Protocol for a clinical trial of telehealth-based social communication skills training for people with traumatic brain injury and their communication partners

Rietdijk, Rachael; Power, Emma; Brunner, Melissa; Togher, Leanne

doi:10.1017/brimp.2019.9

Cited by 6 publications

(6 citation statements)

References 55 publications

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“…The trial protocol was registered at the Australian New Zealand Clinical Trials Registry (ACTRN12615001024538) and has been described in detail elsewhere. 18 The Strengthening the Reporting of Observational Studies in Epidemiology statement 19 guided reporting of quantitative measures, and the Standards for Reporting Qualitative Research checklist 20 guided reporting of qualitative components.…”

Section: Methodsmentioning

confidence: 99%

“…Although participants only received intervention in this study via one of the modes, all participants had at least one experience of a telehealth interaction, given that pre-training assessments for this study were conducted via Skype. 18 Furthermore, it was assumed that all participants had experience with participating in traditional in-person rehabilitation (either as a person with TBI or as a carer), given that all participants were at least six months post injury. This broad context formed the basis of participants' ability to draw comparisons between the delivery modes.…”

Section: Post-training Interviewmentioning

confidence: 99%

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Acceptability of telehealth-delivered rehabilitation: Experiences and perspectives of people with traumatic brain injury and their carers

et al. 2020

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Introduction Communication skills training for people with traumatic brain injury (TBI) and their carers is recommended best practice. Delivery via telehealth could improve access to this training. This paper focuses on the acceptability of telehealth delivery of communication skills training. Methods A mixed-methods investigation of acceptability of telehealth to people with TBI and their carers was incorporated into a clinical trial. Thirty-six people with TBI (23 metropolitan and 13 regional) and their carers were recruited. Metropolitan participants were randomly allocated to telehealth or in-person intervention at a 1:3 ratio. Regional participants were allocated to telehealth. Telehealth and in-person participants were compared on retention, time to complete the programme, home practice completion and therapeutic alliance ratings. Participants completed semi-structured interviews regarding their views on telehealth, which were analysed using thematic analysis. Results There were no significant differences between telehealth and in-person participants in retention rate, time to complete the programme, degree of home practice completion or therapeutic alliance ratings. Three themes were identified: ‘telehealth delivery opens a window for access to rehabilitation in the context of my daily life’, ‘in-person delivery offers rehabilitation based on natural human interaction’ and ‘weighing telehealth against in-person delivery’. Discussion Participants found telehealth delivery acceptable, as indicated by the similarity between groups in the quantitative process measures, and as reported in interviews. Some reported a preference for in-person delivery if there had been a choice of delivery mode. Participants described characteristics of the two delivery modes which were relevant to their attitudes towards telehealth.

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Section: Methodsmentioning

confidence: 99%

Section: Post-training Interviewmentioning

confidence: 99%

Acceptability of telehealth-delivered rehabilitation: Experiences and perspectives of people with traumatic brain injury and their carers

et al. 2020

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“…Functional intervention methods using context sensitive approaches have been shown in the literature to optimize social communication outcomes (Finch et al., 2016; Lê et al., 2022). A number of evidence based, manualized intervention approaches target interactional aspects of discourse after TBI, including TBIExpress (Togher et al., 2010), TBIConnect (Rietdijk et al., 2019), CommCope‐I (Douglas et al., 2019) and IMPACT, a metacognitive strategy training intervention (Finch et al., 2017). Consistent with this literature, survey respondents reported prioritizing metacognitive strategy training, conversational partner training and social skills training in their intervention approaches for individuals post‐TBI.…”

Section: Discussionmentioning

confidence: 99%

How do speech–language pathologists assess and treat spoken discourse after TBI? A survey of clinical practice

Steel

Coluccio

Elbourn

et al. 2022

Intl J Lang & Comm Disor

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BackgroundSpoken discourse is commonly affected after traumatic brain injury (TBI). Although guidelines recommend prioritizing discourse‐level skills in cognitive communication management, previous literature has highlighted challenges in managing discourse clinically. Little is known about how speech–language pathologists (SLPs) assess and treat discourse after TBI.AimsTo investigate current SLP practice to determine the alignment of clinical practice with research evidence and recommendations.Methods & ProceduresThis online survey consisted of 30 questions on SLPs’ practice with discourse assessment, analysis and treatment processes, including the materials and methods used and rationales for decision‐making. Participants were recruited through national and international SLP professional bodies, TBI‐specific or SLP special‐interest groups and social media. Survey responses were analysed using descriptive statistics, with free text included to support individual responses.Outcomes & ResultsThere were 70 participants, from Australia, the United States, UK and New Zealand. Nearly half the participants had over 11 years of experience working with adults with TBI and a quarter had over 20 years of experience. Participants reported that they regularly evaluated the discourse ability of people with TBI, most commonly during spontaneous conversation or with a personal narrative task. Discourse intervention approaches mostly targeted client self‐monitoring ability, social skills or conversational interactions. Practice varied dependent on setting, with more SLPs in community or outpatient services undertaking discourse assessment and treatment than in hospital settings.Conclusions & ImplicationsOverall, survey respondents’ management of spoken discourse aligned with recommendations in the research literature, incorporating an individualized, goal‐based approach. Factors affecting the use of discourse in practice included client‐specific factors and needs, availability of time for transcription and analysis, and SLPs’ knowledge level and confidence with discourse. Increased knowledge of discourse methods and treatment approaches could help inform decision‐making for SLPs working in TBI.WHAT THIS PAPER ADDSWhat is already known on this subject Spoken discourse is one of the most affected areas of communication for people with TBI. Although recent research has provided guidance on assessment and treatment options for TBI discourse, it is unknown how SLPs manage spoken discourse clinically.What this paper adds to existing knowledge This research adds to the limited research on how SLPs across clinical settings and regions manage discourse assessment and treatment. Respondents’ practice was generally aligned with recommendations, featuring individualized, goal‐based practice. Potential barriers to discourse implementation included client factors and SLP knowledge, training, and service delivery factors.What are the potential or actual clinical implications of this work? This survey provides evidence that clinical translation is starting to occur in this field, but there remains a need for increased knowledge of assessment and treatment methods, training, and TBI‐specific resources to better support SLP practice, particularly relating to transcription. Core reporting outcomes in research on TBI discourse management would assist with translation of the findings to practice.

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“…32 Single-case designs give preliminary data for exploring communication partner training but should be scaled up to show effectiveness as for one study 38 which formed the basis of an RCT in progress with 36 participants. 53 Also follow-up measures, which were used in less than half of the studies should be included more often to [54][55][56] Self-report measures of communicative ability completed by people with TBI and their communication partners were used with mixed results. Even when the same outcome of perceived communicative ability was used, not all studies noted improvement.…”

Section: Effectiveness Of Communication Partner Trainingmentioning

confidence: 99%

Description and Effectiveness of Communication Partner Training in TBI: A Systematic Review

Behn

Francis

Togher

et al. 2020

Journal of Head Trauma Rehabilitation

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database inception to February 2019. Eligibility criteria: Empirical studies on interventions for adult communication partners where the primary focus of the program (>50%) was on improving communication skills of people with TBI and/or communication partners. Data: participants, characteristics of the training, outcome measures and findings. Risk of bias: standard checklists were used for methodological quality (PEDRO, ROBiN-T) and intervention description (TIDieR). Synthesis: narrative synthesis and effect sizes (Cohen's d) for group-level studies. Outcomes: Ten articles (describing eight studies) met eligibility criteria: three randomized controlled trials, two non-randomised controlled trials and three single-case experimental designs. Studies included a total of 258 people with TBI and 328 communication partners, however all but one study had fewer than 65 participants. Methodological quality varied and intervention description poor. Three studies in the final synthesis (n=41 communication partners, n=36 people with TBI) reported positive intervention effects. Effect sizes in group studies were (d=0.80-1.13) for TBI and (d=1.16-2.09) for communication partners. Conclusions: The articles provided encouraging though limited evidence for training communication partners. Greater methodological rigour, more clearly described interventions, and consistent use of outcome measures and follow-up post-treatment are needed. Further research in this field is warranted.

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Protocol for a clinical trial of telehealth-based social communication skills training for people with traumatic brain injury and their communication partners

Cited by 6 publications

References 55 publications

Acceptability of telehealth-delivered rehabilitation: Experiences and perspectives of people with traumatic brain injury and their carers

Acceptability of telehealth-delivered rehabilitation: Experiences and perspectives of people with traumatic brain injury and their carers

How do speech–language pathologists assess and treat spoken discourse after TBI? A survey of clinical practice

Description and Effectiveness of Communication Partner Training in TBI: A Systematic Review

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