Communication after traumatic brain injury: the effectiveness of a Pragmatics rehabilitation programme
Issue: Vol 9 No. 2 (2018)
Journal: Journal of Interactional Research in Communication Disorders
Subject Areas: Linguistics
DOI: 10.1558/jircd.38533
Abstract:
Objective: The present study intends to assess the effects of a Pragmatics rehabilitation programme on communication skills.
Method: We have recruited 12 participants who had suffered from severe or moderate Traumatic Brain Injury (TBI), with more than two years post-onset, who were randomly divided into two groups, an Experimental Group (EG) and a Control Group (CG). The EG followed a specific programme for the rehabilitation of Pragmatic Communication and the CG followed a programme of communication stimulation through group conversation. Each programme consisted of 24 one-hour, thirty-minute sessions, twice a week, for 12 weeks. In order to verify the efficacy of the programme, both groups were assessed before and after using the two equivalent forms of the same scale, Forms A and B, of The Assessment Battery of Communication (ABaCo).
Results: Improvements were observed in both groups, although much more evident in the EG. Both groups obtained better results regarding Extralinguistic Comprehension and Production (questions, assertions, commands, requests and ironies by using gesticulation). In the EG there was also an improvement in Paralinguistic Production (facial expressions and intonation).
Conclusion: The results demonstrate the effectiveness and relevance of establishing rehabilitation programmes for communicative pragmatic disorders after TBI. The study shows how a simple conversation intervention programme can be beneficial when more elaborated therapies cannot be executed.
Author: Nicole Agrela, Maria EmÃlia Santos, Sandra Guerreiro
References :
Angeleri, R., Bosco, F. M., Zettin, M., Sacco, K., Colle, L. and Bara, B.G. (2008). Communicative impairment in traumatic brain injury: A complete pragmatic assessment. Brain & Language 107: 229–245. https://doi.org/10.1016/j.bandl.2008.01.002
Angeleri, R., Bosco, F. M, Gabbatore, I., Bara, B. G. and Sacco, K. (2012). Assessment battery for communication (ABaCO): normative data. Behavior Research Methods 44: 1–43. https://doi.org/10.3758/s13428-011-0174-9
Aten, J. L., Caligiuri, M. P. and Holland, A. L. (1982). The efficacy of functional communication therapy for chronic aphasic patients. Journal of Speech and Hearing Disorders 47 (1): 93–96.
Braden, C., Hawley, L., Newman, J., Morey, C., Gerber, D. and Felix, C. H. (2010). Social communication skills group treatment: A feasibility study for persons with traumatic brain injury and comorbid conditions. Brain Injury 24(11): 1298–1310. https://doi.org/10.3109/02699052.2010.506859
Body, R. and Perkins, M. R. (2004). Validation of linguistic analyses in narrative discourse after traumatic brain injury. Brain Injury 18 (7): 707–724.
Bosco, F. M., Angeleri, R., Zuffranieri, M., Bara, B. G. and Sacco, K. (2012). Assessment Battery for Communication: Development of two equivalent forms. Journal of Communication Disorders 45 (4): 290–303. https://doi.org/10.1016/j.jcomdis.2012.03.002
Bosco, F. M., Angeleri, R., Sacco, K. and Bara, B. G. (2015). Explaining pragmatic performance in traumatic brain injury: a process perspective on communicative errors. International Journal Language communication disorder 50 (1): 63–83. https://doi.org/10.1111/1460-6984.12114
Dahlberg, C., Hawley, L., Morey, C., Newman, J., Cusick, C. P. and Harrison-Felix, C. (2006). Social communication skills in persons with post-acute traumatic brain injury: Three perspectives. Brain Injury 20: 425–435. https://doi.org/10.1080/02699050600664574
Dahlberg, C. A., Cusick, C. P., Hawley, L. A., Newman, J. K., Morey, C. E., Harrison-Felix, C. L. and Whiteneck, G. G. (2007). Treatment efficacy of social communication skills training after traumatic brain injury: A randomized treatment and deferred treatment controlled trial. Archives of Physical Medicine and Rehabilitation 88: 1561–1573. https://doi.org/10.1016/j.apmr.2007.07.033
Despins, E. H., Turkstra, L. S., Struchen, M. A. and Clark, A. N. (2016). Sex-based differences in perceived pragmatic communication ability of adults with traumatic brain injury. Archives of Physical Medicine and Rehabilitation 97(2): S26–32. https://doi.org/10.1016/j.apmr.2014.06.023
Dummond, S. S. and Boss, M. R. (2004). Functional communication screening in individuals with traumatic brain injury. Brain Injury 18 (1): 41–56. https://doi.org/10.1080/0269905031000149461
Ehrlich, J. S. and Sipes, A. L. (1985) Group treatment of communication skills for head trauma patients. Cognitive Rehabilitation 3(1): 32–37.
Finch, E., Cornwell, P., Copley, A., Doig, E. and Fleming, J. (2017). Remediation of social communication impairments following traumatic brain injury using metacognitive strategy intervention: a pilot stud. Brain Injury 31: 13–14. https://doi.org/10.1080/02699052.2017.1346284
Freitas, S., Simões, M., Martins, C., Vilar, M. and Santana, I. (2010). Estudo de adaptação do Montreal Cognitive Assessment (MoCa) para a população portuguesa. Avaliação Psicológica 9(3): 345–357.
Gabbatore, I., Sacco, K., Angeleri, R., Zettin, M., Bara, B. and Bosco F. (2015). Cognitive Pragmatic Treatment: A rehabilitative programme for traumatic brain injury individuals. Journal Head Trauma Rehabilitation 30(5): 14–28. https://doi.org/10.1097/HTR.0000000000000087
Galski, T., Tompkins, C. and Johnston, M. V. (1998). Competence in discourse as a measure of social integration and quality of life in persons with traumatic brain injury. Brain Injury 12 (9): 769–782.
Gindri, G., Pagliarin, K. C., Casarin, F. S., Branco, L. D., Ferré, P., Joanette, Y. and Fonseca, R. P. (2014). Rehabilitation of discourse impairments after acquired brain injury. Dement Neuropsychol 8(1): 58–65.
Hawley, L. A. and Newman, J. K. (2010). Group interactive structured treatment (GIST): A social competence intervention for individuals with brain injury. Brain Injury 24(11): 1292–1297. https://doi.org/10.3109/02699052.2010.506866
Holland, A. L. (1991). Pragmatic aspects of intervention in aphasia. Journal of Neuro-linguistics 6 (2): 197–211.
LeBlanc, J., De Guise, E., Champoux, M. C., Couturier, C., Lamoureux, J., Marcoux, J. and Feyz, M. (2014). Acute evaluation of conversational discourse skills in traumatic brain injury. International Journal of Speech-Language Pathology 16(6): 582–593. https://doi.org/10.3109/17549507.2013.871335
McDonald, S. (1993). Viewing the brain sideways? Right hemisphere versus anterior models of non-aphasic language disorders. Aphasiology 7(6): 535–549.
Macdonald, S. and Wiseman-Hakes, C. (2010). Knowledge translation in ABI rehabilitation: A model for consolidating and applying the evidence for cognitive-communication interventions. Brain Injury 24 (3): 486–508.
Nasreddine, Z., Phillips, N. A., Bédirian, V., Charbonneau, S., Whitehead, V., Collin, I., Cummings, J. L. and Chertkow, H. (2005). The Montreal Cognitive Assessment, MoCA: A brief screening tool for Mild Cognitive Impairment. American Geriatrics Society 53: 695–699.
Ponsford, J. L., Downing, M. G., Olver. J., Ponsford, M., Acher, R., Carty, M. and Spitz, G. (2014). Longitudinal follow-up of patients with traumatic brain injury: Outcome at two, five, and ten years post-injury. Journal Neurotrauma 31(1): 64–77. https://doi.org/10.1089/neu.2013.2997
Rousseaux, M., Vérigneaux, C., and Kozlowski, O. (2010). An analysis of communication in conversation after severe traumatic brain injury. European Journal of Neurology 17: 922–929. https://doi.org/10.1111/j.1468-1331.2009.02945.x
Sacco, K, Angeleri, R., Bosco, F. M., Colle, L., Mate, D. and Bara, B. G. (2008). Assessment Battery for Communication – ABaCo: A new Instrument for the Evaluation of Pragmatic Abilities. Journal of Cognitive Science 9: 111–157.
Sacco, K., Gabbatore, I., Geda, E., Duca, S., Cauda, F., Bara, B. G. and Bosco, F. M. (2016). Rehabilitation of Communicative Abilities in Patients with a History of TBI: Behavioral Improvements and Cerebral Changes in Resting-State Activity. Frontiers in Behavioral Neuroscience 10: 48. https://doi.org/10.3389/fnbeh.2016.00048
Sainson, C., Barat, M. and Aguert, M. (2014). Communication disorders and executive function impairment after severe traumatic brain injury: An exploratory study using the GALI (a grid for linguistic analysis of free conversational interchange). Annals of Physical and Rehabilitation Medicine 57 (9–10): 664–683.
Sim, P., Power, E. and Togher, L. (2013) Describing conversations between individuals with traumatic brain injury (TBI) and communication partners following communication partner training: Using exchange structure analysis. Brain Injury 27(6): 717–742. https://doi.org/10.3109/02699052.2013.775485
Stemmer, B., Giroux, F., and Joanette, Y. (1994). Production and evolution of request by right hemisphere brain-damage individuals. Brain and Language 7: 1–31.
Togher, L., McDonald, S., Code, C., and Grant, S. (2004). Training communication partners of people with traumatic brain injury: A randomized controlled trial. Aphasiology 18(4): 313–335.
Togher, L., McDonald, S., Tate, R., Power, E., and Rietdijk, R. (2013). Training communication partners of people with severe traumatic brain injury improves everyday conversations: A multicenter single blind clinical trial. Journal of Rehabilitation Medicine 45: 637–645. https://doi.org/10.2340/16501977-1173
Togher, L., McDonald, S., Tate, R., Rietdijk, R. and Power, E. (2016). The effectiveness of social communication partner training for adults with severe chronic TBI and their families using a measure of perceived communication ability. NeuroRehabilitation 38(3): 243–255. https://doi.org/10.3233/NRE-151316
Turkstra, L., Brehm, S. E., and Montgomery, E. B. (2006). Analysing conversational discourse after traumatic brain injury: Isn’t it about time? Brain Impairment 7: 234–245.
Winson, R., Wilson, B.A., and Bateman, A. (2017). Brain Injury Rehabilitation Workbook. New York: The Guilford Press.