Steel Joanne, Ferguson Alison, Spencer Elizabeth, Togher Leanne
a Deparment of Speech Pathology , The University of Newcastle , Newcastle , Australia.
b NHMRC Centre of Research Excellence in Brain Recovery, Moving Ahead , Sydney , Australia.
Brain Inj. 2017;31(10):1320-1330. doi: 10.1080/02699052.2017.1332385. Epub 2017 Jun 28.
Social communication impairment is a persisting and debilitating consequence of traumatic brain injury (TBI). However, there has been little empirical speech-language pathology (SLP) study focusing on the early stage of recovery after TBI, including during post-traumatic amnesia (PTA). This research reports on social communication presentation and recovery during late PTA and the post-acute period, assessed with standardized measures.
Using mixed-methods case study research, four participants with severe TBI were assessed with social communication assessment measures over the later stages of PTA and/or at PTA emergence, and at follow-up three months later. Assessment tools included the Measure of Cognitive Linguistic Abilities Family Questionnaire, the La Trobe Communication Questionnaire and The Profile of Pragmatic Impairment in Communication and included patient and friend/family perspectives.
It was possible to identify a profile of social communication disorder on SLP measures for participants during PTA that persisted at follow-up, but with decreased severity. Self and friend/family member ratings of social communication indicated an increased awareness of social difficulty at three months after PTA emergence.
Findings provided information about presentation and course of recovery of social communication ability for participants in the early stage of rehabilitation after TBI. These findings have implications for timing and methods of SLP assessment during PTA.
社交沟通障碍是创伤性脑损伤(TBI)持续存在且使人衰弱的后果。然而,很少有实证性言语语言病理学(SLP)研究关注TBI后恢复的早期阶段,包括创伤后遗忘症(PTA)期间。本研究报告了用标准化测量方法评估的PTA后期和急性后期的社交沟通表现及恢复情况。
采用混合方法案例研究,对4名重度TBI患者在PTA后期和/或PTA出现时以及3个月后的随访中进行社交沟通评估测量。评估工具包括认知语言能力测量家庭问卷、拉筹伯沟通问卷和沟通中语用障碍概况,涵盖患者及朋友/家人的观点。
有可能在PTA期间为参与者确定一份基于SLP测量的社交沟通障碍概况,该概况在随访时持续存在,但严重程度有所降低。社交沟通的自我及朋友/家人评分表明,PTA出现3个月后对社交困难的意识有所增强。
研究结果提供了关于TBI后康复早期阶段参与者社交沟通能力的表现及恢复过程的信息。这些结果对PTA期间SLP评估的时机和方法具有启示意义。