Support Network Responses to Acquired Brain Injury

Acquired brain injury (ABI) affects social relationships; however, the ways social and support networks change and evolve as a result of brain injury is not well understood. This study explored ways in which survivors of ABI and members of their support networks perceive relationship changes as recovery extends into the long-term stage. Two survivors of ABI and members of their respective support networks participated in this case study integrating information from interviews, field notes, and artifacts. Inductive data analysis revealed themes of adjustment to impairments and compensations, connection changes with other people, feelings of protectiveness toward the survivor, emotional intensity, and the influence of personality traits on the recovery process. Application of these themes to intervention suggests health care professionals might benefit from shifting their focus from the survivor alone to the survivor functioning within a social support network

People with spinal cord injury (SCI) require extensive rehabilitation to maximize independence and quality of life. Much of this treatment occurs on an outpatient basis through telerehabilitation or clinic-based services. Synchronous telerehabilitation ha

People with spinal cord injury (SCI) require extensive rehabilitation to maximize independence and quality of life. Much of this treatment occurs on an outpatient basis through telerehabilitation or clinic-based services. Synchronous telerehabilitation has become increasingly common in recent years, but many professionals remain reluctant to suggest it when clinic-based services are available. This survey study explored case managers’ perceptions regarding advantages and disadvantages of synchronous telerehabilitation versus clinic-based physical therapy services for people with SCI. Respondents were 89 case managers responsible for service provision coordination. Results showed a significant preference for clinic-based rather than telerehabilitation physical therapy services. Relative experience with the two service delivery models significantly affected perceptions. Only facilitating travel convenience differed significantly as a reason for recommending one service delivery method over the other. The incongruity between perceptions about synchronous telerehabilitation and existing literature about its cost, convenience, and efficacy suggests a need for additional education

Changes in Responsiveness when Brain Injury Survivors with Impaired Consciousness Hear Different Voices

Primary objective—The researchers sought to determine whether individuals with impaired consciousness secondary to acquired brain injury (ABI) changed in responsiveness when purposefully presented with familiar, unfamiliar, and synthetic voice messages. Research design—Researchers used an ABA single case study design across stimuli. Participants were 3 minimally-responsive ABI survivors. Methods and procedures—Participants heard auditory stimuli two times daily for thirty days. Data from video recordings included tallies of behavioural responses at 10-second intervals throughout baseline, intervention, and post-intervention phases of each session. Statistical calculations allowed determination of responsiveness changes across time intervals within sessions. Main outcomes and results—Unique response profiles emerged across survivors. Two participants demonstrated responsiveness changes with presentation of auditory stimuli. None demonstrated a clinically-significant differential response based on voice type. Conclusions—Findings suggest that auditory stimulation results in arousal changes in some ABI survivors regardless of the familiarity of voices presented

Changes in Responsiveness when Brain Injury Survivors with Impaired Consciousness Hear Different Voices

Primary objective—The researchers sought to determine whether individuals with impaired consciousness secondary to acquired brain injury (ABI) changed in responsiveness when purposefully presented with familiar, unfamiliar, and synthetic voice messages. Research design—Researchers used an ABA single case study design across stimuli. Participants were 3 minimally-responsive ABI survivors. Methods and procedures—Participants heard auditory stimuli two times daily for thirty days. Data from video recordings included tallies of behavioural responses at 10-second intervals throughout baseline, intervention, and post-intervention phases of each session. Statistical calculations allowed determination of responsiveness changes across time intervals within sessions. Main outcomes and results—Unique response profiles emerged across survivors. Two participants demonstrated responsiveness changes with presentation of auditory stimuli. None demonstrated a clinically-significant differential response based on voice type. Conclusions—Findings suggest that auditory stimulation results in arousal changes in some ABI survivors regardless of the familiarity of voices presented

The Impact of Contextualization and Personal Relevance on Communicative Performance by People with Severe Aphasia

The purpose of this research is to determine how best to represent information in AAC systems for people with moderate/severe/profound chronic aphasia. The researcher hypothesized that people with moderate/severe/profound chronic aphasia will use AAC systems more efficiently and effectively when information is represented through personally-relevant highly contextualized pictures rather than iconic symbols or non-personally relevant contextualized pictures. Data was collected from eight participants with moderate/severe/profound chronic aphasia. Results from eight participants indicated, that people with moderate/severe/profound chronic aphasia prefer and identify personally relevant highly contextualized pictures with greater accuracy than iconic symbols or non-personally relevant contextualized pictures

Current and Future AAC Research Considerations for Adults with Acquired Cognitive and Communication Impairments

Adults with acquired language impairments secondary to stroke, traumatic brain injury, and neurodegenerative diseases are candidates for communication supports outside of the traditional restoration-based approaches to intervention. Recent research proves repeatedly that augmentative and alternative communication (AAC) provides a means for participation, engagement, conversation, and message transfer when individuals can no longer expect full return of premorbid communication skills and that inclusion of communication supports should begin early. We discuss current research and future directions for integrated systems of technical supports that include low-technology, high tech, and partner-dependent strategies for adults with severe and chronic aphasia, cognitive-communication problems resulting from traumatic brain injuries, and primary progressive aphasia

Using visual scene displays to create a shared communication space for a person with aphasia

Background: Low-tech visual scene displays (VSDs) combine contextually rich pictures and written text to support the communication of people with aphasia. VSDs create a shared communication space in which a person with aphasia and a communication partner co-construct messages. Aims: The researchers examined the effect of low-tech VSDs on the content and quality of communicative interactions between a person with aphasia and unfamiliar communication partners. Methods & Procedures: One person with aphasia and nine unfamiliar communication partners engaged in short, one-on-one conversations about a specified topic in one of three conditions: shared-VSDs, non-shared-VSDs, and no-VSDs. Data included discourse analysis scores reflecting the conceptual complexity of utterances, content unit analyses of information communication partners gathered from the interaction, and Likert-scale responses from the person with aphasia about his perception of communicative ease and effectiveness. Outcomes & Results: Comparisons made across conditions revealed: (a) the most conversational turns occurred in the shared-VSDs condition; (b) communication partners produced utterances with higher conceptual complexity in the shared-VSDs condition; (c) the person with aphasia conveyed the greatest number of content units in the shared- VSDs condition; and (d) the person with aphasia perceived that information transfer, ease of conversational interaction, and partner understanding were best in the shared-VSDs condition. Conclusions: These findings suggest that low-tech VSDs have an impact on the manner and extent to which a person with aphasia and a communication partner contribute to conversational interactions involving information transfe

Augmented input: The effect of visuographic supports on the auditory comprehension of people with chronic aphasia

Background: Augmented input (AI), or the use of visuographic images and linguistic supports, is a strategy for facilitating the auditory comprehension of people with chronic aphasia. To date, researchers have not systematically evaluated the effects of various types of AI strategies on auditory comprehension. Aims: The purpose of the study was to perform an initial evaluation of the changes in auditory comprehension accuracy experienced by people with aphasia when they received one type of AI. Specifically, the authors examined the effect four types of non-personalized visuographic image conditions on the comprehension of people with aphasia when listening to narratives. Methods & Procedures: A total of 21 people with chronic aphasia listened to four stories, one in each of four conditions (i.e., no-context photographs, low-context drawings with embedded no-context photographs, high-context photographs, and no visuographic support). Auditory comprehension was measured by assessing participants’ accuracy in responding to 15 multiple- choice sentence completion statements related to each story. Outcomes & Results: Results showed no significant differences in response accuracy across the four visuographic conditions. Conclusions: The type of visuographic image provided as AI in this study did not influence participants’ response accuracy for sentence completion comprehension tasks. However, the authors only examined non-personalized visuographic images as a type of AI support. Future researchers should systematically examine the benefits provided to people with aphasia by other types of visuographic and linguistic AI supports

Augmented input: The effect of visuographic supports on the auditory comprehension of people with chronic aphasia

Background: Augmented input (AI), or the use of visuographic images and linguistic supports, is a strategy for facilitating the auditory comprehension of people with chronic aphasia. To date, researchers have not systematically evaluated the effects of various types of AI strategies on auditory comprehension. Aims: The purpose of the study was to perform an initial evaluation of the changes in auditory comprehension accuracy experienced by people with aphasia when they received one type of AI. Specifically, the authors examined the effect four types of non-personalized visuographic image conditions on the comprehension of people with aphasia when listening to narratives. Methods & Procedures: A total of 21 people with chronic aphasia listened to four stories, one in each of four conditions (i.e., no-context photographs, low-context drawings with embedded no-context photographs, high-context photographs, and no visuographic support). Auditory comprehension was measured by assessing participants’ accuracy in responding to 15 multiple- choice sentence completion statements related to each story. Outcomes & Results: Results showed no significant differences in response accuracy across the four visuographic conditions. Conclusions: The type of visuographic image provided as AI in this study did not influence participants’ response accuracy for sentence completion comprehension tasks. However, the authors only examined non-personalized visuographic images as a type of AI support. Future researchers should systematically examine the benefits provided to people with aphasia by other types of visuographic and linguistic AI supports

Augmented input: The effect of visuographic supports on the auditory comprehension of people with chronic aphasia

Background: Augmented input (AI), or the use of visuographic images and linguistic supports, is a strategy for facilitating the auditory comprehension of people with chronic aphasia. To date, researchers have not systematically evaluated the effects of various types of AI strategies on auditory comprehension. Aims: The purpose of the study was to perform an initial evaluation of the changes in auditory comprehension accuracy experienced by people with aphasia when they received one type of AI. Specifically, the authors examined the effect four types of non-personalized visuographic image conditions on the comprehension of people with aphasia when listening to narratives. Methods & Procedures: A total of 21 people with chronic aphasia listened to four stories, one in each of four conditions (i.e., no-context photographs, low-context drawings with embedded no-context photographs, high-context photographs, and no visuographic support). Auditory comprehension was measured by assessing participants’ accuracy in responding to 15 multiple- choice sentence completion statements related to each story. Outcomes & Results: Results showed no significant differences in response accuracy across the four visuographic conditions. Conclusions: The type of visuographic image provided as AI in this study did not influence participants’ response accuracy for sentence completion comprehension tasks. However, the authors only examined non-personalized visuographic images as a type of AI support. Future researchers should systematically examine the benefits provided to people with aphasia by other types of visuographic and linguistic AI supports