Severe acquired brain injury: rehabilitation of communicative skills in children and adolescents

Abstract

The purpose of this study was to examine the use of a descriptive taxonomy for assessment of communicative abilities, the Pragmatic Protocol, in a rehabilitation setting with brain-injured children and adolescents. Eight severely brain-damaged children/youths were assessed with the Pragmatic Protocol during an intensive 6-week rehabilitation period. The nature and extent of communicative functioning was rated independently by a speech language pathologist and a rehabilitation assistant. The data suggests that the number of inappropriate pragmatic behaviours is relatively high, above all regarding aspects of speech/language and nonverbal communication. Interrater agreement reached approximately 95% considering nature of the communicative dysfunction in each patient. Results indicate the use of the Pragmatic Protocol as a useful tool to trace aspects of communicative competence in need of further, detailed exploration. Information concerning intact abilities is clarified and can be used in designing treatment.

Sociosexual and Communication Deficits after Traumatic Injury to the Developing Murine Brain

“…Impairments in recognizing and interpreting non-verbal emotional cues are common in children after TBI [120], [121], as well as pragmatic communication deficits including understanding sarcasm, differentiating truth from deception, using complex language, and comprehending figurative language such as metaphors [122]. Communication impairments may also manifest as excessive talkativeness, tangential and inappropriate conversation [123], [124], [125]. The consequences of such deficits are negative long-term outcomes including rejection by peers and limitations related to education and employment [2], [122].…”

Introducing the model of cognitive-communication competence: A model to guide evidence-based communication interventions after brain injury

“…Social communication success is determined by the goals, conventions, boundaries, or expectations of that particular context and can be enhanced or inhibited by the skills of the communication partner (72,133). Social communication impairments after ABI include difficulties with such skills as conversational initiation, fluency (speed, efficiency, revisions, mazes, false starts, repetitions), topic management (maintenance, turn taking, shift), listener-oriented behaviours or perspective taking, self-regulation (of topics, comments, tone, interjections), and adaptation to changing circumstances or distractions in the environment (visual, auditory, interruptions) (29,50,72,114,(215)(216)(217). These deficits can arise as a result of cognitive, communication, emotional, and physical factors including deficient attention, organization, working memory, or executive functions (114,143,159).…”

Using the La Trobe Communication Questionnaire to Measure Perceived Social Communication Ability in Adolescents With Traumatic Brain Injury

“…The specific manifestations of TBI-related pragmatic impairment include difficulties in meeting the informational needs of the listener (McDonald, 1993;Snow et al, 1997;, lack of logical structure and coherence in discourse (Chapman et al, 1992;Ewing-Cobbs, Fletcher, Levin, Iovino, & Miner, 1998;Liles, Coelho, Duffy, & Zalagens, 1989;O'Flaherty & Douglas, 1997), difficulty with implied meaning (Barnes & Dennis, 2001;Dennis & Barnes, 1990;O'Flaherty & Douglas, 1997;McDonald, 1992) inappropriate choice of conversational content/topic (Fyrberg, Marchioni, & Emanuelson, 2007;Togher, Hand & Code, 1997;Snow et al 1997), inappropriate interaction style (McDonald & van Sommers, 1993;O'Flaherty & Douglas, 1997), inappropriate change in topic/tangentiality (Bracy & Douglas, 2005;Fyrberg et al, 2007), and impoverished content (Brookshire, Chapman, Song, & Levin, 2000;Snow et al, 1997;Stout, Yorkston, & Pimentel, 2000). The consequence of such deficits is that conversations with individuals with TBI frequently require the communication partner to maintain the flow of conversation (Bracy & Douglas, 2005;Coelho, Youse & Le, 2002;Togher et al, 1997;Turkstra, 2000).…”