Cognitive-communication Disorder Research Articles

“Everyone’s brains are different…you can’t just have one therapy plan to suit everyone” – A qualitative investigation of community-based rehabilitation services following traumatic brain injury

Purpose To examine the lived experiences of adults who have received community-based rehabilitation (CBR) services in Australia or New Zealand for cognitive-communication disorders (CCDs) following traumatic brain injury (TBI) and their support people. Participants’ recommendations for future models of care were also explored to enhance rehabilitation services for people with TBI. Method A qualitative descriptive approach grounded in phenomenology was used, whereby semi-structured interviews were conducted with each participant. A total of 28 interviews were completed, four in-person and 24 via video conferencing. Two participant groups were recruited: Adults with TBI; and their support people. Sixteen adults with a self-reported diagnosis of cognitive-communication disorder (CCD) following TBI who had received CBR and 12 support people were included. Interviews were analysed using reflexive thematic analysis. Result Four themes were identified by the participant groups indicating the core pillars of CBR models of care. They included the importance of: (a) accessible and inclusive CBR services; (b) specialised clinical skills and treatment approaches; the acknowledgment that (c) knowledge is power; and the significance of (d) peer networks and support. Conclusion This study further advances the evidence base of how services can be optimised to meet the complex needs of adults with CCDs following a TBI. Clinicians, researchers, and service providers should endeavour to incorporate the four core pillars outlined to enhance future CBR models of care for this clinical population.

Self-reported longitudinal impacts of the COVID-19 pandemic on adults with acquired communication disorders

Purpose Adults with acquired communication disorders are particularly vulnerable to potential negative effects from the changes that arose during the COVID-19 pandemic. In this longitudinal study, we asked: How did the self-perceived impacts of the pandemic on adults with acquired communication disorders change over time? Method We developed an online survey to investigate changes in day-to-day behaviours, psychosocial elements, and communication abilities among members of a community-based stroke recovery centre in the USA. Participants included adults with aphasia or other cognitive-communication disorder from stroke or brain injury. We compared survey responses from summer 2020 (n = 50) and summer 2021 (n = 24) using a concurrent mixed methods design. Result The impacts of the pandemic changed over time. By 2021, participants reported a more “normal” amount of time spent on in-person socialising and healthcare, improved quality of life and connectedness to others, and an improvement in overall communication ability. Across both years, participants shared comments regarding changes in routine, increased use of technology, and the positive benefit of therapy groups. Conclusion Self-perceived psychosocial elements and communication abilities among stroke and other brain injury survivors changed over the course of the pandemic. Clinicians and researchers should continue providing this population with support and opportunities for engagement.

Attentional Orienting and Disfluency-Related Memory Boost Are Intact in Adults With Moderate-Severe Traumatic Brain Injury.

Traumatic brain injury (TBI) is associated with a range of cognitive-communicative deficits that interfere with everyday communication and social interaction. Considerable effort has been directed at characterizing the nature and scope of cognitive-communication disorders in TBI, yet the underlying mechanisms of impairment are largely unspecified. The present research examines sensitivity to a common communicative cue, disfluency, and its impact on memory for spoken language in TBI. Fifty-three participants with moderate-severe TBI and 53 noninjured comparison participants listened to a series of sentences, some of which contained disfluencies. A subsequent memory test probed memory for critical words in the sentences. Participants with TBI successfully remembered the spoken words (b = 1.57, p < .0001) at a similar level to noninjured comparison participants. Critically, participants with TBI also exhibited better recognition memory for words preceded by disfluency compared to words from fluent sentences (b = 0.57, p = .02). These findings advance mechanistic accounts of cognitive-communication disorder by revealing that, when isolated for experimental study, individuals with moderate-severe TBI are sensitive to attentional orienting cues in speech and exhibit enhanced recognition of individual words preceded by disfluency. These results suggest that some aspects of cognitive-communication disorders may not emerge from an inability to perceive and use individual communication cues, but rather from disruptions in managing (i.e., attending, weighting, integrating) multiple cognitive, communicative, and social cues in complex and dynamic interactions. This hypothesis warrants further investigation.

Communication and Psychosocial Outcomes 2-Years After Severe Traumatic Brain Injury: Development of a Prognostic Model

ObjectiveTo examine predictive factors underlying communication and psychosocial outcomes at 2 years post-injury. Prognosis of communication and psychosocial outcomes after severe traumatic brain injury (TBI) is largely unknown yet is relevant for clinical service provision, resource allocation, and managing patient and family expectations for recovery. DesignA prospective longitudinal inception design was employed with assessments at 3 months, 6 months, and 2 years. ParticipantsThe cohort included 57 participants with severe TBI (N=57). SettingSubacute and post-acute rehabilitation. Main Outcome MeasuresPreinjury/injury measures included age, sex, education years, Glasgow Coma Scale, and PTA. The 3-month and 6-month data points included speech, language, and communication measures across the ICF domains and measures of cognition. The 2-year outcome measures included conversation, perceived communication skills, and psychosocial functioning. Predictors were examined using multiple regression. InterventionsNot applicable. ResultsThe cognitive and communication measures at 6 months significantly predicted conversation measures at 2 years and psychosocial functioning as reported by others at 2 years. At 6 months, 69% of participants presented with a cognitive-communication disorder (Functional Assessment of Verbal Reasoning and Executive Strategies [FAVRES]). The unique variance accounted for by the FAVRES measure was 7% for conversation measures and 9% for psychosocial functioning. Psychosocial functioning at 2 years was also predicted by pre-injury/injury factors and 3-month communication measures. Pre-injury education level was a unique predictor, accounting for 17% of the variance, and processing speed/memory at 3 months uniquely accounted for 14% of the variance. ConclusionCognitive-communication skills at 6 months are a potent predictor of persisting communication challenges and poor psychosocial outcomes up to 2 years after a severe TBI. Findings emphasize the importance of addressing modifiable cognitive and communication outcomes variables during the first 2 years after severe TBI to maximize functional patient outcomes.

Stakeholder views on cognitive communication assessment and intervention for a person living independently in the community with severe traumatic brain injury.

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. 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. 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. 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. 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 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.

INCOG 2.0 Guidelines for Cognitive Rehabilitation Following Traumatic Brain Injury, Part IV: Cognitive-Communication and Social Cognition Disorders.

Moderate to severe traumatic brain injury causes significant cognitive impairments, including impairments in social cognition, the ability to recognize others' emotions, and infer others' thoughts. These cognitive impairments can have profound negative effects on communication functions, resulting in a cognitive-communication disorder. Cognitive-communication disorders can significantly limit a person's ability to socialize, work, and study, and thus are critical targets for intervention. This article presents the updated INCOG 2.0 recommendations for management of cognitive-communication disorders. As social cognition is central to cognitive-communication disorders, this update includes interventions for social cognition. An expert panel of clinicians/researchers reviewed evidence published since 2014 and developed updated recommendations for interventions for cognitive-communication and social cognition disorders, a decision-making algorithm tool, and an audit tool for review of clinical practice. Since INCOG 2014, there has been significant growth in cognitive-communication interventions and emergence of social cognition rehabilitation research. INCOG 2.0 has 9 recommendations, including 5 updated INCOG 2014 recommendations, and 4 new recommendations addressing cultural competence training, group interventions, telerehabilitation, and management of social cognition disorders. Cognitive-communication disorders should be individualized, goal- and outcome-oriented, and appropriate to the context in which the person lives and incorporate social communication and communication partner training. Group therapy and telerehabilitation are recommended to improve social communication. Augmentative and alternative communication (AAC) should be offered to the person with severe communication disability and their communication partners should also be trained to interact using AAC. Social cognition should be assessed and treated, with a focus on personally relevant contexts and outcomes. The INCOG 2.0 recommendations reflect new evidence for treatment of cognitive-communication disorders, particularly social interactions, communication partner training, group treatments to improve social communication, and telehealth delivery. Evidence is emerging for the rehabilitation of social cognition; however, the impact on participation outcomes needs further research.

Rehabilitation of communication in people with traumatic brain injury: a systematic review of types of intervention and therapeutic ingredients (Rehabilitación de la comunicación en personas con traumatismo encefalocraneal: una revisión sistemática de tipos de intervención e ingredientes terapéuticos)

ABSTRACT Background: the treatment of cognitive-communication disorder (CCD) has proven an adequate approach to the social well-being of people with traumatic brain injury (TBI). Objective: describe the types of treatment and therapeutic ingredients — and their effectiveness — available for the direct treatment of CCD in people with TBI. Method: a systematic review following PRISMA guidelines was carried out. The effectiveness of each type of treatment and the therapeutic ingredients available were assessed. Results: 22 articles met inclusion criteria. Three interventions (rehabilitation of emotional perception-regulation and social cognitive skills, pragmatic skills and conversation/interaction) achieved recommendation A. All therapeutic ingredients (education, functional goals, progressive approach, modelling, skills practice, feedback, simulation, practice with peers, emotional adjustment) had sufficient evidence for recommendation level A. Conclusions: direct communication treatment is an effective approach for people with brain injury and should be included as a practice standard. The need to develop a generic model to treat CCD that combines therapeutic ingredients from diverse interventions is discussed.

Cognitive-communication disorder following right hemisphere damage: Narrative production.

Cognitive-communication disorder (CCD) results from the association of language and cognition impairment that may follow right hemisphere (RH) damage and impair the quality of life of affected persons. We studied a set of 1,625 narratives produced by a cohort of 125 individuals (50 with a single right vascular lesion in the MCA territory and 75 cognitively healthy controls) using a task of picture-based discourse production. Discourse production was analyzed in its macro-and microlinguistic aspects to characterize better the linguistic mechanisms underlying RH patients' performance. The RH group produced more words and elocutions than controls, with a lower rate of informational content and a higher percentage of global coherence errors (all p-values <0.0001). Individuals with RH lesions showed formal lexical and syntactic aspects of discourse mostly preserved. Alterations in the macrostructure of discourse prevailed over microstructural alterations in our sample, according to most literature studies. The group of individuals with RH lesions produced narratives containing more words and utterances, with a lesser degree of lexical information and more global coherence errors.

Test item priorities for a screening tool to identify cognitive-communication disorder after right hemisphere stroke

ABSTRACT Background Early recognition of stroke signs and symptoms is critical to ensure people receive the right treatment at the right time. Communication impairment associated with left-hemisphere stroke is easily identifiable due to the recognisable signs of aphasia, whereas signs of cognitive-communication disorder (CCD) after right hemisphere (RH) stroke are often subtler. In contrast to aphasia, no sensitive screening tools exist to allow for early identification of CCD after RH stroke. Aims To prioritise test items required for a screening tool to identify CCD after RH stroke from the perspective of expert speech-language pathologists. Methods & Procedures The nominal group technique (NGT) was used with expert speech-language pathologists to determine the most important test items required for a screening tool to identify RH CCD. Results were analysed using a quantitative measure of item ranking and inductive content analysis. Outcomes & Results Five expert speech pathologists located across Australia and the USA, representing a mix of clinicians and researchers participated in the nominal group. The highest ranked test items across the four cognitive-communication domains (lexical semantics, discourse, pragmatics and prosody) were interpretation of sarcasm or humour, rating conversational discourse, a conversational skills checklist, and expressive prosody. Content analysis revealed three themes: Assessment Domains, Considerations in Item Design and Knowledge Gap. Conclusions The NGT revealed that multiple considerations exist in developing a screening tool for CCD after RH stroke.

Updating and Refining Prevalence Rates of Traumatic Brain Injury–Related Communication Disorders Among Post-9/11 Veterans: A Chronic Effects of Neurotrauma Consortium Study

Purpose To describe the prevalence of communication disorders in a cohort of 84,377 deployed post-9/11 veterans stratified by blast traumatic brain injury (TBI) exposure. Secondary aim was to evaluate the association between postconcussion symptoms, such as posttraumatic stress disorder, depression, anxiety, insomnia, pain, headache, substance use disorder, and auditory problems, among veterans with and without a communication disorder diagnosis. Method This is a retrospective study of the prevalence of aphasia, apraxia of speech and dysarthria, cognitive-communication disorder, fluency, and voice disorders among veterans, stratified by TBI severity and blast status. Data were obtained from the national Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn roster file provided by the Department of Veterans Affairs Office of Public Health and the Veterans Affairs' TBI screening and subsequent comprehensive TBI evaluation. Results Cognitive-communication disorder was the most prevalent diagnosis, comprising 57.1% of all communication disorder diagnoses, followed by voice disorder (19%) and aphasia (16%). Increased age was significantly associated with higher rates of aphasia, apraxia of speech/dysarthria, and voice disorder. Conclusions The current study shows that, while the overall total number of communication disorder diagnoses was higher in the blast groups than in the nonblast groups, TBI severity was a more significant risk factor for a diagnosis, with veterans in the more severe groups at a higher risk of being diagnosed with a communication disorder when compared to those with mild TBI and no blast exposure. In order to better inform rehabilitation and clinical management of communication conditions, it is critical to examine the influence of blast and postconcussive symptoms in post-9/11 veterans.

Enabling people with communication and cognitive impairments to provide feedback on service satisfaction: development and reliability testing of an adapted pictorial questionnaire

Introduction/aims Evaluation of patient satisfaction with health services is mandatory within the UK, but patients with communication difficulties are often excluded by their inability to complete written questionnaires. This study examines the test–retest reliability and agreement of an adapted, pictorial patient satisfaction questionnaire, based on the Talking Mats technique. Methods A total of 26 participants, who had a range of communication impairments resulting from brain injury, completed two questionnaires while in specialist rehabilitation: a standard written and adapted pictorial questionnaire, at two time points to evaluate test–retest reliability. Agreement between the two questionnaire formats was also examined. Results Test–retest reliability in overall scores between Time 1 and 2 was substantial for both the adapted pictorial questionnaire (k=0.72 [95% confidence interval 0.388, 0.76]) and the standard written questionnaire (ϰ=0.78 [95% confidence interval 0.74, 0.82]). Overall agreement between the two techniques was ϰ=0.76 (95% confidence interval 0.73, 0.79). Eighty-six per cent of questions for patients with aphasia showed at least ‘moderate’ agreement between the two questionnaire types compared with only 67% in participants with cognitive communication disorder. Conclusions The adapted pictorial questionnaire is a reliable tool for people with brain injury who have aphasia, enabling some patients to provide service satisfaction feedback who would have otherwise been excluded using a written questionnaire.

Investigation of self-assessment in group therapy for cognitive communication disorder (CCD) and aphasia

Investigation of self-assessment in group therapy for cognitive communication disorder (CCD) and aphasia

Language and cognitive communication disorder during post-traumatic amnesia: Profiles of recovery after TBI from three cases

ABSTRACTBackground: There has been limited empirical speech–language pathology (SLP) study of language and cognitive communication during post-traumatic amnesia (PTA) and the early stages after TBI. The purpose of the current research was to explore the potential means and utility of assessing cognitive communication during PTA and the post-acute recovery period.Method: This research used a longitudinal mixed methods design to describe language and cognitive communication assessment and recovery profiles of three patients with TBI. Cognitive communication was assessed with repeated standardised and non-standardised methods during PTA (rated with Westmead PTA Scale) and at follow-up 3 months after PTA emergence.Results: All participants demonstrated a profile of language and cognitive communication strengths and weaknesses during PTA and the post-acute period, also evident at follow-up. Improvement occurred gradually throughout PTA, although with individual fluctuation across test occasions. There was no marked change in communication function immediately before and after PTA emergence, indicating that cognitive communication ability and those functions measured on the Westmead PTA Scale (memory and orientation) did not recover at the same rate.Conclusion: It was feasible to assess language and cognitive communication throughout PTA and the post-acute period, and early assessment results were relevant to the patient’s ongoing communicative function. It is suggested that early and repeated SLP assessment may contribute to the prediction of persisting cognitive communication issues.

Social participation following right hemisphere stroke: influence of a cognitive-communication disorder

ABSTRACTBackground: The ability to return to social activities and roles is an important focus of rehabilitation for people affected by stroke. Rehabilitation professionals currently have limited evidence on the impact of a cognitive-communication disorder (CCD) following right hemispheric (RH) stroke on social participation, and how to support return to social activities and roles.Aims: This study describes (1) social participation change as reported by people with RH stroke; (2) compares social participation change across two groups based on the presence or absence of CCD following RH stroke; and (3) compares self and proxy reports of changes in participation.Methods & Procedures: A telephone survey was conducted with randomly selected people with first onset, unilateral RH stroke, and with matched significant others (proxies). The Sydney Psychosocial Reintegration Scale (SPRS-2) was utilised to explore change associated with stroke across Occupational Activities (OA), Interpersonal Relationships (IR) and Independent Living Skills (LS). Survey responses were compared utilising independent t-tests across two groups based on the presence or absence of CCD. Participant-proxy agreement was established using inter-rater correlation coefficient.Outcomes & Results: Change in social participation was reported for thirty-six participants with an average age of 65.95 years (SD = 13.09), of whom 58.3% were male and 38.9% employed at the time of the stroke. Time post-stroke to completion of the SPRS-2 ranged from six to 33 months. Most participants (94.4%, n = 34) reported change in at least one of the SPRS-2 domains. The presence of CCD had an impact on social participation as measured on the SPRS-2, which was significantly different to what was reported by participants without a communication impairment post-RH stroke (p = 0.02.) Inter-rater agreement statistic (Kappa) indicated a fair participant-proxy dyad agreement in the group with CCD, and a moderate agreement in the group without CCD across the SPRS-2 domains.Conclusions: Changes in social participation following RH stroke occur across Occupational Activities, Interpersonal Relationships and Independent Living Skills for the majority of people and occur with greater frequency and degree where a CCD is present. This exploratory study highlights the importance of rehabilitation goals that address social participation to reduce potential social isolation in people with CCD post-RH stroke. Further identification of risk factors for social participation restriction in this population is required to better inform rehabilitation timing and focus.

Cognitive-communication disorder following right hemisphere stroke: exploring rehabilitation access and outcomes.

Background: Rehabilitation positively influences return to activities and social roles in people with aphasia. The cognitive-communication disorder (CCD) found following a right hemisphere stroke has been less extensively researched with rehabilitation access and outcomes yet to be determined.Objectives: To document rehabilitation access and outcomes for people with CCD post-stroke; and compare outcomes based on presence (viz CCD; aphasia) or absence of communication impairment.Methods: A retrospective chart audit was completed for patients with first onset unilateral stroke, with a hospital length of stay (LOS) of at least two days and a communication assessment by a speech pathologist. Data extracted included presence and severity of communication impairment, access to and LOS in a rehabilitation unit, and functional outcome measures recorded at rehabilitation discharge.Results: The majority of the 115 patients who met inclusion criteria were living independently (n = 112, 97.4%) at the time of stroke. CCD (66%) was diagnosed with similar frequency to aphasia (68%). The presence of communication impairment did not result in significant differences in rehabilitation LOS and discharge destination when compared to hemispheric strokes without communication impairment. Severity of CCD was an independent predictor of functional gain by rehabilitation discharge.Conclusions: People with CCD require comparable access to rehabilitation as people with aphasia, and severity of CCD should be considered in determining rehabilitation LOS. A large number of people are discharged with ongoing CCD which warrants exploration of potential participation restrictions created by the communication impairment.

Cognitive Impairment and Rehabilitation Strategies After Traumatic Brain Injury.

Traumatic brain injury (TBI) is among the significant causes of morbidity and mortality in the present world. Around 1.6 million persons sustain TBI, whereas 200,000 die annually in India, thus highlighting the rising need for appropriate cognitive rehabilitation strategies. This literature review assesses the current knowledge of various cognitive rehabilitation training strategies. The entire spectrum of TBI severity; mild to severe, is associated with cognitive deficits of varying degree. Cognitive insufficiency is more prevalent and longer lasting in TBI persons than in the general population. A multidisciplinary approach with neuropsychiatric evaluation is warranted. Attention process training and tasks for attention deficits, compensatory strategies and errorless learning training for memory deficits, pragmatic language skills and social behavior guidance for cognitive-communication disorder, meta-cognitive strategy, and problem-solving training for executive disorder are the mainstay of therapy for cognitive deficits in persons with TBI. Cognitive impairments following TBI are common and vary widely. Different cognitive rehabilitation techniques and combinations in addition to pharmacotherapy are helpful in addressing various cognitive deficits.

ICF-Based Analysis of Communication Disorders in Dementia of Alzheimer's Type

Purpose: Dementia of Alzheimer's type (DAT) is a major cognitive communication disorder. The present study attempted to analyse communication disorders in DAT in the International Classification of Functions (ICF) framework. The study investigated the impact of the severity of communication disorders in persons with DAT on activity participation and environment components of the ICF. Method: Thirty bilingual individuals with DAT in the age range of 65-88 years were classified into three groups of mild, moderate and severe degree of dementia. Forty-three items of the American Speech-Language-Hearing Association Functional Assessment of Communication Skills for Adults (ASHA FACS) were linked to the ICF framework. A few additional items were also added for a complete profiling of DAT. A total of 50 (ASHA FACS + ICF) items were rated and administered for the purpose of the study. Results: The study revealed a disproportionate impact of the severity of DAT on activity participation and environment components of the ICF. Conclusion: The present study investigated the utility of the ICF framework for profiling the functionality of persons with DAT. This profiling highlighted the need for ensuring effective communication and quality of life in the DAT population.

No. 90 Influence of Cognitive-Communication Disorder on Dysphagia Prognosis in Patients With Brain Injury

PM&RVolume 6, Issue 8S2 p. S113-S113 Poster Presentation No. 90 Influence of Cognitive-Communication Disorder on Dysphagia Prognosis in Patients With Brain Injury Javiera González SLP, Javiera González SLPSearch for more papers by this authorSandra Olivares OT, Sandra Olivares OTSearch for more papers by this authorClaudio Soto, Claudio SotoSearch for more papers by this authorDaniel Muñoz, Daniel MuñozSearch for more papers by this author Javiera González SLP, Javiera González SLPSearch for more papers by this authorSandra Olivares OT, Sandra Olivares OTSearch for more papers by this authorClaudio Soto, Claudio SotoSearch for more papers by this authorDaniel Muñoz, Daniel MuñozSearch for more papers by this author First published: 18 September 2014 https://doi.org/10.1016/j.pmrj.2014.08.223Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume6, Issue8S28th World Congress of the International Society of Physical & Rehabilitation Medicine (ISPRM)August 2014Pages S113-S113 RelatedInformation

Speech pathologists’ current practice with cognitive-communication assessment during post-traumatic amnesia: A survey

Primary objective: To investigate speech pathologists’ current practice with adults who are in post-traumatic amnesia (PTA).Method: Speech pathologists with experience of adults in PTA were invited to take part in an online survey through Australian professional email/internet-based interest groups.Results: Forty-five speech pathologists responded to the online survey. The majority of respondents (78%) reported using informal, observational assessment methods commencing at initial contact with people in PTA or when patients’ level of alertness allowed and initiating formal assessment on emergence from PTA. Seven respondents (19%) reported undertaking no assessment during PTA. Clinicians described using a range of techniques to monitor cognitive-communication during PTA, including static, dynamic, functional and impairment-based methods.Conclusions: The study confirmed that speech pathologists have a key role in the multidisciplinary team caring for the person in PTA, especially with family education and facilitating interactions with the rehabilitation team and family. Decision-making around timing and means of assessment of cognitive-communication during PTA appeared primarily reliant on speech pathologists’ professional experience and the culture of their workplace. The findings support the need for further research into the nature of cognitive-communication disorder and resolution over this period.

Back to Their Old Selves

Back to Their Old Selves