Fatigue management by speech-language pathologists for adults with traumatic brain injury.

This study uses a qualitative approach to examine common techniques used by speech-language pathologists (SLPs) to manage fatigue in communication intervention following traumatic brain injury (TBI). Thirteen SLPs from New Zealand hospital and rehabilitation services completed semi-structured interviews in which they discussed their current management strategies. A number of management-related themes recurred throughout the interviews, highlighting the basis of fatigue-management-focused (FMF) communication intervention. The four fatigue-related themes were: intervention structure, client and family strategies, monitoring by both the client and therapist, and lifestyle and daily activities. From these four themes, a model of current SLP practice was developed for clients with TBI. This model will provide the basis for future studies evaluating the effectiveness of FMF communication intervention.

Clinical influences.

Mark Ylvisaker influenced a paradigm shift on approaches to assessment and intervention of individuals with a traumatic brain injury (TBI). This article describes the influence of Mark Ylvisaker on my speech-language therapy practice in TBI rehabilitation, from shaping assessment research through supporting a practical, problem-solving approach to intervention. In this article, only a small selection of his therapeutic concepts and recommendations are described. The concepts selected-context and meaningfulness, collaboration, and measuring performance-are those that are pertinent to functional communication assessment. The three interventions chosen illustrate the applicability of Mark Ylvisaker's work in different contexts and across different levels of disability following TBI. They are also selected as they promote personally satisfying communication for the client and illustrate the contribution that speech-language therapy may make to TBI rehabilitation overall.

The application of the ICF in cognitive-communication disorders following traumatic brain injury.

The purpose of this article is to discuss the usefulness of the World Health Organization's International Classification of Functioning, Disability and Health (ICF) for describing cognitive-communication disorders. Prominent issues influencing our appreciation of cognitive-communication disorders are elaborated. These are issues with terminology, assessment (including the role of supporting cognitive processes), and the sociocultural context of the individual with cognitive-communication disorders following traumatic brain injury (TBI). This is followed by a demonstration of how the ICF framework supports a systematic approach for understanding cognitive-communication disorders in individuals who have sustained a TBI. Finally an example of the ICF applied to the rehabilitation of a woman with cognitive-communication disorders following a TBI is presented.

The validity of functional assessments of communication and the Activity/Participation components of the ICIDH-2: do they reflect what really happens in real-life?

UNLABELLED: This paper aims to provide a better understanding of the nature of functional communication activities so that assessment and treatment efforts are based on a theoretical framework and empirical data. Three sources of information are discussed. The first is the Activity/Participation dimensions of the World Health Organization's International Classification of Functioning, Disability, and Health. The second source is existing assessments of functional communication. The final source is data obtained from observational studies conducted in our research unit. The studies have observed the everyday communication of people with aphasia, people with Traumatic Brain Injury (TBI), and patients in hospital. The simplification of real-life communication in the WHO classification scheme, the variability of item sampling in existing assessments, and the complexity of communication observed in real-life settings has led to the conclusion that there are three levels of functional communication assessment: generic, population-specific, and individualized. Clinicians may choose which level suits their purpose. When clinicians routinely choose from a range of sophisticated functional assessments to inform their therapy, the seed that Martha Taylor Sarno planted and nourished for the past 30 years or more will truly flourish throughout the world of speech-language pathology. LEARNING OUTCOMES: As a result of this activity, participants will (1) understand the theoretical framework and data base that motivates assessment and treatment of functional communication activities, (2) be able to discuss the World Health Organization's Classification of Functioning, Disability and Health and (3) gain information about functional assessment and observational sampling of real world communication activities across three levels.