Communication Recovery Following Severe Traumatic Brain Injury: Examining the First Year

Abstract

By the year 2030, it is projected that over 240 million individuals will be affected by Traumatic Brain Injury (TBI). Communicating with a person who has a TBI-related cognitive-communication disorder has been described as uninteresting, effortful and unrewarding. There is currently limited evidence around cognitive-communication recovery and prognosis. Consequently, there is a lack of guidance around timing, planning and prioritisation of Speech-Pathology resources with this population. The aim of this project was to explore the nature of cognitive-communication recovery following TBI. A systematic review of cognitive-communication recovery revealed a limited body of evidence across the first few years following TBI. To address this research gap, this study used an inception cohort, comprising of 57 participants who were assessed at 3, 6, 9 and 12 months following their injury. Improvements in discourse skills were observed across the entire first year. However, the TBI group remained significantly below the control group at all time points. The time period between 9-12 months was particularly critical for recovery. A further study revealed the predictive value of the discourse measure in relation to psychosocial outcomes, which may support prioritisation of rehabilitation goals. Aphasia was identified as a key factor of recovery and was further explored from a clinical perspective. This project advocates for active Speech Pathology services up to and possibly beyond the first year following injury. Implementing this renewed understanding of communication recovery following TBI is likely to promote improved timing, planning and prioritization of Speech-Pathology services during the first important year of rehabilitation. Further research into understanding communication recovery is required to support longer-term outcomes along the continuum of care.