Measuring outcomes of a peer-led social communication skills intervention for adults with acquired brain injury: A pilot investigation

Abstract

Reduced social competence following severe acquired brain injury (ABI) is welldocumented. This pilot study investigated a peer-led group intervention based on the claim that peer models may be a more effective mechanism for behaviour change than clinician-led approaches. Twelve participants with severe ABI were recruited from a post-acute neurorehabilitation setting, and randomly assigned to either a peer-led intervention or a staff-led activity group (usual care) (Clinicaltrials.gov: NCT02211339). The groups met twice a week for 8 weeks. A peer was trained separately to facilitate interaction in the intervention group. Training comprised 16 individual sessions over 4 weeks. Group behaviour was measured twice at baseline, after intervention and at maintenance (4 weeks), using the Adapted Measure of Participation in Conversation (MPC) and the Interactional Network Tool (INT), a newly devised measure of group conversational interaction.Outcome measures showed differential sensitivity. The groups did not differ in baseline behaviour. Findings showed a significant improvement in the treated group on the MPC transaction scale post-intervention (p=.02). The intervention group showed more balanced interaction post-intervention on the INT and at follow-up.Findings show preliminary evidence of advantage for peer-led groups. The INT shows promise as a method to detect change in group communication behaviour.

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

“…A validated and clinically feasible measure to promote personally relevant goal setting and to monitor progress with cognitive-communication treatment is goal attainment scaling (GAS) 38,53–55. The aim is to build on success and target areas where the person can achieve positive outcomes.…”

“…52 A validated and clinically feasible measure to promote personally relevant goal setting and to monitor progress with cognitive-communication treatment is goal attainment scaling (GAS). 38,[53][54][55] The aim is to build on success and target areas where the person can achieve positive outcomes. Goal attainment, as measured by GAS, is most effective when the person with TBI is actively engaged in the goal setting process and can learn to self-monitor communication behaviors.…”

Experiences of adults with stroke attending a peer-led peer-support group

“…These programs often incorporate a coupled peer and professional-led approach, where professionals work with individuals with lived experience to provide peer-support interventions (Kessler et al, 2014; Wijekoon et al, 2020). Preliminary evidence from a peer-led brain injury group found it improved social communication better than a staff-led intervention (Howell et al, 2021). However, there is limited research that explores peer-led, peer-support groups for stroke survivors that did not involve a healthcare professional or other outside group.…”

Measuring group social interactions following acquired brain injury: an inter-rater reliability evaluation

“…This investigation tested their reliability with group interaction data. The evaluation preceded a pilot study comparing the effects of a peer-led social communication intervention versus usual care (Howell et al, 2020). One new measure, the Interactional Network Tool (INT) (Howell, 2018) was also evaluated.…”

“…The evaluation preceded a pilot study comparing the effects of a peer-led social communication intervention versus usual care (Howell et al, 2020). One new measure, the Interactional Network Tool (INT) (Howell, 2018) was also evaluated. This measure was developed specifically to evaluate conversation behaviour in an ABI group.…”