Communication in children and adolescents after acquired brain injury: An exploratory study.

OBJECTIVE: The usability of the Communicative Effectiveness Index (CETI) in adolescents with acquired brain injury was investigated and compared with linguistic, cognitive and brain injury data. DESIGN: A prospective, longitudinal, between-group design. SUBJECTS: Thirty participants were divided into 2 subgroups: CETI+ and CETI- groups. METHODS: Parental CETI ratings of daily communication were compared with linguistic data and IQ test results. Lesion site and aetiology were also studied. RESULTS: The CETI+ group (n = 16) had a mean score greater than 75 out of 100, while the mean score of the CETI- group (n = 14) was below 75. Complex daily communication was impaired in both groups, but the CETI- group scored significantly lower on verbal IQ and grammar comprehension tests and had more naming difficulties. A majority of subjects in the CETI- group had a left hemisphere injury. Traumatic vs non-traumatic acquired brain injury did not differentiate the results.  Conclusion: Specific complex CETI items provided unique information that is not easily measured by linguistics and cognitive tests for use with the acquired brain injury group. Parental evaluations of communication skills were well reflected in language and verbal IQ test results. Left hemisphere injury was associated with poorer communication outcome.

Severe acquired brain injury: rehabilitation of communicative skills in children and adolescents.

The purpose of this study was to examine the use of a descriptive taxonomy for assessment of communicative abilities, the Pragmatic Protocol, in a rehabilitation setting with brain-injured children and adolescents. Eight severely brain-damaged children/youths were assessed with the Pragmatic Protocol during an intensive 6-week rehabilitation period. The nature and extent of communicative functioning was rated independently by a speech language pathologist and a rehabilitation assistant. The data suggests that the number of inappropriate pragmatic behaviours is relatively high, above all regarding aspects of speech/language and nonverbal communication. Interrater agreement reached approximately 95% considering nature of the communicative dysfunction in each patient. Results indicate the use of the Pragmatic Protocol as a useful tool to trace aspects of communicative competence in need of further, detailed exploration. Information concerning intact abilities is clarified and can be used in designing treatment.