The investigation of treatment outcomes for adults with chronic brain injury following intensive multidisciplinary treatment

Although communication sciences and disorders (COMD) research supports intensive treatment for individuals with chronic brain injury, funding to provide these services is limited. This study explored the use of interdepartmental university resources to provide an intensive, multidisciplinary chronic brain injury program. Methodologically, treatment regimes were designed with clinical faculty as practicum experiences for COMD master’s degree students. Subjects with a single onset head injury or cerebral vascular accident greater than one year were recruited to participate in the Intensive Treatment, Weekly Treatment or Control Groups. Pre, Post, and Post-Post Testing were used to measure cognitive-linguistic, quality of life and physical function. Additionally, treatment groups participated in electronic Experience Sampling Method (ESM) probes which queried their perception of happiness, tiredness, stress, and communication satisfaction throughout treatment using a Palm Zire 31 Personal Data Assistant. Both treatment programs were contextually-oriented, stressing functional multi-modality communication and compensatory techniques. Three hours of small and medium group COMD treatment were administered to the Weekly Group once weekly. The six subjects in the Intensive Group received a 35 hour weekly program including: COMD (12 hours), modified Tai Chi (3 hours), and psychological support for them and caregivers (4 ¼ hours). One-way repeated measures analysis of variance with partial eta squared effect size was used to analyze measures in the standardized battery. Intensive Group cognitive linguistic function appeared to significantly differ from the other groups on the Communication Activities of Daily Living-2 and Aphasia Diagnostic Profile Writing subtest suggestive of functional communication gains. Results of the ESM probes indicate that the Intensive Group was reportedly more happy and satisfied with their communication than the Weekly Group. The participants of the Intensive Group appeared to physically benefit from 3 weeks of modified Tai Chi in rate of ambulation. Limitations of the study, including self selection of treatment condition and differing severity across treatment groups, must be addressed by expanding the subject pool in follow-up research

Environmental symbol recognition across neurologically damaged and non-damaged individuals: Building a case for the Environmental Symbol Recognition Test

Research suggests that patients with aphasia perform significantly poorer than neurologically normal subjects in all areas of symbolic recognition except for via iconographic symbols. This work is an expansion of a previous study on an environmental symbol recognition test (ESRT). Stimuli on the ESRT include company logos, highway signs, and environment ideograms. Results indicate a significant difference in performance between the neurologically normal (N=41) and neurologically impaired (N=82). Between group comparisons were also found to be significant (i.e. TBI, L Hemisphere w/aphasia). Further, comparison with Aphasia Diagnostic Profile (ADP) performance for a subset of neurologically impaired subjects, yielded significant correlations between ADP subtests and the ESRT score

The Investigation of Treatment Outcomes for Adults with Chronic Brain Injury following Intensive Multidisciplinary Treatment

Following efficacy research supporting intensive treatment in chronic brain injury, this study investigated an interdepartmental, university-based, intensive treatment program. Eighteen participants composed the Intensive, Weekly and No Treatment groups. Results suggested that the Intensive Group incurred significant gains on the CADL-2 with the strongest communication gains 6 weeks post treatment. Additionally, the Intensive Group reported more daily post-treatment happiness and communication satisfaction than the Weekly Group with improved ambulation following 3 weeks of modified Tai Chi. Results suggest that university training programs may offer an effective, cost-effective service delivery option for this population

Utilizing the "Experience Sampling Method" to Monitor Communicative Quality of Life During Treatment for a Single Subject with Chronic Aphasia

Research in chronic aphasia typically incorporates Quality of Life measures to determine functional outcomes of treatment. This single subject study utilizes the Experience Sampling Method (ESM) in which the 75 year old, one year post CVA subject responds to 4-5 questions on a Palm Tungsten Personal Data Assistant (PDA) at the end of each activity during an intensive treatment program. Comparison of responses to the 10 treatment activities suggests that responses regarding the perception of communication and stress were the most negative, but, that less structured activities were more stressful than those communicatively focused. Theoretical and clinical findings will be discussed