Department of Communication Sciences and Disorders, University of Wisconsin-Eau Claire.
Am J Speech Lang Pathol. 2021 Apr 16;30(2S):863-882. doi: 10.1044/2021_AJSLP-20-00074. Epub 2021 Mar 30.
Purpose Individuals with traumatic brain injury (TBI) experience impairments to self-regulation and social communication that strain relationships. Video self-modeling (VSM) provides visible and audible, tangible evidence of what they do well and what could improve. Conducting such training in the context of authentic exchanges with their everyday partners may support positive change in social communication. The present investigation sought to evaluate indices of improved social communication. Method A mixed-methods design was employed for this case series investigation. Quantitative measures include pre- and postoutcomes on goal attainment scales (GASs) and measures of conversational effectiveness. Qualitative measures include responsiveness to video-supported prompts, conversational behaviors, and metacognitive statements. Results Participants perceived gains on GAS of 3-4 s, as well as perceived improvements on the La Trobe Communication Questionnaire. Those gains were validated by gains on the adapted Measure of Participation in Conversation and Measure of Skill in Supported Conversation. Individuals with TBI and their partners reached consensus on most goals and postintervention La Trobe Communication Questionnaire ratings. Participants made accurate judgments about their behaviors at a high rate, given video review. Conversational behaviors and use of metacognitive statements varied across participants and conversational contexts. Field notes and session transcripts provide evidence that both dyads increased internalization of VSM goals and purpose. Conclusions Joint VSM shows promise as a method for eliciting accurate self-assessments among individuals with TBI and their close partners. Both dyads perceived positive gains in interactions within and outside their dyads. Furthermore, joint VSM and GAS appear to improve self-awareness and internalization of VSM goals and purpose.
目的 创伤性脑损伤（TBI）患者的自我调节和社交沟通能力受损，这会影响他们的人际关系。视频自我示范（VSM）提供了他们做得好和需要改进的可见可听的有形证据。在与日常伙伴进行真实交流的背景下进行这种培训，可以支持社交沟通的积极变化。本研究旨在评估社交沟通改善的指标。
方法 本案例系列研究采用混合方法设计。定量测量包括目标达成量表（GAS）和会话有效性测量的前后结果。定性测量包括对视频支持提示的反应、会话行为和元认知陈述。
结果 参与者在 GAS 上的得分提高了 3-4 个等级，并且在拉筹伯沟通问卷上的得分也有所提高。这些收益得到了在适应后的对话参与度测量和支持对话技能测量上的收益的验证。TBI 患者及其伴侣在大多数目标和干预后的拉筹伯沟通问卷评分上达成了共识。参与者在接受视频审查时，以较高的准确率对自己的行为做出判断。会话行为和元认知陈述的使用因参与者和会话情境而异。现场记录和会话抄本提供了证据，表明两个参与者都增加了对 VSM 目标和目的的内化。
结论 联合 VSM 有望成为一种在 TBI 患者及其亲密伙伴中引出准确自我评估的方法。两个参与者都在他们的互动中感知到了积极的收益，无论是在他们的二人组内还是外。此外，联合 VSM 和 GAS 似乎可以提高自我意识和对 VSM 目标和目的的内化。
