TBI outcomes and discourse (Elbourn et al., 2019)

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, Koo, & 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 S1. Discourse Inventory and Monitoring Resource. Elbourn, E., Kenny, B., Power, E., & Togher, L. (2019). 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, 28(4), 1463–1478. https://doi.org/10.1044/2019_AJSLP-18-0204