Attentional Deficits and Conversational Discourse in Closed-Head Injury

Effective communication skills require the integrity of a number of cognitive abilities that are frequently disrupted following closed-head injury (CHI). This study investigated whether improvements in a specific cognitive ability, attention, would facilitate conversational discourse for individuals with CHI. A single subject multiple treatments comparison design was employed. Two individuals with CHI participated in two treatments, attention based and social skills based. Treatment effect sizes suggested that the two treatments were active; however, performances of both participants were variable throughout the study reducing the magnitude of change observed. Implications for clinical practice and future research are discussed

Treatment of Conversational Discourse Following Closed-Head Injury

Chronic deficits in cognitive abilities and conversational discourse contribute to long-term functional disability and decreased quality of life for individuals with CHI. This study investigated whether improvements in a specific cognitive ability, attention, would facilitate conversational discourse for an individual with CHI. A single subject multiple treatments comparison design was employed utilizing two interventions, one attention-based and one social skills-based. Treatment effect sizes suggest that both treatments were active; however, the participant’s performance was variable reducing the magnitude of change observed. Qualitative findings revealed positive real-world consequences associated with the improvements in attention and conversational skills

Conversational Discourse: Attention Training following Closed Head Injury

Preliminary data is presented from a study in progress investigating whether speech-language pathology (SLP) intervention for a specific cognitive deficit (attention) will facilitate improvement of functional communication skills (conversational discourse) for individuals with closed head injury (CHI) at an acute rehabilitation phase. A randomized design was used to create treatment and control groups. Results from one individual are analyzed utilizing two procedures to determine which may be more useful in characterizing conversational ability of individuals in this population. The results will assist in research procedures for the remaining data. This study may lead to treatment recommendations for individuals with CHI

Attentional deficits and conversational discourse in closed-head injury

Persisting deficits in conversational skills are a contributing factor to poor psychosocial adjustment and social isolation following closed-head injury (CHI). Therefore, conversational discourse may be more clinically relevant for the CHI population in terms of long-term outcomes than other genres of discourse. Effective communication skills require the integrity of a number of cognitive abilities that are frequently disrupted following CHI. Chronic cognitive deficits contribute to long-term dysfunction and have also been correlated with poor outcome in individuals with CHI. However, there is a paucity of empirical information regarding the role that underlying cognitive abilities may play in the conversational discourse deficits observed in individuals with CHI. Although treatment studies have suggested that training of specific skills does not generalize to functional tasks, no treatment study to date has utilized performance on a functional communicative task, such as conversational discourse, as an outcome measure. The present study investigated whether improvements in a specific cognitive ability attention, would facilitate conversational discourse for three individuals with CHI. A single subject A-B-A-C-A multiple treatments comparison design was employed. Three individuals with CHI participated in two treatments, one attention-based and one social skills-based. It was hypothesized that attention training would provide the greater benefit by improving attention as well as conversational discourse while social skills training would improve only conversation. Treatment effect sizes suggest that both treatments were active; however, performances of all three participants were variable throughout the study reducing the magnitude of change observed. Overall, the results of this study suggest that the two treatment regimens, whether presented in isolation or in combination had some effect on each of the participant\u27s conversational performances though not to the extent anticipated. Therefore, it is unclear at this time if the APT-II, the IPR, or the combination of both treatments is the most effective approach to treating conversational discourse deficits in this population. Continued research regarding the treatment of cognitive deficits as a means to improving conversational discourse performance in individuals with CHI is needed. Implications for clinical practice and future research are discussed.