Background: Many people who have a severe traumatic brain injury (TBI) are not able to resume employment and consequently experience profound changes in their lifestyle. They have increased amounts of ’spare time’ yet often find it difficult to engage in meaningful activity. Leisure activities are one way in which meaningful activity can be increased.

Aims: This systematic review has two purposes: first, to identify and evaluate the efficacy of community-based interventions for leisure/social activity after TBI, and second to provide details on the types of intervention.

Method: Systematic searches were conducted of Medline, PsycINFO and PsycBITE to October 2014, as well as hand searches of two occupational therapy journals. Inclusion criteria were as follows: peer reviewed journal articles on adults with TBI who had participated in a trial evaluating a community-based intervention specifically targeting leisure/social activity. All research methodologies using primary studies that provided empirical, quantitative data were considered. Scientific quality of the studies was evaluated using the PEDro Scale for controlled trials and the Risk of Bias in N-of-1 Trials Scale for single-case designs.

Results: Two independent raters screened 196 abstracts, resulting in nine articles that met selection criteria. Data were then independently extracted by the raters. Four of the nine studies used a control condition in their research design (two randomised controlled trials, one controlled but non-randomised study, and one single-case experiment using a changing criterion design). Two of the studies conducted between-group analyses with significant treatment effects for mood and quality of life using active leisure programmes (Tai Chi Qigong and a combined programme of outdoor adventure experiences and goal setting respectively). Intervention programmes identified in the review were then grouped and described according to the approach or model used, including active leisure programmes, social peer mentoring, individual brokered leisure services and a therapeutic recreation model. Additional intervention models and approaches that did not result directly from the systematic review were also described because they provide information on the current approaches used in practice (Clubhouse model and leisure education programmes in the stroke population).

Conclusions: There is some evidence for the effectiveness of community-based interventions for leisure/social activity for people who have had a TBI to improve mood and quality of life. The conclusions of this review are that the interventions for this area need to be planned and specific, structured and goal-driven, intensive and conducted over a period of months.

Background: Persistent post-concussion symptoms (PCS) are associated with adverse psychosocial outcomes, including psychological distress and poorer health-related quality of life (HRQOL). Research has found that the occurrence of persistent PCS can be lowered via paper-based psychoeducation. Unfortunately, these resources have mostly been evaluated in adult populations. Studies in children have failed to address the role of parents in the development and maintenance of PCS, and unfortunately fail to reach a large proportion of the mild traumatic brain injury (mTBI) population who do not attend hospital. This study aimed to describe and evaluate a parent information booklet and child information website, for the prevention of paediatric PCS.

Methods: Children with uncomplicated mTBI were randomly assigned to either the Intervention (n = 29) or Usual Care condition (n = 20). Families completed pre-treatment, post-treatment (3 month) and follow-up (6 month) assessments of children's PCS, cognitive and psychosocial functioning, and parent's psychosocial functioning. Families also provided feedback on the psychoeducation resources.

Results: The Intervention programme, compared to Usual Care, was not associated with significant reductions in children's PCS or HRQOL, parent or child psychological distress, or parent or child knowledge of mTBI.

Conclusions: Psychoeducation resources do not appear to be superior to usual care in promotion of both child and parent psychosocial outcomes following mTBI.

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.

This paper is a personal exploration of one woman's lived experience with aphasia, verbal dyspraxia and accent change following cryptogenic ischaemic stroke. I share insights into my experiences, especially of an emotional and cultural nature, after growing up multilingual in Europe and then living with communication changes in a predominantly English-speaking country (Australia) and following return to Europe. My formal reflections commenced 15 years after the stroke and, following my previous studies in the medical field, multimodal visual arts and philosophy, were initiated in the context of postgraduate study emphasising a multimodal arts-based, collaborative, experiential approach to reconstructing understandings of experiences, values and meanings. Central features of this personal narrative include emergent, iterative enquiry and learning: emergent, in that the enquiry was open-ended, allowing for an element of surprise and the opportunity to pursue unanticipated directions; iterative, in that it involved knowingly experiencing and conversing about what had been discovered in order to engage with the process of continuous meaning-making. Following the enquiry, fellow students provided intersubjective responses to issues that touched personal reflection on their part. In particular, I highlight one fellow student's intersubjective responses that touched me in return by providing especially pertinent understanding and images.

Objective: To evaluate the olfactory and psychophysical performances in a 13-year-old boy with intellectual disability and severe hypoplasia of the corpus callosum and of the olfactory bulbs, compared to controls.

Methods: The Sniffin’ Sticks Identification Test was administered to the patient and to a patient control child with cognitive delay, with the same mental (5 years) and chronological age, but normal brain magnetic resonance image. Two typically developing control participants, aged 13 and 5, were also evaluated. Psychophysical tests were performed during the olfactory assessment by smart portable sensors.

Results: A significant decrease in olfactory function and a different psychophysical response to stimuli were observed in the patient compared to control participants, suggesting absence of ‘odorous stress’. A higher olfactory score but a similar psychophysical trend was found in the patient control with cognitive delay, while the two other control participants showed a selective increase of the anxiety state depending on the odour presented.

Conclusions: Olfactory dysfunction is reported in children with neurodevelopmental disabilities. Low-cost, portable devices to assess olfactory function are proposed for use with children with intellectual disability. Stress monitoring by unobtrusive platforms provides discriminant information in this subset, as compared to controls.

The reliable change index (RCI) was introduced approximately 30 decades ago in order to provide an empirical, statistically grounded technique for determining whether improvement after a therapeutic intervention was real or due to measurement error. Since the definitions of the properties and limitations of scales of measurement described by Stevens in 1947, there has been vigorous controversy about whether it is permissible to analyse ordinal data with parametric statistics. Specifically, are parameters and statistics such as means and standard deviations meaningful in the context of ordinal data? These are important concerns because many of the scales used to measure outcomes in behavioural research and clinical settings yield ordinal-scale measures. Given that the standard deviation is used in the computation of the RCI, the question as to whether or not the RCI is reliable when used with ordinal-scale data is explored. Data from the SPRS-2 was used to calculate minimum reliable difference criteria in terms of both (ordinal) Total Raw Scores (MRDRS) and logit scores (MRDLS) derived from Rasch analysis. Test–retest differences across the Total Raw Score range were evaluated using each criterion. At both extremes of the range, small changes in Total Raw Score not deemed to be reliable according to the MRDRS criterion were classified as reliable according to the MRDLS criterion. Conversely, test–retest changes in the centre of the range deemed to be reliable according to the MRDRS criterion were classified as unreliable according to the MRDLS criterion. It is suggested that while MRDRS can determine numerically reliable differences, MRDLS can determine reliable differences that are meaningful in terms of the underlying construct being measured.

There was an error made in the Declaration of Interest statement included in the above published article. To ensure transparency in the research process the authors wish to change the present Declaration of Interest statement to the following. The Triple P-Positive Parenting Program is owned by the University of Queensland (UQ). The University through its main technology transfer company UniQuest Pty Limited, has licensed Triple P International Pty Ltd to disseminate the program worldwide. Royalties stemming from this dissemination activity are distributed in accordance with the University's intellectual property policy and flow to the Parenting and Family Support Centre, School of Psychology, UQ; Faculty of Health and Behavioral Sciences; and contributory authors. No author has any share or ownership in Triple P International Pty Ltd. Matthew Sanders is the founder and an author on various Triple P programs and a consultant to Triple P International.