Traumatic brain injuries (TBIs) are characterized by cognitive dysfunction, including the disruption of executive functioning, memory, and attention. Cognitive-communication disorders (CCDs), which may present a range of challenges for individuals in various social settings, are a common outcome of TBIs. CCDs may include diminished auditory comprehension and impaired verbal communication, and they can vary from individual to individual. For example, some people with TBI experience confusion and produce little verbal communication, while others produce wordy, inefficient communication.
Communication barriers can lead to lower quality of life for individuals after a TBI, largely due to reduced employment opportunities and diminished social participation. As a result, targeted interventions addressing speech pathology and community-based rehabilitation are important throughout the acute stages of TBI recovery. Many speech pathologists working with CCD patients follow the World Health Organization’s guidelines, which offer a framework for community-based rehabilitation services based on the impact of a TBI on each individual.
Despite the existence of these guidelines, there is little research on the implementation of speech pathology practices for adults with CCD following TBI in the community setting. Therefore, a team of researchers aimed to identify current practices and implications for future services by surveying 51 speech pathologists working with TBI patients, followed by an interview with 14 participants with TBI. They found that community-based speech pathology services were largely home-based (60%) and that most (88%) of the participants reported that they do not utilize community or public spaces. Only 16% of participants frequently attended group therapy, which was attributed to a lack of resources. The most common, meaningful treatment approaches for communication skills were functional therapy, strategies to compensate for communication difficulties, and social skills development. Most speech pathologists included significant others in therapy sessions and provided communication partner training.
These results support the idea that community-based services for individuals recovering from TBI should be tailored to each patient’s needs. The lack of group therapy sessions among most speech pathologists suggests a gap in services targeting social communication skills, which may be an important factor for clinicians to consider. Optimal planning of future community-based health service will require continued integration of perspectives from those involved in TBI rehabilitation and those who have lived experience with TBI.
Kelly C, Cornwell P, Copley A, et al. Community-based rehabilitation for adults with cognitive-communication disorders following traumatic brain injury: A mixed methods investigation. Brain Injury. (August 2022).