Hostname: page-component-586b7cd67f-l7hp2 Total loading time: 0 Render date: 2024-11-20T15:25:11.300Z Has data issue: false hasContentIssue false

Improving Communication-specific Coping after Traumatic Brain Injury: Evaluation of a New Treatment using Single-case Experimental Design

Published online by Cambridge University Press:  14 January 2015

Jacinta M. Douglas*
Affiliation:
Department of Human Communication Sciences, La Trobe University, Victoria, Australia Summer Foundation, Victoria, Australia
Lucy Knox
Affiliation:
Department of Human Communication Sciences, La Trobe University, Victoria, Australia
Carren De Maio
Affiliation:
Department of Human Communication Sciences, La Trobe University, Victoria, Australia Scope, Victoria, Australia
Helen Bridge
Affiliation:
Department of Human Communication Sciences, La Trobe University, Victoria, Australia Beachside and South Eastern Suburbs Speech Pathology Services, Victoria, Australia
*
Address for correspondence: Prof. Jacinta Douglas, Department of Human Communication Sciences, La Trobe University, Bundoora, Victoria, 3086, Australia. E-mail: [email protected]
Get access

Abstract

Background and aims: Impaired communication is a well-documented and enduring consequence of traumatic brain injury (TBI). As a result of this impairment, people with TBI frequently experience communication breakdown and associated stress. Typically, we use communication-specific coping strategies in situations characterised by communication breakdown. Productive strategies enhance message transfer; non-productive strategies do little to resolve problems and frequently result in negative social interaction. This research aimed to evaluate the effectiveness of a new treatment, Communication-specific Coping Intervention (CommCope-I), which specifically targets coping in the context of communication breakdown.

Method: Single-case experimental design (A–B–A with follow-up using multiple probes) across two participants was used. Participants were Samantha, a 30-year-old woman who had sustained severe TBI 8 years previously, and Thomas, a 34-year-old man who had sustained severe TBI when he was 29 years old. CommCope-I is a 6-week programme which targets personally relevant productive coping strategies identified collaboratively with the client. Productive coping scripts are developed and practised through a series of graded scenarios that are evaluated with the aid of video recording.

Results: Percentage of non-overlapping corrected data (PNCD) was used to analyse the results. PNCD involves a data-correction procedure to remove baseline trend from the data series prior to calculating the change produced as a result of intervention. A large treatment effect was demonstrated in both participants (PNCD: end of treatment Samantha = 100%, Thomas = 100%, 3-month follow-up Samantha = 100%, Thomas = 100%). These results are consistent with highly effective treatment.

Conclusions: This study provides sound phase-1 evidence for the effectiveness of CommCope-I.

Type
Articles
Copyright
Copyright © Australasian Society for the Study of Brain Impairment 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bootes, K., & Chapparo, C. (2010). Difficulties with multitasking on return to work after TBI: A critical case study. Work, 36, 207216.CrossRefGoogle ScholarPubMed
Bracy, C., & Douglas, J. (2005). Marital dyad perceptions of injured partners’ communication following severe traumatic brain injury. Brain Impairment, 6, 112.Google Scholar
Brooks, N., Campsie, L., Symington, C., Beattie, A., & McKinlay, W. (1987). Effects of severe head injury on patient and relative within seven years of injury. Journal of Head Trauma Rehabilitation, 2, 113.Google Scholar
Cicerone, K., Langenbahn, D., Braden, C., Malec, J., Kalmar, K., Fraas, M., . . . Ashman, T. (2011). Evidence-based cognitive rehabilitation: updated review of the literature from 2003 through 2008. Archives of Physical Medicine and Rehabilitation, 92 (4), 519530.Google Scholar
Dahlberg, C., Cusick, C., Hawley, L., Newman, J., Morey, C., Harrison-Felix, C., & Whiteneck, G. (2007). Treatment efficacy of social communication skills training after traumatic brain injury: a randomized treatment and deferred treatment controlled trial. Archives of Physical Medicine and Rehabilitation, 88 (12), 15611573.Google Scholar
Dahlberg, C., Hawley, L., Morey, C., Newman, J., Cusick, C.P., & Harrison-Felix, C. (2006). Social communication skills in persons with post-acute traumatic brain injury: Three perspectives. Brain Injury, 20 (4), 425435.Google Scholar
Douglas, J. (2004). The evidence base for the treatment of cognitive-communicative disorders following traumatic brain injury in adults. In Reilly, S., Douglas, J. & Oates, J. (Eds.), Evidence based practice issues in speech pathology. London: Whurr.Google Scholar
Douglas, J. (2010). Using the La Trobe Communication Questionnaire to measure perceived social communication ability in adolescents with traumatic brain injury. Brain Impairment, 11 (2), 171182.Google Scholar
Douglas, J., Bracy, C., & Snow, P. (2007a). Measuring perceived communicative ability after traumatic brain injury: Reliability and validity of the La Trobe Communication Questionnaire. Journal of Head Trauma Rehabilitation, 22, 3138.CrossRefGoogle ScholarPubMed
Douglas, J., Bracy, C., & Snow, P. (2007b). Exploring the factor structure of the La Trobe Communication Questionnaire: Insights into the nature of communication deficits following traumatic brain injury. Aphasiology, 21, 11811194.Google Scholar
Douglas, J. & Mitchell, C. (2012). Measuring communication-specific coping: Development and evaluation of the Communication-specific Coping Scale. Brain Impairment, 13 (1), 170171.Google Scholar
Douglas, J., O’Flaherty, C., & Snow, P. (2000). Measuring perception of communicative ability: The development and evaluation of the La Trobe Communication Questionnaire. Aphasiology, 14, 251268.Google Scholar
Douglas, J.M. & Spellacy, F.J. (2000). Correlates of depression in adults with severe traumatic brain injury and their carers. Brain Injury, 14, 7188.Google ScholarPubMed
Friedman, A. & Douglas, J. (2005). Social participation and coping with communication breakdown following severe traumatic brain injury. Brain Injury, Supplement, 5051.Google Scholar
Galski, T., Tompkins, C., & Johnston, M. (1998). Competence in discourse as a measure of social integration and quality of life in persons with traumatic brain injury. Brain Injury, 12, 769782.Google Scholar
Grice, P. (1975). Logic in conversation. In Cole, P. & Morgan, P. (Eds.), Studies in syntax and semantics (Vol. 3, pp. 4158). New York: Academic Press.Google Scholar
Henry, J., & Crawford, J. (2005). The short-form version of the Depression Anxiety Stress Scales (DASS-21): Construct validity and normative data in a large non-clinical sample. British Journal of Clinical Psychology, 44, 227239.Google Scholar
Knox, L., & Douglas, J. (2009). Long-term ability to interpret facial expression after traumatic brain injury and its relation to social integration. Brain and Cognition, 69, 442449.Google Scholar
Lovibond, S.H., & Lovibond, P.F. (1995). Manual for the Depression Anxiety Stress Scales (2nd ed.). Sydney: Psychology Foundation.Google Scholar
Manolov, R., & Solanas, A. (2009). Percentage of nonoverlapping corrected data. Behavior Research Methods, 41 (4), 12621271.Google Scholar
McDonald, S., Tate, R., Togher, L., Bornhofen, C., Long, E., Gertler, P., & Bowen, R. (2008). Social skills treatment for people with severe, chronic acquired brain injuries: a multicenter trial. Archives of Physical Medicine and Rehabilitation, 89 (9), 16481659.Google Scholar
Mellick, D. (2000). The Craig Handicap Assessment and Reporting Technique – Short Form. The Center for Outcome Measurement in Brain Injury. Retrieved from http://www.tbims.org/combi/chartsf.Google Scholar
Mitchell, C., & Douglas, J. (2011). Coping with communication breakdown: A comparison between adults with severe TBI and healthy controls. Brain Impairment, Supplement, 41.Google Scholar
Muir, A., & Douglas, J. (2007). Coping with communication breakdown after severe traumatic brain injury. Brain Impairment, 8, 83.Google Scholar
O’Flaherty, C., & Douglas, J. (1997). Living with cognitive-communicative difficulties following traumatic brain injury: using a model of interpersonal communication to characterise the subjective experience. Aphasiology, 11, 889911.CrossRefGoogle Scholar
Olver, J.H., Ponsford, J.L., & Curran, C.A. (1996). Outcome following traumatic brain injury: A comparison between two and five years after injury. Brain Injury, 10, 841848.Google Scholar
Ponsford, J., Olver, J., & Curran, C. (1995). A profile of outcome: 2 years after traumatic brain injury. Brain Injury, 9, 110.Google Scholar
Rietdjik, R., Simpson, G., Togher, L., Power, E., & Gillett, L. (2013). An exploratory prospective study of the association between communication skills and employment outcomes after severe traumatic brain injury. Brain Injury, 27, 812818.Google Scholar
Scruggs, T.E., & Mastropieri, M.A. (1998). Summarizing single-subject research: Issues and applications. Behavior Modification, 22 (3), 221242.Google Scholar
Shorland, J., & Douglas, J. (2010). Understanding the role of communication in maintaining and forming friendships following traumatic brain injury. Brain Injury, 24 (4), 569580.CrossRefGoogle ScholarPubMed
Snow, P., Douglas, J., & Ponsford, J. (1998). Conversational discourse abilities following severe traumatic brain injury: A longitudinal follow-up. Brain Injury, 11, 911935.Google Scholar
Snow, P., Douglas, J., & Ponsford, J. (1999). Narrative discourse following severe traumatic brain injury: A longitudinal follow-up. Aphasiology, 13, 529551.Google Scholar
Struchen, M., Clark, A., Sander, A., Mills, M., Evans, G., & Kurtz, D. (2008a). Relation of executive functioning and social communication measures to functional outcomes following traumatic brain injury. Neurorehabilitation, 23, 185198.CrossRefGoogle ScholarPubMed
Struchen, M.A., Pappadis, M.R., Mazzei, D.K., Clark, A.N., Davis, L.C., & Sander, A.M. (2008b). Perceptions of communication abilities for persons with traumatic brain injury: Validity of the La Trobe Communication Questionnaire. Brain Injury, 22 (12), 940951.CrossRefGoogle ScholarPubMed
Struchen, M., Pappadis, M., Sander, A., Burrows, C., & Myszka, A. (2011). Examining the contribution of social communication abilities and affective/behavioral functioning to social integration outcomes for adults with traumatic brain injury. Journal of Head Trauma Rehabilitation, 26, 3042.Google Scholar
Tate, R., McDonald, S., Perdices, M., Togher, L., Schultz, R., & Savage, S. (2008). Rating the methodological quality of single-subject designs and n-of-1 trials: Introducing the Single-Case Experimental Design (SCED) Scale. Neuropsychological Rehabilitation, 18 (4), 385401.Google Scholar
Tate, R., Perdices, M., Rosenkoetter, U., Wakim, D., Godbee, K., Togher, L., & McDonald, S. (2013). Revision of a method quality rating scale for single-case experimental designs and n-of-1 trials: The 15-item Risk of Bias in N-of-1 Trials (RoBiNT) Scale. Neuropsychological Rehabilitation, 23 (5), 619638.Google Scholar
Togher, L., McDonald, S., Tate, R., Power, E., & Rietdijk, R. (2013). Training communication partners of people with severe traumatic brain injury improves everyday conversations: A multicenter single blind clinical trial. Journal of Rehabilitation Medicine, 45, 637645.Google Scholar
Togher, L., Wiseman-Hakes, C., Douglas, J., Stergiou-Kita, M., Ponsford, J., Teasell, R., . . . On behalf of the INCOG Expert Panel. (2014). INCOG recommendations for management of cognition following TBI Part IV: Cognitive communication. Journal of Head Trauma Rehabilitation, 29 (4), 353368.Google Scholar
Tu, L., Togher, L., & Power, E. (2011). The impact of communication partner and discourse task on a person with traumatic brain injury: The use of multiple perspectives. Brain Injury, 25, 560580.CrossRefGoogle ScholarPubMed
Watts, A., & Douglas, J. (2006). Interpreting facial expression and communication competence following severe traumatic brain injury. Aphasiology, 20, 707722.Google Scholar
Whiteneck, G.G., Charlifue, S.W., Gerhart, K.A., Overhosler, J.D., & Richardson, G.N. (1992). Quantifying handicap: A new measure of long-term rehabilitation outcomes. Archives of Physical Medicine Rehabilitation, 73, 519526.Google ScholarPubMed
Ylvisaker, M. (2006). Self-coaching: A context-sensitive, person-centred approach to social communication after TBI. Brain Impairment, 7, 235246.Google Scholar
Zhang, L., Abreu, B.C., Gonzales, V., Seale, G., Masel, B., & Ottenbacher, K.J. (2002). Comparison of the Community Integration Questionnaire, the Craig Handicap Assessment and Reporting Technique, and the Disability Rating Scale in Traumatic Brain Injury. Journal of Head Trauma Rehabilitation, 17, 497509.CrossRefGoogle ScholarPubMed