How can we evaluate and improve social communication in individuals after a traumatic brain injury (TBI)?
Social communication impairments are one of the more common communication problems after a TBI. Successful social communication skills involve the ability to tap into our cognitive ability to control speech and language skills, awareness of social rules, and emotional control. Studies have stated that difficulties in communicating have contributed to the loss of meaningful relationships and the inability to maintain employment that end up leading to social isolation and loneliness.
Hypothesis:
Social communication skills training in a group setting would improve specific individual pragmatic communication deficits for people with a TBI, overall social life and satisfaction with life will improve in the group training, and this would be acquired and maintained at a 6-months post treatment.
Research Design:
97 candidates were deemed eligible, 60 enrolled
52 were in the free primary analysis treatment versus the no-treatment effect
Those 52 were of at least 1 year post injury, received rehabilitation, and showed deficits in social communication
randomized treatment and deferred treatment controlled trial with a follow up at 3, 6, and 9 months post-treatment
12 weekly group sessions (1.5 hour each)
Group treatment allowed the participants to practice skills and get appropriate feedback from other members in the group.
“Treatment groups typically target specific communication behaviors with individualized treatment goals, role playing to practice specific skills, feedback through videotape, and skill use in natural environments.” (Dahlberg, C. et al 2007)
Results:
Profile of Functional Impairment in Communication (PFIC) improved
Social Communication Skills Questionnaire - Adapted (SCSQ-A) improved
Goal Attainment Scale (GAS) improved
Satisfaction With Life Scale (SWLS) improved
Significantly improved from the baselines after 12 weeks and significantly gotten better than the baselines at the 6-month follow ups.
After the 12 weeks of treatment (all of the above) those who received the social communication skills training had improved and maintained those skills in the post-treatment follow ups.
Conclusion:
TBI subjects who received social communication skills training had improved communication skills that were maintained on follow up. Overall life satisfaction for participants was improved. Group leaders and more had noted progress in the TBI subjects, therefore supporting the clinical significance of the treatment.
“Hopefully, future multicenter trials will establish the effectiveness of the treatment intervention and its positive effect on the lives of people with TBI.” (Dahlberg, C. et al 2007)
Here is a very touching story of Natalie Forstbauer and her personal experiences with TBI. Although she touches upon a wide array of how her TBI affected her life, her story also highlights the way in which she had to reinvent herself to communicate, not only to others but to herself as well.
References:
Dahlberg, Cynthia A.,M.A., C.C.C., Cusick, C. P., B.A., Hawley, L. A., M.S.W., Newman, Jody
K.,M.A., C.C.C., Morey, Clare E.,M.A., C.C.C., Harrison-Felix, C., & Whiteneck, G. G., PhD. (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(12), 1561-1573. doi:10.1016/j.apmr.2007.07.033
TEDx Talks. (2019) Brain Injury to Brain Upgrade | Natalie Forstbauer | TEDxChiliwack
[Video]. YouTube. https://www.youtube.com/watch?v=AinF06mBUhs&t=1s