Cognitive-communication Disorders Research Articles

Practical Strategies to Optimize Cognitive-Communication Intervention in Complex Real-World Conditions: A Life Integration Approach.

Cognitive-communication intervention (CCI) service gaps compromise quality of life for individuals with acquired brain injuries. Speech-language pathologists (SLPs) must examine barriers to care and develop solutions to address current problems in awareness of cognitive-communication disorders, understanding of SLP services, access and referral mechanisms, and care pathways. They must also adapt CCI to the complexities and constraints of daily life. In this article, we explore actions that clinical SLPs can take to overcome service barriers and advocate for fair, timely, and evidence-based CCI. This clinical focus article examines barriers to CCI and provides a set of tools and strategies SLPs can employ to address them. These strategies are organized into a framework called the Life Integration Approach (LIA), which has 10 elements to guide clinical service planning: (a) evidence application, (b) communication education and assertiveness, (c) access and referral, (d) assessment, (e) therapeutic engagement, (f) cognitive-communication goal setting, (g) instructional practices, (h) life integration, (i) communication partner collaboration, and (j) resource allocation. Resources are provided to demonstrate how the LIA can integrate advocacy with clinical service while adapting to complex conditions of life, competing priorities, and service constraints. Although barriers to provision of quality SLP CCI may seem formidable, there are practical actions SLPs can take to advocate for and adapt CCI services to life demands for individuals living with the devastating effects of brain injury.

Mind–Body Practices and Exercise in the Rehabilitation of Poststroke Aphasia, Mild Cognitive Impairment, and Dementia

Purpose: The purpose of this article is to provide speech-language pathologists (SLPs) with a background in mind–body practices and exercise to prevent and treat cognitive, language, and cognitive communication disorders from a healthy aging viewpoint. Method: An online database search was conducted using a narrative review of mind–body interventions recommended by SLPs and other rehabilitation specialists. Conclusions: Mind–body practices and exercise are a low-cost, accessible, nonpharmacological intervention that may promote beneficial outcomes for individuals who are at risk for neurologic disease. Recent research on risk factors for mild cognitive impairment and dementia suggests that the underlying disease progression may be slowed or stopped with lifestyle modification (e.g., increased physical activity). Additionally, individuals recovering from stroke could potentially experience better outcomes with lifestyle modification (e.g., stress reduction). There has been increased popular interest in mindfulness as a component of a healthy lifestyle, which suggests that both patients and therapists may be receptive to incorporating it into traditional rehabilitation practices, provided there is reasonable support for its benefits. The aim of this article is to provide a rationale for integrating mind–body practices and exercise into speech-language pathology services to decrease levels of unhealthy stress, increase physical activity, and enhance cognition and communication.

Animal-assisted services for adults with acquired neurogenic communication disorders: A scoping review.

There is increasing interest in the incorporation of animal-assisted services (AAS) in therapy for adults with acquired neurogenic communication disorders. AAS have the potential to enhance speech and language therapy engagement and outcomes. However, a greater understanding of the nature and potential benefits of these interventions is needed. To describe the existing evidence for the incorporation of AAS in therapy with adults with acquired neurogenic communication disorders and to identify areas for future research. A scoping review was conducted and reported in alignment with the Preferred Reporting Items for Systematic Reviews and Meta-analyses checklist extension for scoping reviews (PRISMA-ScR). Seven databases (PubMed, Embase, CINAHL, PsycINFO, Cochrane, Scopus, Web of Science) and grey literature (Google) were searched. Two reviewers independently screened titles, abstracts and full texts against eligibility criteria using Covidence software. The Template for Intervention Description and Replication (TIDieR) checklist guided extraction of intervention data. A total of 17 studies with adults with aphasia, apraxia of speech and cognitive-communication disorders were included. While terminology varied, most interventions met the definition of animal-assisted therapy or animal-assisted activity and used therapy dogs. Across studies, a range of outcomes were targeted, and positive benefits were reported for participant mood, emotions, motivation and satisfaction. There were mixed, but mostly positive, benefits on social behaviour, communication and participation. AAS has been incorporated in therapy for adults with acquired neurogenic communication disorders, predominately with people with dementia. Across studies, communication impairments and AAS interventions were insufficiently or inconsistently described. Improved reporting would assist understanding of the potential benefits of AAS as an adjunct therapy. A quality appraisal of existing studies, and meta-analysis of findings, is needed to draw conclusions about the effectiveness of AAS as a complementary therapy for people with acquired neurogenic communication disorders. What is already known on this subject There is increasing interest and research in AAS as an adjunct to traditional speech and language therapy. Several clinical populations have been shown to benefit from the incorporation of AAS as a complementary therapy approach, including adults with acquired neurogenic communication disorders. To date there has not been a comprehensive review of literature in the area. What this paper adds to the existing knowledge This review aimed to describe what is known about AAS as an adjunct intervention for adults with acquired neurogenic communication disorders. A total of 17 studies were identified, the majority conducted with people living with dementia. Overall, consistent positive benefits of AAS were reported on participant mood, positive emotions, motivation, and satisfaction. There were mixed, but mostly positive, benefits of AAS on social behaviour, including both verbal and non-verbal communication outcomes, and participation. What are the practical and clinical implications of this work? These results suggest a potential therapeutic benefit for the inclusion of AAS into traditional modalities used by speech-language therapists with people with acquired neurogenic communication disorders. However, clinicians should view these findings with caution. Studies were often insufficiently or inconsistently reported, and a quality appraisal and meta-analysis of existing studies would be needed to draw clear conclusions on the effectiveness of AAS as a complementary approach for people with acquired neurogenic communication disorders.

Toward the Realization of a Team Approach that Places the Person with Cognitive Communication Disorders at the Center

Toward the Realization of a Team Approach that Places the Person with Cognitive Communication Disorders at the Center

“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.

Development and validation of MyCommunication-Adults, a self-report communicative participation measure.

People with communication problems experience challenges in participation. Optimizing communicative participation for this population is an important outcome of speech and language therapy. Participation experiences are best assessed from the patient's perspective, using a patient-reported outcome measure (PROM). The Communicative Participation Item Bank (CPIB) has been developed to identify perceived problems in communicative participation. However, previous research has shown that the item bank does not cover all domains and concepts of communicative participation, contains general communication items, and is not suitable for all people with communication problems. To develop a comprehensive PROM aimed at measuring communicative participation for all adults with communication problems and test its content validity. An initial pool of 242 items was based on three sources: relevant content from an earlier literature review and concept elicitation study, and the translation of the items of the CPIB. This item pool was pilot-tested for comprehensibility and comprehensiveness using cognitive debriefing interviews in adults with different communication problems (speech, language, voice, hearing and cognitive communication disorders). This resulted in a second version of the item bank. The content validity of this version was tested in a group of professionals. The last (third) version of 133 items was tested for content validity in a second, new group of adults with various communication problems. The initial pool of 242 items was developed and pilot-tested in 27 adults with different communication problems. After modifications, 161 items remained, which were tested in a content validity study with 25 people with different communication problems and five professionals (in the field of speech and language therapy and speech and language research). The professionals considered 91.9% of the item bank relevant and comprehensible, and comprehensive by adding two items. The item bank was then considered relevant, comprehensible and comprehensive by the group of adults with communication problems. A total of 133 items remained in the item bank, related to the International Classification of Functioning, Disability and Health (ICF) Activities and Participation domains 'mobility', 'self-care', 'domestic life', 'interpersonal interactions and relationships', 'major life areas' and 'community, social and civic life'. MyCommunication-Adults is an item bank for measuring communicative participation in adults with communication difficulties. The next step is to test the psychometric properties of the item bank, in order to establish a final item bank. The refined description of the construct of communicative participation can already be used for participation-focused goal-setting between individuals with communication problems and speech and language therapists. What is already known on the subject The CPIB was developed to measure communicative participation in community-dwelling adults with communication problems. The item bank does not cover all domains and concepts of communicative participation, contains general communication items and not all questions seem to be relevant for specific target groups (e.g., hearing population). What this paper adds to the existing knowledge This study presents a refined description of the construct of communicative participation and the development of a new comprehensive PROM aimed at measuring this construct for all adults with communication difficulties. The development of the PROM is based on a previously conducted literature review and concept elicitation study. This study describes the development process of this new PROM, called MyCommunication-Adults, and the assessment of its content validity. What are the potential or actual clinical implications of this work? The refined description of the construct of communicative participation can be used for participation-focused goal-setting between individuals with communication problems and speech and language therapists.

Making Assessment Real: Audrey Holland's Contributions to the Assessment of Aphasia and Cognitive-Communication Disorders in Clinical and Research Settings.

For half a century, Dr. Audrey Holland investigated, developed, and implemented ways to extend the assessment of adult language and cognitive-communication disorders beyond traditional impairment-based approaches. This article summarizes Dr. Holland's many groundbreaking contributions to assessment practices by describing and exemplifying major conceptual and measurement innovations that have emerged from her research of both formal and informal assessment techniques. Dr. Holland's assessment contributions encompass the development of many widely used measures of functional communication, discourse, and cognitive-communication abilities. She also contributed to the development of assessment principles that have become part of best-practice standards of care. Some of her most significant contributions include: Drawing attention to assessment within authentic functional contexts; highlighting connections between language, communication, related cognitive abilities, and broader aspects of health including quality of life; raising psychometric standards; and emphasizing the value of implementing multiple person-centered measurement techniques spanning formal and informal as well as quantitative and qualitative approaches. Dr. Holland's career-long commitment and contributions to developing more meaningful and authentic assessment practices have transformed our field and substantively elevated the quality of care and services that we are able to provide to all persons who are impacted by language and cognitive-communication disorders.

Analyzing the Social Communication of People with Traumatic Brain Injury: The Benefits of Hindsight, Technology Advances, and Professor Audrey Holland's Wisdom.

Professor Audrey Holland is best known for her extraordinary contributions to the field of aphasia rehabilitation; however, for those working in the field of cognitive-communication disorders (CCDs) following traumatic brain injury (TBI), Audrey made seminal contributions to the conceptualization of language disturbances following TBI, setting the scene for a new era of investigation and discovery. This article describes Audrey's contributions which redefined communication disorders following TBI as being different from aphasia, leading to discourse and everyday communication being the gold standard for CCD assessment. Incorporating Professor Holland's influences, this article describes the advances made during the past two decades including the theoretical development of frameworks to inform clinical assessment; expert consensus guidelines that support the assessment of the individual in activities relating to their family life, their friends, their work, and their relationships; the policy from an International Classification of Functioning, Disability and Health (ICF) perspective; advances in technology including the use of automated discourse measures; TBIBank; and main concept analysis. Professor Holland's profound impacts include the recognition that communication skills play a central role in maximizing all aspects of one's life.

The Importance of Identifying Children With Brain Injury in Schools: Speech-Language Pathologists as Crucial Partners

Purpose: The purpose of this article is to describe the importance of and strategies to identify traumatic brain injury (TBI) and associated cognitive-communication disorders (CCDs) in children, a priority identified by the attendees at the Fourth International Cognitive-Communication Disorders Conference. Childhood TBI is associated with a range of difficulties, including CCDs, that can adversely impact functioning and participation into adulthood. Identifying a history of TBI in children in schools is the crucial first step to then monitor, assess, and provide evidence-based intervention and accommodations in collaboration with families and medical and educational professionals. Conclusion: Given that CCDs are treatable, effective identification, assessment, and management of students with TBI and resulting CCDs can reduce adverse outcomes in adult survivors of childhood TBI. Speech-language pathologists must be aware of their expertise in assessing and treating CCDs in children with TBI and advocate for programmatic and policy changes to better identify and support children with TBI.

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.

A Study on Improving Speech Perception in Noise and Cognitive-Communication Abilities in Elderly Individuals Wearing Hearing Aids through Web-Based Auditory Training

Purpose: This study aimed to explore the impact of web-based auditory training on speech perception in noise and cognitive-communication abilities in elderly individuals wearing hearing aids. The focus was on addressing communication difficulties commonly experienced by this demographic.Methods: Twenty participants, with over 6 months of hearing aid use, were divided into a training group (undergoing 8 weeks of weekly 60-minute web-based auditory training) and a non-training group. The training program included tasks like listening to sentences in noise, short and long stories, sentence arrangement, and crossword quizzes. Various assessments, such as Korean Repeat and Recall Test and Brief test Cognitive-Communication Disorders evaluations, were conducted before and after training. The Korean version of Montreal Cognitive Assessment test served as a prescreening measure for cognitive impairments.Results: Significant improvements were observed in the training group’s speech perception in noise, recall, and cognitive-communicative abilities post-training. Conversely, the non-training group showed no statistically significant differences.Conclusion: The findings suggest that web-based auditory training holds promise for enhancing cognition and communication in elderly hearing aid users. Future studies could further explore the comparative effectiveness of auditory training by categorizing participants into face-to-face, remote, and hybrid groups. This research contributes valuable insights into addressing communication challenges in the aging population through innovative training methods.

The Opinions and Working Experiences of Doctors from Different Branches of Medicine Working in Turkey Concerning Speech and Language Pathologists

Objective: This study aimed to examine the thoughts, knowledge, collaborative processes, and experiences of doctors in different branches of medicine, as these comprise the occupational groups in which speech-language pathologists/therapists (SLPs) work in interdisciplinary and multidisciplinary capacities. &#x0D; Material and Method: A Google survey was created focusing on the opinions about and working experiences of doctors in different branches of medicine working in Turkey with SLPs. The questionnaire consisted of 18 questions and four parts. &#x0D; Results: The study was conducted with 116 doctors, 28.4% of whom were neurologists, 28.4% were otorhinolaryngologists, 21.6% were pediatricians, and 21.6% were other specialists. Only 25.9% (n=30) have worked with an SLP before. Speech sound disorders, fluent speech disorders, and developmental language disorders were the most frequently chosen SLP study areas among all the specialties in which doctors in all branches of medicine work. The lowest number of doctors chose swallowing disorders, followed by cognitive communication disorders and X-linked language disorders, as the field of work of SLPs. &#x0D; Conclusion: It was found that the number of SLPs working in doctors' institutions, the level of cooperation between doctors and SLPs, and doctors' knowledge about the working areas of SLPs were low. It has been observed that physicians' awareness, especially in swallowing and cognitive communication disorders, is lacking. A strong partnership between physicians and SLPs is vital for appropriate service delivery to patients. For this reason, the number of SLPs working in institutions should be increased, as should the level of knowledge among doctors in different branches of medicine concerning SLPs’ services.

ASSESSMENT PRACTICES OF SPEECH AND LANGUAGE PATHOLOGISTS FOR COGNITIVE COMMUNICATION IMPAIRMENT AFTER TRAUMATIC BRAIN INJURY

Background of the Study: The aim of the present research was to examine the assessment practices of Speech-Language Pathologists for Cognitive Communication Disorders after Traumatic Brain Injury. Methodology: It was a cross-sectional survey method, a convenient sampling technique. Research was carried out from January 2021 to June 2021. The sample size was n=21, out of which n= 9 (42.8%) participants, each from Rawalpindi and Islamabad n= 3 (14.4%) participants from Lahore filled in their responses. Medium; being Online, the questionnaire was distributed either through email, WhatsApp or Facebook MessengerApp. SLPs who were undergraduates or who had no experience working with TBI clients were excluded. Questionnaire included 12 items. Responses of research participants were recorded using Google Forms and presented in the form of n (%). The data were analyzed using descriptive analysis, and chi-square analysis was performed to confirm the association between settings, city of practice and years of experience through Statistical Package of Social Sciences (SPSS) Version 22.0. Results: Speech-Language Pathologists reported that they routinely assessed (62% each) Receptive and Expressive communication. However; less than half of the participants routinely evaluated domains like verbal pragmatic skills (43.3%), functional communication (33.3%) and phonemic awareness (33.3%). SLPs assessed their clients by employing tests like MoCA (55.62%), Quick Aphasia Battery (18.75%), Cognitive Assessment (LOTCA Protocol) (14.35%) and a combination of Formal (48%) and Informal (52%) clinical interviews. Conclusion: Informal discourse assessment is incorporated more frequently as compared to informal discourse evaluation in assessment practices of Speech-Language pathologists of Pakistan for cognitive communication impairment followed by traumatic brain injury. Keywords: Brain injuries, cognitive dysfunction, language therapy, rehabilitation, speech therapy, traumatic.

Communication-related aspects of prospective memory: an exploratory factor analysis of prospective memory questionnaires.

Prospective memory (PM) questionnaires are frequently used to evaluate perceptions of PM skills in daily life. This study aimed to systematically investigate communication-specific attributes using pre-existing PM self-rating questionnaires to inform clinicians and researchers about the role of PM in cognitive communicative evaluations. PM-related items from three questionnaires (i.e., Prospective Memory Questionnaire, Comprehensive Assessment of Prospective Memory, and Prospective and Retrospective Memory Questionnaire) were compiled and embedded in Google Forms and distributed to 70 Speech-Language Pathologists (SLPs) with expertise in Cognitive Communicative Disorders across India. Participants first identified items related to communication, and were then contacted to rate the communication-related PM items using a Likert scale for their degree of appropriateness. Responses from 40 SLPs were obtained and subjected to item-content validity index (i-CVI) and exploratory factor analysis (EFA). Of the 114 PM items, 28 received ratings over 50% for their relevance to communication. Of the 28 items, 21 had an i-CVI score greater than 0.8. After the removal of overlapping content, 14 items were finalized and subjected to EFA, which resulted in four factors: PM failure due to loss of communicative content, PM failure due to loss of communicative intent, PM cost due to ongoing interference, and PM failure linked to the priority of communicative intent. This study highlights communication-related aspects of PM that can be used as a framework for SLPs to assess and research PM skills.

Barriers and facilitators to the assessment of cognitive-communication disorders in children and adolescents after traumatic brain injury: a survey of Australian clinical practice

Barriers and facilitators to the assessment of cognitive-communication disorders in children and adolescents after traumatic brain injury: a survey of Australian clinical practice

Cognitive-Communication Disorders and Neurodisability in the Criminal Justice System: Emerging Roles, Responsibilities, and Opportunities for Speech-Language Pathologists

Purpose:The purpose of this clinical focus article is to provide a framework for speech-language pathologists (SLPs) supporting youth and adults in the criminal justice system (CJS) who have cognitive-communication disorders (CCDs) related to neurodisability.Method:We provide an overview of communication disorders and CCDs in the CJS as well as the underlying etiologies leading to neurodisability, with a primary focus on traumatic brain injury. Additionally, we provide a framework for understanding the underlying factors that contribute to criminalization and recidivism as well as elucidate the role of SLPs in the context of the CJS.Results:SLPs have an important role to play with youth and adults in the CJS and should be routinely involved in the screening of communication disorders; in the provision of assessments, intervention, education, and training; and in advocacy roles.Conclusion:The high prevalence of CCDs in the CJS affords a unique and important role for SLPs to be active members of the interdisciplinary justice team, which, ultimately, may improve outcomes and reduce the cycle of recidivism.

Developing a Digital Health Intervention for Conversation Skills After Brain Injury (convers-ABI-lity) Using a Collaborative Approach: Mixed Methods Study.

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. 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. 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. 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. 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.

The pervasive and unyielding impacts of cognitive-communication changes following traumatic brain injury.

Cognitive-communication disorders (CCDs) are common in the traumatic brain injury (TBI) population. Despite this, there has been limited research that explores the long-term impacts of reduced cognitive-communication functioning on daily life for this population. To identify the long-term impacts of cognitive-communication impairment as reported by adults with TBI and their significant others. A qualitative descriptive approach grounded in phenomenology was used. Semi-structured, one-on-one interviews were conducted with adults with CCDs following TBI (n = 16) and their significant others (n = 12) to explore their lived experiences. Reflexive thematic analysis revealed an overarching theme of 'The pervasive and unyielding impacts of cognitive-communication changes on daily life following TBI'. Within this overarching theme, three subthemes were identified: (1) self-awareness of communication changes; (2) fatigue; and (3) self-identity and life roles. The findings from this study highlight the long-term negative impacts of reduced cognitive-communication functioning on daily life. Health professionals supporting this population should consider ways to reduce the significant impact CCDs have on the lives of adults following TBI and their significant others. In addition, the findings highlight the importance of long-term rehabilitation services following TBI, with further research needed that explores how these services can be optimised. What is already known on this subject Cognitive-communication disorders (CCDs) affect the majority of adults who experience moderate to severe traumatic brain injury (TBI) and encompass any component of communication that is affected by cognition. The hallmark characteristic of CCDs are breakdowns that affect social communication skills as well as cognitive-linguistic deficits. Combined, these can have dramatic implications for a person's quality of life, their level of independence, employment opportunities and social participation. There has been limited research to date that explores the long-term impacts of CCDs on the lives of adults following TBI. Further research that explores these impacts is needed to improve the support services and rehabilitation models of care available for this population. What this study adds The overarching theme was 'The pervasive and unyielding impacts of communication changes on daily life following TBI' with subthemes including changed communication, self-awareness of communication changes, fatigue and self-identity and life roles. The findings from this study highlight the long-term negative impacts of reduced cognitive-communication functioning on everyday functioning and quality of life as well as the importance of long-term rehabilitation services following TBI. What are the clinical implications of this work? Speech-language therapists and other health professionals working with this clinical population should consider how to address the significant and long-lasting impacts of CCDs. Due to the complex nature of the barriers experienced by this clinical population, an interdisciplinary targeted approach is advised wherever possible when providing rehabilitation services.

Long COVID: The impact on language and cognition

COVID-19 continues to have profound health and economic consequences around the world. Aside from the large number of deaths from this viral infection, there is a growing population of individuals who have not made a good recovery from their COVID illnesses. These children and adults continue to experience COVID symptoms for months and even years after the onset of their illness. One group of symptoms that can be particularly troubling are language and cognitive difficulties. These difficulties can compromise learning and academic attainment and prevent a return to employment in adults. The author has examined the language skills of 110 adults who reported experiencing Long COVID. Among these individuals, 99 adults reported significant cognitive-linguistic difficulties as part of their ongoing COVID symptoms. This article examines these difficulties in detail. It proposes that these cognition-based language difficulties should be included in the class of cognitive-communication disorders. These disorders are typically assessed and treated by speech-language pathologists who manage communication difficulties in clients with traumatic brain injury, right-hemisphere damage, and neurodegeneration.

Validation study of Arizona Battery for Communication Disorders of Dementia in Greek monolingual cognitively impaired patients

The evaluation of cognitive-communication disorders is performed with several types of assessment methods. These methods include different types of cognitive and language tests such as the Arizona Battery for Communication Disorders of Dementia (ABCD). The present study aimed to validate the ABCD in the Greek language. 132 individuals participated in the study: 60 adults in cognitive health (ACH) and 72 patients [24 Parkinson Disease (PD) patients without cognitive impairment, 24 with Parkinson Disease Dementia (PDD) and 24 with Alzheimer's Disease (AD)]. The cognitive and mental status of all participants was estimated by means of the Mini Mental State Examination (MMSE), the Abbreviated Mental Test Score (AMTS), the Clock Drawing Test (CDT), the Instrumental Activities of Daily Living (IADL), the Neuropsychiatric Inventory (H-NPI) the Geriatric Depression Scale -15 (GDS-15) and the ABCD. Statistically significant differences were found between all tests administered with the PDD and AD patients having the lower scores. The ABCD showed good psychometric properties, internal consistency (Cronbach alpha=0. 901) and discriminatory ability. It was significantly correlated with the AMTS, CDT, IADL, and MMSE.The Greek version of the ABCD demonstrated good validity, sensitivity, and discriminatory ability. The ABCD is a valuable instrument to assess cognitive-communication dis-orders.