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Treatment Approaches for Communication in Brain Injury Victims by Charles Watson


Posted on February 20, 2020

Treatment approaches for TBI can greatly affect the quality of life and help them develop a positive attitude toward attaining goals. The restorative treatment approach involves direct therapy for improving or restoring impaired function(s) through retraining. Compensatory treatment approach focuses on adapting to deficits by learning different or new ways of doing things. It draws on the individual’s strengths to maximize his or her abilities through the use of external or internal aids. 

Treatment Options

Augmentative and alternative communication (AAC): Involves replacing or supplementing natural speech and writing with aided or unaided symbols. The selection and use of appropriate AAC system following TBI depend on the sufferers’ communication abilities and needs as well as neurobehavioral, cognitive, sensory, motor, and perceptual impairments. 

Cognitive-Communication Treatment: Focuses on compensating for deficits or on restoring skills. Treatments include the following:

  • Sensory stimulation: This is usually used in TBI victims that are in a comatose or minimally conscious state to improve arousal and responsiveness during recovery.   
  • Dual-task training: Focuses on training brain injury victims to carry out two competing tasks simultaneously. These tasks may be a combination of cognitive and/ or motor tasks.   

Computer-assisted treatment: This method employs specially designed software to improve cognitive-communication functions. These programs can be run on computers, tablets, and smartphones, and CAT can be used and monitored in person or remotely by a clinician. Depending on the ability of the TBI sufferer, exercises can be increased in difficulty as performance improves. 

Teaching techniques used in cognitive-communication treatment include direct instruction and strategy-based instruction.

Metacognitive skills training uses goal setting strategies for learning and behavioral success. Strategies such as self-reflection, self-talk, mental imagery, and agendas provide feedback and track progress toward goals. 

Compensatory strategy training uses internal and external aids to develop skills that are still intact to overcome the insufficiencies resulting from TBI.  Internal aids improve memory and include mnemonics, visual imagery, and elaborative encoding and association. 

External aids improve attention, recall of events and information, time management, and organization. It has been discovered after many studies that the method approached for rehabilitation and treatment greatly alters the rate of recovery. This is because a patient’s progress was measured in the patient’s willingness and participation to thrive for recovery.

Initially, treatment programs and procedures were devised by clinicians themselves until they realized that there was no standard or generalized treatment for all. Each victim responded to treatment in a different way. For this reason, treatments were made more holistic to encompass all kinds of victims with various traumas. 

Social Communication Interventions

Using pragmatic language norms, interventions have been designed to improve conversational skills in order to assist the TBI victim in navigating social situations. 

This treatment has been devised basically to provide counseling and training so that the victim can learn how to react and behave in various situations that happen in everyday life. This training sharpens the mind to process and interpret other’s behavior independently. 

When all aspects of the treatment are carefully planned out and implemented, the victim tends to show a higher ratio of progress and signs of recovery.