Citation

Finch E, Copley A, Cornwell P, Kelly C. Arch. Phys. Med. Rehabil. 2015; 97(8): 1352-1365.

Affiliation

Allied Health Research Collaborative, Metro North Hospital and Health Service, Chermside, Queensland, Australia.

Copyright

(Copyright © 2015, Elsevier Publishing)

DOI

10.1016/j.apmr.2015.11.005

PMID

26679234

Abstract

OBJECTIVE: To determine whether behavioural interventions are beneficial for adults with social communication difficulties following Traumatic Brain Injury (TBI). DATA SOURCES: Electronic databases were searched through 2013 to find behavioural intervention trials. Key words used in our search were: intervention, therapy, treatment, and program combined with pragmatic disorder, pragmatic impairment, social communication disorder/impairment, conversation disorder/impairment, social disorder/impairment, cognitive-linguistic and cognitive-communication deficit; adult; and traumatic brain injury, head injury and brain injury. Hand searches of the reference lists of relevant papers were also conducted. STUDY SELECTION: To be selected for detailed review, papers found in the initial search were assessed by two reviewers and had to meet the following criteria: (1) population (adults with TBI), (2) intervention (behavioural intervention) and (3) outcomes (changes in social communication). Papers needed to describe interventions that were delivered directly to adults with TBI with or without other people (such as significant others) involved. Of the 2181 articles initially identified, 15 were selected for detailed review. DATA SYNTHESIS: Of the 15 publications that met the study criteria, seven were single case design studies, three were randomised control trials (RCT), one was a non-randomised control trial (nRCT) and four were cohort studies. The methodological qualities of eligible papers were examined using the PEDro and SCED rating scales. The interventions described in the studies fell into two broad categories: those addressing a specific impairment in social communication, and context-specific interventions with a holistic focus on social communication skills. Studies using context-sensitive approaches had been published more recently and were generally group studies with higher methodological quality.

CONCLUSIONS: Overall interventions addressing social communication skills for people with TBI were found to be beneficial irrespective of treatment approach utilised. While the evidence base is small and with varying levels of scientific rigour, there is a body of quality evidence that supports the use of context-sensitive approaches. Further research is still required to determine the role of impairment-specific versus context-specific interventions when treating individuals with social communication skills after TBI to inform clinical decision-making.

Language: en