tate R, Holland A, MacWhinney B, Togher L. Discourse recovery after severe traumatic brain injury: exploring the first year. Brain Inj 2018; 33:143-159. [DOI: 10.1080/02699052.2018.1539246] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Elise Elbourn
- Faculty of Health Sciences, The University of Sydney, Lidcombe, Australia
| | - Belinda Kenny
- Faculty of Health Sciences, The University of Sydney, Lidcombe, Australia
| | - Emma Power
- Faculty of Health Sciences, The University of Sydney, Lidcombe, Australia
| | - Cynthia Honan
- School of Medicine, The University of Tasmania, Hobart, Australia
| | - Skye McDonald
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Robyn Tate
- Faculty of Health Sciences, The University of Sydney, Lidcombe, Australia
| | - Audrey Holland
- Speech, Language and Hearing Sciences, The University of Arizona, Tucson, USA
| | - Brian MacWhinney
- Department of Psychology, Carnegie Mellon University, Pittsburgh, USA
| | - Leanne Togher
- Faculty of Health Sciences, The University of Sydney, Lidcombe, Australia
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O'Rourke A, Power E, O'Halloran R, Rietdijk R. Common and distinct components of communication partner training programmes in stroke, traumatic brain injury and dementia. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2018; 53:1150-1168. [PMID: 30295014 DOI: 10.1111/1460-6984.12428] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Revised: 08/10/2018] [Accepted: 09/10/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Communication partner training (CPT) programmes for health and care staff working with people with the neurologically based communication disorders associated with stroke, traumatic brain injury (TBI) and dementia are efficacious in improving communication. However, current programmes are lengthy and disorder specific, and therefore may not be suitable as staff training tools in environments with people with multiple communication disorders, and services with a variety of neurological populations. AIMS To identify common and distinct components of CPT programmes for stroke, TBI and dementia in order to determine whether there are common delivery methods and content that can be consolidated to improve implementation of CPT in health and care services. METHODS & PROCEDURES A qualitative enquiry was used. Four CPT programmes targeting three disorders were identified from systematic reviews and literature searches. Programme data were recorded onto data sheets from manuals, study articles and supplementary materials, and were categorized using the Intervention Taxonomy (ITAX). Content analysis and elements of constant comparative analysis were employed to analyse the CPT programmes. OUTCOMES & RESULTS Delivery characteristics were similar across all four programmes. All were delivered face to face in either group or individual contexts. However, duration varied from 1 to 35 h. Six of the 12 categories of information provided were common across all programmes, including 'strategy' 'background to disorder', 'information about communication', 'information about program', 'negative behaviours to avoid' and 'purpose of program'. Programmes differed in the types of skill-building techniques used, with the most common being videos (3/4 programmes), discussions (2/4 programmes) and trainer demonstrations (2/4 programmes). While strategies provided to trained partners targeted similar domains of communication, only 3/96 individual strategies were common to all programmes. CONCLUSIONS & IMPLICATIONS There are both common and distinct components in content and delivery methods across CPT programmes. Further research is needed to evaluate the distinct components of the programmes, to determine which individual strategies are efficacious, and which approach to skill-building techniques is most effective. The present study has contributed a comprehensive list of programme components, which can form a basis for describing and refining CPT programmes in future.
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Affiliation(s)
- Angela O'Rourke
- Discipline of Speech Pathology, Faculty of Health Sciences, University of Sydney, Sydney, NSW, Australia
| | - Emma Power
- Discipline of Speech Pathology, Faculty of Health Sciences, University of Sydney, Sydney, NSW, Australia
| | - Robyn O'Halloran
- Discipline of Speech Pathology, School of Allied Health, La Trobe University, Melbourne, VIC, Australia
| | - Rachael Rietdijk
- Discipline of Speech Pathology, Faculty of Health Sciences, University of Sydney, Sydney, NSW, Australia
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Rietdijk R, Power E, Brunner M, Togher L. A single case experimental design study on improving social communication skills after traumatic brain injury using communication partner telehealth training. Brain Inj 2018; 33:94-104. [DOI: 10.1080/02699052.2018.1531313] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Rachael Rietdijk
- Faculty of Health Sciences, The University of Sydney, Sydney, Australia
| | - Emma Power
- Faculty of Health Sciences, The University of Sydney, Sydney, Australia
- Graduate School of Health, The University of Technology, Sydney, Australia
| | - Melissa Brunner
- Faculty of Health Sciences, The University of Sydney, Sydney, Australia
- Graduate School of Health, The University of Technology, Sydney, Australia
| | - Leanne Togher
- Faculty of Health Sciences, The University of Sydney, Sydney, Australia
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Steel J, Togher L. Social communication assessment after TBI: a narrative review of innovations in pragmatic and discourse assessment methods. Brain Inj 2018; 33:1-14. [PMID: 30303397 DOI: 10.1080/02699052.2018.1531304] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 08/25/2018] [Accepted: 08/27/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Social communication assessment after traumatic brain injury (TBI) remains a challenging area within speech-language pathology (SLP) clinical practice. Difficulties include the lack of TBI-specific standardized assessment instruments and limited knowledge and uptake of discourse assessment methods clinically. The aim of this paper was to review recent research literature reporting on innovative social communication and discourse assessment measures and methods, to guide evidence-based SLP practice and inform future research. MAIN CONTRIBUTION This review describes novel standardized and non-standardized assessment tools for SLP use reported in TBI research literature from the past 15 years. Measures include published assessment batteries and pragmatic rating scales designed for use with adults with TBI, and novel discourse tasks and protocols. CONCLUSION This paper delineates social communication assessment measures and discourse analyses described in research literature that may be practical for SLPs to use with adults with TBI. The clinical implications and utility of these measures are discussed. This should assist SLPs in decision-making on social communication assessment for adults with TBI. Further research is needed to investigate translation of research knowledge on discourse assessment methods to SLP practice.
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Affiliation(s)
- Joanne Steel
- a Speech Pathology , The University of Technology , Sydney , Australia
- b Moving Ahead , NHMRC Centre of Research Excellence in Brain Recovery, School of Psychology, University of New South Wales ,, Sydney , Australia
| | - Leanne Togher
- b Moving Ahead , NHMRC Centre of Research Excellence in Brain Recovery, School of Psychology, University of New South Wales ,, Sydney , Australia
- c Speech Pathology , The University of Sydney , Sydney , Australia
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MacDonald S. Introducing the model of cognitive-communication competence: A model to guide evidence-based communication interventions after brain injury. Brain Inj 2017; 31:1760-1780. [DOI: 10.1080/02699052.2017.1379613] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Sheila MacDonald
- Adjunct Lecturer, Department of Speech-Language Pathology, University of Toronto, Toronto, Ontario, Canada
- Owner, Sheila MacDonald & Associates, Guelph, Ontario, Canada
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Mitchell C, Bowen A, Tyson S, Butterfint Z, Conroy P. Interventions for dysarthria due to stroke and other adult-acquired, non-progressive brain injury. Cochrane Database Syst Rev 2017; 1:CD002088. [PMID: 28121021 PMCID: PMC6464736 DOI: 10.1002/14651858.cd002088.pub3] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Dysarthria is an acquired speech disorder following neurological injury that reduces intelligibility of speech due to weak, imprecise, slow and/or unco-ordinated muscle control. The impact of dysarthria goes beyond communication and affects psychosocial functioning. This is an update of a review previously published in 2005. The scope has been broadened to include additional interventions, and the title amended accordingly. OBJECTIVES To assess the effects of interventions to improve dysarthric speech following stroke and other non-progressive adult-acquired brain injury such as trauma, infection, tumour and surgery. SEARCH METHODS We searched the Cochrane Stroke Group Trials Register (May 2016), CENTRAL (Cochrane Library 2016, Issue 4), MEDLINE, Embase, and CINAHL on 6 May 2016. We also searched Linguistics and Language Behavioral Abstracts (LLBA) (1976 to November 2016) and PsycINFO (1800 to September 2016). To identify further published, unpublished and ongoing trials, we searched major trials registers: WHO ICTRP, the ISRCTN registry, and ClinicalTrials.gov. We also handsearched the reference lists of relevant articles and contacted academic institutions and other researchers regarding other published, unpublished or ongoing trials. We did not impose any language restrictions. SELECTION CRITERIA We selected randomised controlled trials (RCTs) comparing dysarthria interventions with 1) no intervention, 2) another intervention for dysarthria (this intervention may differ in methodology, timing of delivery, duration, frequency or theory), or 3) an attention control. DATA COLLECTION AND ANALYSIS Three review authors selected trials for inclusion, extracted data, and assessed risk of bias. We attempted to contact study authors for clarification and missing data as required. We calculated standardised mean difference (SMD) and 95% confidence interval (CI), using a random-effects model, and performed sensitivity analyses to assess the influence of methodological quality. We planned to conduct subgroup analyses for underlying clinical conditions. MAIN RESULTS We included five small trials that randomised a total of 234 participants. Two studies were assessed as low risk of bias; none of the included studies were adequately powered. Two studies used an attention control and three studies compared to an alternative intervention, which in all cases was one intervention versus usual care intervention. The searches we carried out did not find any trials comparing an intervention with no intervention. The searches did not find any trials of an intervention that compared variations in timing, dose, or intensity of treatment using the same intervention. Four studies included only people with stroke; one included mostly people with stroke, but also those with brain injury. Three studies delivered interventions in the first few months after stroke; two recruited people with chronic dysarthria. Three studies evaluated behavioural interventions, one investigated acupuncture and another transcranial magnetic stimulation. One study included people with dysarthria within a broader trial of people with impaired communication.Our primary analysis of a persisting (three to nine months post-intervention) effect at the activity level of measurement found no evidence in favour of dysarthria intervention compared with any control (SMD 0.18, 95% CI -0.18 to 0.55; 3 trials, 116 participants, GRADE: low quality, I² = 0%). Findings from sensitivity analysis of studies at low risk of bias were similar, with a slightly wider confidence interval and low heterogeneity (SMD 0.21, 95% CI -0.30 to 0.73, I² = 32%; 2 trials, 92 participants, GRADE: low quality). Subgroup analysis results for stroke were similar to the primary analysis because few non-stroke participants had been recruited to trials (SMD 0.16, 95% CI -0.23 to 0.54, I² = 0%; 3 trials, 106 participants, GRADE: low quality).Similar results emerged from most of the secondary analyses. There was no evidence of a persisting effect at the impairment (SMD 0.07, 95% CI -0.91 to 1.06, I² = 70%; 2 trials, 56 participants, GRADE: very low quality) or participation level (SMD -0.11, 95% CI -0.56 to 0.33, I² = 0%; 2 trials, 79 participants, GRADE: low quality) but substantial heterogeneity on the former. Analyses of immediate post-intervention outcomes provided no evidence of any short-term benefit on activity (SMD 0.29, 95% CI -0.07 to 0.66, I² = 0%; 3 trials, 117 participants, GRADE: very low quality); or participation (SMD -0.24, 95% CI -0.94 to 0.45; 1 study, 32 participants) levels of measurement.There was a statistically significant effect favouring intervention at the immediate, impairment level of measurement (SMD 0.47, 95% CI 0.02 to 0.92, P = 0.04, I² = 0%; 4 trials, 99 participants, GRADE: very low quality) but only one of these four trials had a low risk of bias. AUTHORS' CONCLUSIONS We found no definitive, adequately powered RCTs of interventions for people with dysarthria. We found limited evidence to suggest there may be an immediate beneficial effect on impairment level measures; more, higher quality research is needed to confirm this finding.Although we evaluated five studies, the benefits and risks of interventions remain unknown and the emerging evidence justifies the need for adequately powered clinical trials into this condition.People with dysarthria after stroke or brain injury should continue to receive rehabilitation according to clinical guidelines.
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Affiliation(s)
- Claire Mitchell
- University of Manchester MAHSCDivision of Neuroscience and Experimental PsychologyEllen Wilkinson BuildingManchesterUK
- Central Manchester University Hospitals NHS Foundation Trust, MAHSCManchester Royal InfirmaryManchesterUK
| | - Audrey Bowen
- University of Manchester MAHSCDivision of Neuroscience and Experimental PsychologyEllen Wilkinson BuildingManchesterUK
| | - Sarah Tyson
- University of ManchesterDivision of Nursing, Midwifery & Social WorkOxford RoadManchesterUKM13 9PL
| | - Zoe Butterfint
- University of East AngliaSchool of Health SciencesQueen's BuildingEarlham RoadNorwichUKNR4 7TJ
| | - Paul Conroy
- University of Manchester MAHSCDivision of Neuroscience and Experimental PsychologyEllen Wilkinson BuildingManchesterUK
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Saldert C. Pragmatic Assessment and Intervention in Adults. PERSPECTIVES IN PRAGMATICS, PHILOSOPHY & PSYCHOLOGY 2017. [DOI: 10.1007/978-3-319-47489-2_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Douglas JM, Knox L, De Maio C, Bridge H, Drummond M, Whiteoak J. Effectiveness of Communication-specific Coping Intervention for adults with traumatic brain injury: preliminary results. Neuropsychol Rehabil 2016; 29:73-91. [DOI: 10.1080/09602011.2016.1259114] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Jacinta M. Douglas
- Living with Disability Research Centre, School of Allied Health, La Trobe University, Victoria, Australia
- Summer Foundation, Victoria, Australia
| | - Lucy Knox
- Living with Disability Research Centre, School of Allied Health, La Trobe University, Victoria, Australia
- Summer Foundation, Victoria, Australia
| | - Carren De Maio
- Living with Disability Research Centre, School of Allied Health, La Trobe University, Victoria, Australia
- Scope, Victoria, Australia
| | - Helen Bridge
- Living with Disability Research Centre, School of Allied Health, La Trobe University, Victoria, Australia
- Beachside & South Eastern Suburbs Speech Pathology, Victoria, Australia
| | - Melanie Drummond
- Living with Disability Research Centre, School of Allied Health, La Trobe University, Victoria, Australia
- Epworth Monash Rehabilitation Medicine Unit, Victoria, Australia
- Speech Pathology Department, Epworth Rehabilitation, Epworth HealthCare, Victoria, Australia
| | - Joanne Whiteoak
- Living with Disability Research Centre, School of Allied Health, La Trobe University, Victoria, Australia
- Speech Pathology Department, Epworth Rehabilitation, Epworth HealthCare, Victoria, Australia
- Speech Pathology Department, Alfred Health/Caulfield Hospital, Caulfield, Australia
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Lancioni G, Singh N, O'Reilly M, Sigafoos J, D'Amico F, Sasanelli G, Denitto F, Lang R. Technology-aided leisure and communication: Opportunities for persons with advanced Parkinson's disease. Dev Neurorehabil 2016; 19:398-404. [PMID: 25826719 DOI: 10.3109/17518423.2014.1002637] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE This study investigated whether simple technology-aided programs could be used to promote leisure and communication engagement in three persons with advanced Parkinson's disease. METHOD The programs included music and video options, which were combined with (a) text messaging and telephone calls for the first participant, (b) verbal statements/requests, text messaging, and reading for the second participant, and (c) verbal statements/requests and prayers for the third participant. The participants could activate those options via hand movement or vocal emission and specific microswitches. RESULTS All three participants were successful in activating the options available. The mean cumulative frequencies of option activations were about five per 15-min session for the first two participants and about four per 10-min session for the third participant. CONCLUSION The results were considered encouraging and relevant given the limited amount of evidence available on helping persons with advanced Parkinson's disease with leisure and communication.
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Affiliation(s)
- Giulio Lancioni
- a Department of Neuroscience and Sense Organs , University of Bari , Bari , Italy
| | - Nirbhay Singh
- b Medical College of Georgia, Georgia Regents University , Augusta , GA , USA
| | - Mark O'Reilly
- c Department of Special Education , University of Texas at Austin , Austin , TX , USA
| | - Jeff Sigafoos
- d Department of Educational Psychology , Victoria University of Wellington , Wellington , New Zealand
| | - Fiora D'Amico
- e S. Raffaele Medical Care Center , Alberobello , Italy
| | | | | | - Russell Lang
- g Department of Curriculum Instruction , Texas State University , San Marcos , TX , USA
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Eriksson K, Hartelius L, Saldert C. Participant characteristics and observed support in conversations involving people with communication disorders. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2016; 18:439-449. [PMID: 27111733 DOI: 10.3109/17549507.2015.1126642] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
PURPOSE Communication partner training is an increasingly common approach to improve the possibilities for people with communication disorders to participate in everyday interaction. So far, though, little is known about what conversation partner characteristics might influence the ability to be a supportive partner in conversation. The current study explored possible associations between the observed skill to support a person with communication difficulties in conversation and the following characteristics of the conversation partner; executive function, inference ability, age, education level and relationship to the person with communication disorder. The impact of the aetiology of the communication difficulties was also explored. METHOD Thirty-five dyads participated: 23 people with aphasia along with 18 significant others and five enrolled nurses and 12 people with Parkinson's disease along with 10 significant others and two enrolled nurses. RESULT Only tendencies of associations were found between observed skill to support conversation and executive function for the significant others and inference ability for the enrolled nurses. CONCLUSION Although type of activity involved in the conversation may be a key factor, the results indicate that executive function and ability to make mental inferences may matter for the ability to support a person with communication disorder in conversation.
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Affiliation(s)
- Karin Eriksson
- a Institute of Neuroscience and Physiology, Division of Speech and Language Pathology , University of Gothenburg , Gothenburg , Sweden and
- b University of Gothenburg Centre for Person-Centred Care (GPCC) , Gothenburg , Sweden
| | - Lena Hartelius
- a Institute of Neuroscience and Physiology, Division of Speech and Language Pathology , University of Gothenburg , Gothenburg , Sweden and
- b University of Gothenburg Centre for Person-Centred Care (GPCC) , Gothenburg , Sweden
| | - Charlotta Saldert
- a Institute of Neuroscience and Physiology, Division of Speech and Language Pathology , University of Gothenburg , Gothenburg , Sweden and
- b University of Gothenburg Centre for Person-Centred Care (GPCC) , Gothenburg , Sweden
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Brassel S, Kenny B, Power E, Elbourn E, McDonald S, Tate R, MacWhinney B, Turkstra L, Holland A, Togher L. Conversational topics discussed by individuals with severe traumatic brain injury and their communication partners during sub-acute recovery. Brain Inj 2016; 30:1329-1342. [DOI: 10.1080/02699052.2016.1187288] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Sophie Brassel
- Discipline of Speech Pathology, Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia
- NHMRC Centre of Research Excellence in Brain Recovery, Sydney, NSW, Australia
| | - Belinda Kenny
- Discipline of Speech Pathology, Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia
- NHMRC Centre of Research Excellence in Brain Recovery, Sydney, NSW, Australia
| | - Emma Power
- Discipline of Speech Pathology, Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia
- NHMRC Centre of Research Excellence in Brain Recovery, Sydney, NSW, Australia
| | - Elise Elbourn
- Discipline of Speech Pathology, Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia
- NHMRC Centre of Research Excellence in Brain Recovery, Sydney, NSW, Australia
| | - Skye McDonald
- NHMRC Centre of Research Excellence in Brain Recovery, Sydney, NSW, Australia
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Robyn Tate
- NHMRC Centre of Research Excellence in Brain Recovery, Sydney, NSW, Australia
- Faculty of Medicine, University of Sydney, Sydney, NSW, Australia
| | - Brian MacWhinney
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Lyn Turkstra
- Department of Communicative Disorders, University of Wisconsin-Madison, Madison, WI, USA
| | - Audrey Holland
- Department of Speech, Language and Hearing Sciences, University of Arizona, Tucson, AZ, USA
| | - Leanne Togher
- Discipline of Speech Pathology, Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia
- NHMRC Centre of Research Excellence in Brain Recovery, Sydney, NSW, Australia
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Togher L, McDonald S, Tate R, Rietdijk R, Power E. The effectiveness of social communication partner training for adults with severe chronic TBI and their families using a measure of perceived communication ability. NeuroRehabilitation 2016; 38:243-55. [DOI: 10.3233/nre-151316] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Leanne Togher
- Speech Pathology, Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia
- National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Brain Recovery, Sydney, NSW, Australia
| | - Skye McDonald
- School of Psychology, The University of New South Wales, Sydney, NSW, Australia
- National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Brain Recovery, Sydney, NSW, Australia
| | - Robyn Tate
- John Walsh Centre for Rehabilitation Research, Northern Clinical School, Faculty of Medicine, University of Sydney, Sydney, NSW, Australia
- National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Brain Recovery, Sydney, NSW, Australia
| | - Rachael Rietdijk
- Speech Pathology, Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia
- National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Brain Recovery, Sydney, NSW, Australia
| | - Emma Power
- Speech Pathology, Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia
- National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Brain Recovery, Sydney, NSW, Australia
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Behn N, Togher L, Power E. Experiences from a communication training programme of paid carers in a residential rehabilitation centre for people with traumatic brain injury. Brain Inj 2015; 29:1554-60. [DOI: 10.3109/02699052.2015.1077992] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Eriksson K, Forsgren E, Hartelius L, Saldert C. Communication partner training of enrolled nurses working in nursing homes with people with communication disorders caused by stroke or Parkinson’s disease. Disabil Rehabil 2015; 38:1187-203. [DOI: 10.3109/09638288.2015.1089952] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Brunner M, Hemsley B, Palmer S, Dann S, Togher L. Review of the literature on the use of social media by people with traumatic brain injury (TBI). Disabil Rehabil 2015; 37:1511-21. [DOI: 10.3109/09638288.2015.1045992] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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INCOG recommendations for management of cognition following traumatic brain injury, part IV: cognitive communication. J Head Trauma Rehabil 2015; 29:353-68. [PMID: 24984097 DOI: 10.1097/htr.0000000000000071] [Citation(s) in RCA: 162] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Cognitive-communication disorders are common in individuals with traumatic brain injury (TBI) and can have a major impact on long-term outcome. Guidelines for evidence-informed rehabilitation are needed, thus an international group of researchers and clinicians (known as INCOG) convened to develop recommendations for assessment and intervention. METHODS An expert panel met to select appropriate recommendations for assessment and treatment of cognitive-communication disorders based on available literature. To promote implementation, the team developed decision algorithms incorporating the recommendations, based on inclusion and exclusion criteria of published trials, and then prioritized recommendations for implementation and developed audit criteria to evaluate adherence to best practice recommendations. RESULTS Rehabilitation of individuals with cognitive-communication disorders should consider premorbid communication status; be individualized to the person's needs, goals, and skills; provide training in use of assistive technology where appropriate; include training of communication partners; and occur in context to minimize the need for generalization. Evidence supports treatment of social communication problems in a group format. CONCLUSION There is strong evidence for person-centered treatment of cognitive-communication disorders and use of instructional strategies such as errorless learning, metacognitive strategy training, and group treatment. Future studies should include tests of alternative service delivery models and development of participation-level outcome measures.
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Lancioni GE, Singh NN, O'Reilly MF, Sigafoos J, Buonocunto F, D'Amico F, Navarro J, Lanzilotti C, Megna M. Occupation and communication programs for post-coma persons with or without consciousness disorders who show extensive motor impairment and lack of speech. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:1110-1118. [PMID: 24582854 DOI: 10.1016/j.ridd.2014.01.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Accepted: 01/28/2014] [Indexed: 06/03/2023]
Abstract
These two studies were aimed at extending the assessment of technology-aided programs for post-coma persons with extensive motor impairment and lack of speech. Specifically, Study I assessed a new program arrangement, in which stimulation access and caregiver attention could be obtained with variations of the same response (i.e., single- versus double-hand closure) by three participants who were diagnosed at the upper level of the minimally conscious state at the start of the study. Study II was aimed at enabling two persons who had emerged from a minimally conscious state to engage in leisure activities, listen to audio-recordings of family members, and send and receive messages. The responses selected for these participants were hand pressure and eyelid closure, respectively. The results of both studies were positive. The participants of Study I increased their responding to increase their stimulation input and caregiver interaction. The participants of Study II managed to successfully select all the options the program included (i.e., the leisure options, as well as the family and communication options). General implications of the programs and the related technology packages for intervention with post-coma persons with multiple disabilities are discussed.
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Affiliation(s)
| | - Nirbhay N Singh
- Medical College of Georgia, Georgia Regents University, Augusta, USA
| | | | | | | | - Fiora D'Amico
- S. Raffaele Rehabilitation Center, Ceglie Messapica, Italy
| | - Jorge Navarro
- S. Raffaele Rehabilitation Center, Ceglie Messapica, Italy
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Lancioni GE, Singh NN, O’Reilly MF, Sigafoos J, Ricciuti RA, Trignani R, Oliva D, Signorino M, D’Amico F, Sasanelli G. Extending technology-aided leisure and communication programs to persons with spinal cord injury and post-coma multiple disabilities. Disabil Rehabil Assist Technol 2013; 10:32-7. [DOI: 10.3109/17483107.2013.860635] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Improving Communication for People with Brain Injury in the 21st Century: The Value of Collaboration. BRAIN IMPAIR 2013. [DOI: 10.1017/brimp.2013.3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This paper describes the value of collaboration from two perspectives. The first perspective highlights the benefit of teaching communication partners collaborative communication strategies to facilitate the interactions of people with traumatic brain injury (TBI). Collaborative strategies encompass the provision of collaborative intent, emotional and cognitive support, positive questioning styles and collaborative turn taking. Translating research outcomes into accessible resources is described with reference to the TBI Express website which has video demonstrations of conversation strategies for communication partners of people with TBI. The broader meaning of collaboration is also discussed, with particular focus on the advantages collaboration can provide in advancing rehabilitation outcomes for people with acquired brain injury, their families and social networks. Collaboration is described in terms of encompassing all relevant contributors to the development of research advances, including people with acquired brain injury, their families and social networks, stakeholders, clinicians, peak bodies, students and researchers. Two examples of large-scale research collaborations occurring within Australia are described, including the NHMRC Clinical Centre of Research Excellence in Aphasia Rehabilitation and the NHMRC Moving Ahead Centre for Research Excellence in Brain Recovery, also known as Moving Ahead.
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