A Systematic Review of Direct Instruction for Individuals with Acquired Brain Injuries and Chronic Brain Disorders

Lower urinary tract dysfunction (LUTD) is common in patients with chronic brain disorders. This study investigated the video-urodynamic study (VUDS) findings of LUTD in patients with chronic brain disorders, including cerebrovascular accident (CVA), Parkinson's disease (PD), and early dementia. A total of 169 patients with a history of chronic brain disorders, including 84 with CVA, 55 with PD, and 30 with early dementia were enrolled. All patients had a comprehensive chart review, including brain disorder subtype, the period from diagnosis to VUDS, the VUDS parameters, and final LUTD. The mean age of patients was 69.2 ± 10.5 years, and the interval from brain insult to VUDS was 61.3 ± 49.7 months. Urodynamic detrusor overactivity (DO) was noted in 73.4% of patients, detrusor underactivity in 10.1%, and detrusor overactivity with detrusor underactivity in 16.6%. Bladder outlet obstruction (BOO) was noted in 60.9% of patients, including bladder neck dysfunction in 21.3%, urethral sphincter dysfunction in 42%, and prostatic obstruction in 10.1% of male patients. Urethral sphincter dysfunction was noted in 60% of patients with PD, 32.1% with CVA, and 36.7% with dementia (p = 0.004). A low mean maximum flow rate increased post-void residual volume, and poor voiding efficiency was common in these patients, without significant differences among the subgroups. Real-world VUDSs revealed that patients with chronic brain disorders not only had a high prevalence of DO but also impaired bladder contractility and a high rate of BOO at the level above the bladder neck and urethral sphincter.

Context: ABI can arise from many causes and is a significant issue for long-term care. Developments in health care have meant that many more people with ABI are living longer, some with complex needs arising from their brain injury. The consequences of injury are generally long-term, even lifelong. Family members of people with ABI are significant to their rehabilitation, support and care, and research has identified many of the challenges they face. Objective: This paper reports work to survey the views of family members of people with ABI to ascertain their experience of the condition and their views and experience of related health and social care services. Method: An online survey was distributed via ABI networks to family members of individuals affected by ABI. One hundred ten respondents ranked the difficulties met by their relative living with an ABI and rated the services they had encountered. A series of open questions enabled respondents to provide greater detail regarding their experience and knowledge. Findings: The key findings are that relationships between the injured and non-injured parties change, alterations to roles and responsibilities are difficult and mediated via unending and complex grief. Relatives reported poor levels of involvement in decisions regarding the provision of social and health care services, a failure to be given good, accurate information in a timely fashion and the need to ‘fight’ for virtually any service provided. Service provision, particularly post-hospital discharge, was very regularly criticized for being either entirely absent, unaware of the impact of brain injury, failing to take account of actual functioning and/or structured in ways that are not concomitant with the needs of the injured person or the relative. Lack of knowledge of the impact of ABI by non-specialist staff and services is particularly highlighted as a barrier to progress and an added burden for relatives to contend with. Social work in particular was commented upon most negatively, most often for a failure to understand the condition and needs. Valued services and professionals are noted to be humane, knowledgeable about ABI, aware of the impact ABI has on the non-injured relative and able to act as a single ‘one-stop’ focal point for service provision. Limitations: As a self-selecting cohort of respondents to an online survey the work is not necessarily generalisable to the population as a whole. The findings, however, provide important considerations for improving social and health care services for people with ABI and the key relatives involved in supporting them. Implications: Commissioners and providers of social and health care services ought to work more closely with family members of people living with ABI. Services and individual practitioners need to be more knowledgeable about the likely functional outcomes of ABI, in particular the impact of invisible impairments to cognition and executive functioning. Relatives identify the benefit of good quality, accurate information and of a knowledgeable single point of contact across time and setting. Knowledge of ABI, of neurorehabilitation and of the impact of ABI upon family members by social workers is noted to be poor and attention to this may help with people’s rehabilitation and to prevent unnecessary additional carer burden.

People with an acquired brain injury (ABI) can struggle to use social media after their injury, due to changes in their cognitive-communication skills, and would like help to improve their skills and connectivity. A focus group study in one Australian brain injury rehabilitation service recently found that ABI rehabilitation professionals are restrictive or reactive (rather than proactive) in their approach to supporting people in using social media after an ABI; however, it is unknown whether this finding reflects practice internationally. To survey a larger international cohort of rehabilitation professionals working with people after ABI to understand their views and experiences of social media use after ABI and to explore ways of addressing social media use during rehabilitation. Participants were recruited via social media posts and email invitations between July 2020 and July 2022 to complete an online survey of 27 questions across three categories, 'Demographic Information' (5 questions), 'Own social media use' (12 questions), and 'Perspectives on social media use after ABI' (10 questions). Directed content analysis was used to explore and interpret the data. Of the 83 rehabilitation professionals who responded to the survey, 68 data sets met eligibility criteria for analysis. Most respondents were aged between 25 and 55 years (86%), and practiced across Australia (53%), the United Kingdom (24%), the United States (16%), Canada (3%), the European Union (3%) and Asia (1%). Most were speech pathologists (68%), occupational therapists (9%) or clinical neuropsychologists (7%). The mean length of experience working with people with ABI was 14.3 years (SD = 10.6). Participants identified benefits in social media use during ABI rehabilitation for social connection and inclusion, whilst also highlighting the risks and their own limitations in knowledge and expertise. Clinical guidance, policy, funding and resources were recommended to support clinicians to successfully address social media goals during rehabilitation. Rehabilitation professionals recommend that social media use be routinely considered during rehabilitation after ABI and report that they need greater access to knowledge, expertise, resources and policy to support this in clinical practice. Addressing social media goals in rehabilitation was reported to be complex and challenging yet rewarding for all involved. Ongoing robust research is urgently required to give rehabilitation professionals an evidence-based framework and resources for assessment and intervention in this space. What is already known on the subject People with an acquired brain injury (ABI) experience challenges in using social media safely and meaningfully after their injury. With little guidance available to support clinical practice, ABI rehabilitation clinicians feel uncertain in their approach to addressing social media goals and want greater access to knowledge, expertise and resources. What this paper adds to existing knowledge This paper provides confirmation of previous work exploring how social media is addressed during rehabilitation and extends on our knowledge through surveying a larger cohort of international ABI rehabilitation professionals. Rehabilitation professionals report that inclusion in online communities is now central to many people's social and occupational endeavours and recommend that social media use be routinely considered during rehabilitation after ABI. When incorporating the use of social media into rehabilitation, clinicians report positive outcomes despite the complexity and challenges faced in doing so. What are the potential or actual clinical implications of this work? Respondents in this study suggested potential approaches and strategies for rehabilitation professionals to consider when supporting social media use after ABI. However, ongoing robust research is urgently required to give rehabilitation professionals an evidence-based framework and resources for assessment and intervention of social media communication skills after brain injury.

We performed a meta-analysis to synthesize evidence on the efficacy and safety of physical exercise as an add-on therapeutic intervention for quality of life (QoL), depressive symptoms and cognition across six chronic brain disorders: Alzheimer’s disease, Huntington’s disease, multiple sclerosis, Parkinson’s disease, schizophrenia and unipolar depression. 122 studies ( = k) (n = 7231) were included. Exercise was superior to treatment as usual in improving QoL (k = 64, n = 4334, ES = 0.40, p < 0.0001), depressive symptoms (k = 60, n = 2909, ES = 0.78, p < 0.0001), the cognitive domains attention and working memory (k = 21, n = 1313, ES = 0.24, p < 0.009), executive functioning (k = 14, n = 977, ES = 0.15, p = 0.013), memory (k = 12, n = 994, ES = 0.12, p = 0.038) and psychomotor speed (k = 16, n = 896, ES = 0.23, p = 0.003). Meta-regression showed a dose–response effect for exercise time (min/week) on depressive symptoms (β = 0.007, p = 0.012). 69% of the studies that reported on safety, found no complications. Exercise is an efficacious and safe add-on therapeutic intervention showing a medium-sized effect on QoL and a large effect on mood in patients with chronic brain disorders, with a positive dose–response correlation. Exercise also improved several cognitive domains with small but significant effects.

&lt;p dir="ltr"&gt;Fatigue is common in patients with acquired brain injury (ABI), including traumatic brain injury as well as non-traumatic conditions, i.e., stroke, subarachnoid hemorrhage, anoxia, and brain tumors, and in patients with chronic pain (CP), and it has a negative impact on quality of life and working capacity. A major obstacle in fatigue research has been the absence of a clear definition of the concept. One model to sorting it out is to make a distinction between subjective self-assessed fatigue as opposed to objective performance-based cognitive fatigability (CF).&lt;/p&gt;&lt;p dir="ltr"&gt;This thesis aims to deepen the understanding of fatigue in patients with ABI or CP by investigating relationships with attention functions and emotional factors, and the communication in the brain's networks in patients with CP, and, furthermore, to explore whether targeted attention training might reduce CF in patients with ABI.&lt;/p&gt;&lt;p dir="ltr"&gt;Study I investigated the association between subjective fatigue and brain injury localization, diagnosis, and depression in a clinical group of ABI patients. A significantly higher proportion of patients with posterior and non-specific lesions reported fatigue compared to those with subcortical/frontal injuries. Stroke patients exhibited lower rates of fatigue compared to the other diagnostic groups. However, following logistic regression, only depression remained as an explanatory factor for self-reported fatigue. Nonetheless, while all depressed patients reported fatigue, not all fatigued patients were depressed.&lt;/p&gt;&lt;p dir="ltr"&gt;Study II evaluated the effect of targeted attention training in reducing CF in patients with ABI. The result showed a small baseline correlation between CF and automatic processing speed and attention span. Also, the group receiving targeted attention training reduced their CF significantly more than the group receiving activity-based attention training. After control for the baseline value of CF, revealing that the targeted attention training-group started at a lower level, there was no significant effect of type of intervention.&lt;/p&gt;&lt;p dir="ltr"&gt;Study III investigated the presence of CF in patients with CP and its relation to attention functions, self-rated fatigue, emotional factors, and pain characteristics. The patients with CP did not exhibit more CF than healthy controls. Self-rated fatigue measures and pain characteristics were not associated with CF, though there was an association between CF and processing speed on a test of sustained and selective attention in the CP group. Self-rated fatigue was strongly associated with self-rated pain intensity, spreading of pain, depression, anxiety, and sleep disturbance.&lt;/p&gt;&lt;p dir="ltr"&gt;Study IV examined the presence of CF in patients with CP during a vigilance task, and whether there was a difference in Blood oxygen level dependent (BOLD) signal during the performance of the task between patients and healthy subjects. While no effect of time was found when comparing regional blood flow across the vigilance task, there were group differences in the patterns of brain activation throughout the task. Patients with CP showed stronger activation in frontal areas, and lower activation primarily in the left middle orbital gyrus and right insula, regions associated with expected reward-value, as compared to healthy controls.&lt;/p&gt;&lt;p dir="ltr"&gt;Part V is a study protocol describing a research project targeting chronic pain, fatigue and cognition, encompassing study III and IV.&lt;/p&gt;&lt;p dir="ltr"&gt;In conclusion, the results showed that subjective fatigue was strongly correlated with depression in both CP and ABI. In CP, subjective fatigue also correlated strongly with self-rated pain characteristics. No correlation between subjective fatigue and CF was found, in line with what has previously been shown in other neurological conditions. Concerning ABI, the result suggests that although depression contributes significantly to fatigue post ABI, fatigue should be recognized as partly distinct from depression in the context of brain injury. CF, in turn, was, although weakly, related to attention functions both in ABI and CP, and furthermore the results indicate that attention training might be a viable method for reducing CF in ABI. Patients with CP showed CF and reduced activation in reward-related brain areas during performance of a vigilance task, implicating deficits in reward processing in CP. This finding is interesting from both theoretical and clinical perspectives, and merits further investigation.&lt;/p&gt;&lt;h3&gt;List of scientific papers&lt;/h3&gt;&lt;p dir="ltr"&gt;I. &lt;b&gt;Holmqvist, A.&lt;/b&gt;, Lindstedt, M. B., &amp; Möller, M. C. (2018). Relationship between fatigue after acquired brain injury and depression, injury localization and aetiology: An explorative study in a rehabilitation setting. J Rehabil Med, 50(8), 725-731. &lt;a href="https://doi.org/10.2340/16501977-2365" target="_blank"&gt;https://doi.org/10.2340/16501977-2365&lt;/a&gt;&lt;/p&gt;&lt;p dir="ltr"&gt;II. &lt;b&gt;Holmqvist, A.&lt;/b&gt;, Bartfai, A., Markovic, G., &amp; Möller, M. C. (2021). Does Intensive Training of Attention Influence Cognitive Fatigability in Patients With Acquired Brain Injury? Front Neurosci, 15, 656876. &lt;a href="https://doi.org/10.3389/fnins.2021.656876" target="_blank"&gt;https://doi.org/10.3389/fnins.2021.656876&lt;/a&gt;&lt;/p&gt;&lt;p dir="ltr"&gt;III. &lt;b&gt;Holmqvist, A.&lt;/b&gt;, Berginström, N., Löfgren, M., Stålnacke, B. M., &amp; Möller, M. C. (2024). Fatigue and cognitive fatigability in patients with chronic pain. Scand J Pain, 24(1). &lt;a href="https://doi.org/10.1515/sjpain-2023-0085" target="_blank"&gt;https://doi.org/10.1515/sjpain-2023-0085&lt;/a&gt;&lt;/p&gt;&lt;p dir="ltr"&gt;IV. &lt;b&gt;Holmqvist, A.&lt;/b&gt;, Engström Nordin, L., Berginström, N., Löfgren, M., Nyberg, L., Stålnacke, B-M., Möller, M. C. Cognitive fatigability and neuronal correlates in chronic pain - a cross-sectional fMRI study. [Manuscript] &lt;/p&gt;&lt;p dir="ltr"&gt;V. Moller, M. C., Berginstrom, N., Ghafouri, B., &lt;b&gt;Holmqvist, A.&lt;/b&gt;, Lofgren, M., Nordin, L., &amp; Stalnacke, B. M. (2023). Cognitive and mental fatigue in chronic pain: cognitive functions, emotional aspects, biomarkers and neuronal correlates-protocol for a descriptive cross-sectional study. BMJ Open, 13(3), e068011. &lt;a href="https://doi.org/10.1136/bmjopen-2022-068011" target="_new"&gt;https://doi.org/10.1136/bmjopen-2022-068011&lt;/a&gt;&lt;/p&gt;

Predicting motor and cognitive outcomes from MRIs of brain structure in children with acquired brain injury: A pilot study.

A-300 Differences in MMPI-2 scores for Individuals with and without Acquired Brain Injuries

BackgroundVery little is known about the prevalence of acquired brain injury (ABI) in Ireland. ABI prevalence has previously been obtained from Belgian general practitioners using a postal survey. We attempted to ascertain the prevalence of ABI in County Mayo through a postal survey of all general practitioners in the county.The specific objectives of this project were to:1. identify whether general practitioners area. aware of patients with ABI aged 18–65 in their practicesb. able to provide prevalence data on ABI in patients aged 18–65c. able to provide data on age, gender and patient diagnosis2. analyse prevalence of ABI from any available data from general practitioners.MethodsA pilot postal survey was performed initially in order to assess the feasibility of the study. It was established that general practitioners did have the necessary information required to complete the questionnaire. A main postal survey was then undertaken. A postal questionnaire was administered to all general practices in County Mayo in the west of Ireland (n = 59). The response rate was 32.2% (n = 19).ResultsGeneral practitioners who replied on behalf of their practice could provide data on patient age, gender and diagnosis. In the nineteen practices, there were 57 patients with ABI. The age-specific prevalence of ABI in the area surveyed was estimated at 183.7 per 100,000. The mean patient population per practice was 2,833 (SD = 950). There were found to be significantly more patients with ABI in rural areas than urban areas (p = 0.006). There were also significant differences in the ages of patients in the different ABI categories. Patients whose ABI was of traumatic origin were significantly younger than those patients with ABI of haemorrhagic origin (p = 0.002).ConclusionAlthough this is a small-scale study, we have ascertained that general practitioners do have data on patients with ABI. Also, some prevalence data now exist where none was available before. These can be used to form the basis of a more substantial programme of university/community partnership research which could provide medical and psychosocial benefits for people with ABI and their families.

Acquired brain injury (ABI) is a serious problem that disproportionately affects individuals in correctional services, but relatively little is known about ABI risks and correlates in forensic psychiatric services. We conducted a retrospective chart review of all admissions to a high secure forensic hospital in Ontario, Canada from January 2009 to December 2012 (n = 637) and collected data on ABI, psychiatric diagnoses, developmental disadvantage, criminal offending, and in-hospital aggression. A k-means cluster analysis was employed to assess risk factors by which men with ABI could be identified and multivariate general linear models were used to identify ABI-related differences in offending history and in-hospital aggression. One-fifth of the men had a documented ABI indicator. Based on our cluster analysis, ABI was more likely to be identified by greater adverse childhood experiences (ACEs), more health problems from pregnancy to childhood, and lower socioeconomic status, suggesting that ABI within the forensic context is associated with greater developmental disadvantage. Men with ABI had more serious pre-admission offences, but not more serious admission offences or in-hospital aggression. Men with ABI were more likely than those without to have higher scores on the Violence Risk Appraisal Guide or to be diagnosed with mood and personality disorders, and less likely to have a schizophrenia diagnosis, suggesting an association between ABI and general mental health pathologies but not with psychotic illness. The disadvantage of ABI among men in forensic psychiatric hospitals is most likely evinced in antisocial behaviour rather than serious mental illness. Given that ACEs are likely to precede or co-occur with ABI, strategies that mitigate ACEs hold promise for ABI prevention.

The discovery of prophylactic vaccines to protect children from life-threatening infectious diseases was an extremely successful accomplishment of the twentieth century, resulting in 31 vaccines in use today. At the dawn of the twenty-first century, vaccines effective for treatment of established chronic diseases are now under investigation, building on the basic science that has identified molecules that participate in the disease process. Excitingly, progress is being made in exploiting antibody-based therapies against chronic brain disorders that represent a major public health burden. Both passive and active immunization strategies show promise in the treatment of two classes of chronic brain disease, Alzheimer's disease, and addiction. Active immunization is the traditional approach to systemically administer a drug or molecule of interest to generate an intended antibody response in patients. Passive immunization involves the administration of an antibody generated in a host or model system, which is maximized for efficacy before administration to a patient. Active immunization with Aβ or passive immunization with anti-Aβ antibodies, for example, dramatically reduced amyloid burden and ameliorated behavioral deficits in a transgenic mouse model of Alzheimer's disease (β-amyloid mice) (Kayed and Jackson, 2009). Similarly, active and passive approaches to vaccinate against cocaine, nicotine, morphine, and methamphetamine indicate reductions in their behavioral and neurochemical effects in animal models (Orson et al, 2008). Despite adverse events such as encephalitis observed in clinical trials of amyloid vaccines, as well as variable antibody levels and short duration of action for these vaccines, the preclinical data continue to spur efforts to overcome remaining challenges and develop human vaccines for chronic brain diseases. The molecule targeted for antibody development, the delivery system and formulation, and the maintenance of antibody response are some of the key variables in the pursuit of safe and effective immunotherapy for chronic brain disease. To date, the primary molecules of interest in Alzheimer's disease have been the pathological hallmarks of the disease Aβ and τ (self-antigens), aggregation of which is widely believed to be downstream of Aβ deposition (Kayed and Jackson, 2009), although the drug molecules (foreign antigens) are of interest for addiction (Orson et al, 2008). These small molecules or peptides are generally poor immunogens and must be tethered to a carrier protein with the goal to stimulate antibodies with high specificity, but to minimize tolerance and adaptive immunity (for example, virus-like particles; Chackerian et al, 2006). Adjuvants are also used to enhance the immune response. Few adjuvants are currently approved for use in humans, but new adjuvants in advanced development may help boost the immune response, particularly induction of antibodies, and therefore their efficacy in Alzheimer's, addiction, and other chronic brain diseases (Reed et al, 2009). The maintenance of an adequate antibody response in vaccines is a critical hurdle. Multiple doses of the vaccines have been used to maintain sufficient (normally high) antibody levels in blood to overcome short-term activity; however, the issue of immune tolerance lingers and may explain, in part, the highly variable antibody responses seen in vaccinees. An interesting question that remains to be adequately addressed is the biological activity of the antibodies. Studies of immune responses against infectious diseases have shown that that the biological activity, rather than the antibody level, is more relevant to ultimate vaccine-induced immunity (see Gromowski and Barrett (2007), for an example). It remains to be seen whether the same is true for immunity induced by vaccines developed for Alzheimer's disease, addictions, and other chronic brain disorders.

No AccessPerspectives on Neurophysiology and Neurogenic Speech and Language DisordersArticle1 Dec 1999School Experiences of Students With Acquired Brain Injury (ABI): What Happens After Transition? Bonnie Todis and Ann Glang Bonnie Todis Teaching ResearchEugene, OR Google Scholar More articles by this author and Ann Glang Teaching ResearchEugene, OR Google Scholar More articles by this author https://doi.org/10.1044/nnsld9.5.3-a SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationTrack Citations ShareFacebookTwitterLinked In References Bauman, L. J., & Adair, E. G. (1992). The use of ethnographic interviewing to inform questionnaire construction.Health Education Quarterly, 19, 9–23. Google Scholar Bigler, E., Clark, E., & Farmer, J. (1997). Traumatic brain injury: 1990s update.In E. Bigler, E. Clar, & J. Farmer (Eds.), Childhood traumatic brain injury: Diagnosis, assessment, and intervention (pp. 3–6). Austin, TX: Pro-Ed. Google Scholar Blosser, J., & DePompei, R. (1994). Pediatric traumatic brain injury: Proactive intervention. San Diego: Singular Publishing Co. Google Scholar Feeney, T., & Ylvisaker, M. (1995). Choice and routine: Antecedent behavioral interventions for adolescents with severe traumatic brain injury.Journal of Head Trauma Rehabilitation, 10, 67–86. Google Scholar Feeney, T., & Ylvisaker, M. (1997). A positive, communication-based approach to challenging behavior after ABI.In A. Glang, G.H.S. Singer, & TodisTodis (Eds.), Children with acquired brain injury: The school’s response (pp. 229–254). Baltimore: Paul H. Brookes. Google Scholar Glang, A., & Todis, B. (1997). Providing ongoing support to educators through team-based consultation.In A. Glang, G.H.S. Singer, & TodisTodis (Eds.), Children with acquired brain injury: The school’s response (pp. 343–368). Baltimore: Paul H. Brookes. Google Scholar Glang, A., Todis, B., Sohlberg, M., & Reed, P. (1996). Helping parents negotiate the school system.In G.A. Singer Glang, & J. Williams (Eds.), Families and children with acquired brain injury: Challenge and adaptation (pp. 149–166). Baltimore: Paul H. Brookes. Google Scholar Harchik, A. E., Sherman, J. A., & Bannerman, D. J. (1993). Choice and control: New opportunities for people with developmental disabilities.Annals of Clinical Psychiatry, 5, 151–162. Google Scholar Kraemer, B., & Blacher, J. (1997). In A. Glang, G. H. S. Singer, & B. Todis (Eds.), Children with acquired brain injury: The school’s response (pp. 3–32). Baltimore: Paul H. Brookes. Google Scholar Lehr, E., & Lantz, J. A. (1990). Behavioral components.In E. Lehr (Ed.), Psychological management of traumatic brain injuries in children and adolescents (pp. 133–153). Rockville, MD: Aspen. Google Scholar Orenstein, A., & Burdoff, M. (1986). Mediating special education disputes. Cambridge, MA: The Research Institute for Educational Problems. Google Scholar Pearpoint, J., Forest, M., & Snow, J. (1992). The inclusion papers: Strategies to make inclusion work. Toronto: Inclusion Press. Google Scholar Seidel, J., Friese, S., & Leonard, D.C. (1995). The Ethnograph v 4.0: A user’s guide. Amherst, MA: Qualis Research. Google Scholar Snow, J. A. (1989). Systems of support: A new vision.In S. Stainback, W. Stainback, & M. Forest, (Eds.), Educating all students in the mainstream of regular education (pp. 221–231). Baltimore: Paul H. Brookes Publishing Co. Google Scholar Sohlberg, M., Todis, B., & Glang, A. (1998). SCEMA: A team based approach to serving secondary students with executive dysfunction following brain injury.Aphasiology, 12, 1047–1092. Google Scholar Stainback, S., & Stainback, W. (1984). Broadening the research perspective in special education.Exceptional Children, 50, 400–408. Google Scholar Tyler, J. (1997) Preparing educators to serve children with ABI.In A. Glang, G.H.S. Singer, & B. Todis (Eds.), Children with acquired brain injury: The school’s response (pp. 323–342). Baltimore: Paul H. Brookes. Google Scholar Vandercook, T., York, J., & Forest, M. (1989). The McGill action planning system (MAPS): A strategy for building the vision.Journal of Association of Severely Handicapped, 14, 205–215. Google Scholar Wehmeyer, M., & Lawrence, M. (1995). Whose future is it, anyway? Promoting student involvement in transition planning.CDEI, 18, 69–83. Google Scholar Ylvisaker, M., Hartwick, P., & Stevens, M. B. (1991). School re–entry following head injury: Managing the transition from hospital to school.Journal of Head Trauma Rehabilitation, 6, 10–22. Google Scholar Ylvisaker, M., Szekeres, S., Hartwick, P., & Tworek, P. (1994). Cognitive intervention.In R. Savage & G. Wolcott (Eds.), Educational dimensions of acquired brain injury (pp. 121–184). Austin, TX: Pro–Ed. 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Family violence (FV) harms communities worldwide so FV prevention strategies and effective responses are urgently needed. This article reports on FV apparent in a study which explored the experiences of people with both ABI and justice system encounters in Victoria, Australia. One hundred interviews and one focus group consulted people with ABI, their families and carers, and various stakeholder groups in the Victorian justice system in Australia. Qualitative content analysis determined dominant themes and sub-themes and the less common themes. Inductive interpretive content analysis identified themes commonly found in previous published research and themes that appeared unique to, or unanticipated in, our data, such as the FV theme upon which this article focuses. Our findings reveal that FV has adversely affected many people with ABI who came into contact with Victoria’s justice system. Further, as ABI and FV often co-occur with substance abuse, mental health problems, socio-economic and many other significant disadvantages, for some FV perpetrators with an ABI, their ABI symptoms and characteristic co-morbidities may be a mitigating factor in their offending. The connection between ABI and family violence emerged as a troubling research theme. Indeed, the impact of FV on too many of our participants with an ABI compels us to call for further related research and secondary prevention programs targeted at FV victims, and offenders, living with ABI. An intersectional understanding of family violence and TBI/ABI in social ecological contexts is required to better understand brain injury at both individual and population levels.

ObjectivesDepression, which is common following acquired brain injury (ABI), has been shown to predict cognitive impairment, rehabilitation outcome, and quality of life. Whilst many studies have examined links between depression and cognitive–affective processing in the non‐ABI population, their applicability to this important clinical group, where cognitive difficulties can be marked, remains unknown. Here, we investigated biases in prospective cognition, which is known to be disrupted in (non‐ABI) depression yet important for well‐being.DesignCross‐sectional design with three groups (depressed ABI, non‐depressed ABI, and non‐ABI control participants). Continuous data were additionally analysed in correlation analyses.MethodsIndividuals with ABI varying in extent of self‐reported depression and matched non‐ABI control participants completed assessments of mood and prospective cognition (anticipating and imagining future events), alongside background tests of executive function and fluid intelligence.ResultsRelative to non‐depressed ABI and control participants, depressed ABI individuals demonstrated a reduced positive bias in prospective cognition: whereas non‐depressed ABI and control participants generated more examples of likely or possible positive versus negative future events, there was no evidence for such a positive bias in depressed ABI participants. Non‐depressed ABI and control participants also reported more vivid mental imagery for positive versus negative future scenarios, whereas such a pattern was not evident in depressed ABI participants. This pattern emerged despite background impairments in fluid intelligence and executive function associated with ABI.ConclusionsThese findings (1) elucidate depression‐linked cognitive–affective processes following ABI, where cognitive difficulties are common, and (2) highlight psychological processes associated with depression that are common to ABI and non‐ABI populations.Practitioner pointsClinical implicationsA relative negative bias in future‐directed cognition is associated with depressed mood in individuals with chronic ABI.Such processes may contribute to the onset and maintenance of depression following ABI.These findings suggest it may be important to consider a role for prospective cognition in psychological interventions for depression following ABI.Limitations of the studyThe extent to which depressed mood following ABI is associated with biases in other cognitive domains remains unclear.Whether similar patterns would be observed in acute patients with more profound cognitive difficulties requires further investigation.Despite large effect sizes, our sample size is modest; these effects thus require replication in larger groups.

Development, validation, reliability and predictive capacity of neuro-motor recovery of the Acute Brain Injury Physiotherapy Assessment (ABIPA): A tool for physiotherapists during early management of people following Acquired Brain Injury (ABI).

Acquired brain injury (ABI) can result in considerable life changes. Having choice and control over daily life is valued by people following ABI. This meta-synthesis will analyse and integrate international research exploring perspectives of choice and control in daily life following ABI. Databases were searched from 1980 to 13 January 2022 for eligible qualitative studies. After duplicates were removed, 22,768 studies were screened by title and abstract, and 241 studies received full-text assessment with 56 studies included after pearling. Study characteristics and findings were extracted that related to personal perspectives on choice and control by people with an ABI (including author interpretation and quotes). Data from each study were coded and then segments of coded data across the studies were compared to create multiple broad categories. Findings were then reduced from categories into 3 overarching themes with 12 subthemes. These themes were: (1) feeling like a second-class citizen; (2) reordering lifeand (3) choosing a path. Participants with an ABI tussled between their feelings of loss following brain injury and their thinking about how they start to regain control and become agents of their own choices. The themes describe their sense of self, their changed selfand their empowered self in relation to 'choice and control'. Re-engaging with choice and control after ABI is dynamic and can be challenging. Health professionals and supporters need to facilitate a gradual and negotiated return to agency for people following ABI. A sensitive and person-centred approach is needed that considers the readiness of the person with ABI to reclaim choice and control at each stage of their recovery. Clear service or process indicators that are built on lived experience research are needed to facilitate changes in service delivery that are collaborative and inclusive. This review included the voices of 765 people living with ABI and was conducted by a diverse team of allied health professionals with practice knowledge and research experience with people following ABI. Twenty-nine of the 56 included studies had participants contributing to their design or analysis.