TIunication disability. Comparison of error-based and errorless learning for people with severe traumatic brain injury: Study protocol for a randomized control trial. (2013). A compensatory approach to treatment may also include accommodations and/or modifications. Dosage refers to the frequency, intensity, and duration of service. Language intervention varies, depending on the child's developmental level at the time of injury and the pattern of deficits that require intervention. The members of the Ad Hoc Joint Committee on Interprofessional Relationships of the ASHA and Division 40 (Clinical Neuropsychology) of the American Psychological Association (APA) included ASHA representatives Pelagie Beeson, Susan Ellis Weismer, Audrey Holland, Susan Langmore, Lynn Maher, Mark Ylvisaker, and Diane Brown (ex officio). Assessment of Language-Related Functional Activities (ALFA) ... on 175 patients with neurogenic communication disorders resulting primarily from left or right hemisphere stroke and traumatic brain injury, and the patient level of care ranged from acute and subacute to home and outpatient settings. Interdisciplinary collaboration and teaming also form an integral part of audiology services to individuals with TBI. (2004). Seminars in Speech and Language, 26, 268–279. The odds of sustaining a TBI are 2.22 times higher in men than in women (Frost, Farrer, Primosch, & Hedges, 2012). (2018). For older children and adolescents, the emphasis is often on inferencing, higher-level comprehension, narrative and discourse processes, and academic or vocational literacy (e.g., summarizing text, taking notes). The ASHA Leader, 14, 10–13. Atlanta, GA: Author. Brain Injury, 34(4), 466-479. See ASHA's resource on common classifications of TBI. outcomes in response to intervention (Coelho, Ylvisaker, & Turkstra, 2005). (2007). Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders, 20, 111–119. San Diego, CA: Plural Publishing. Sohlberg, M. M., Ehlhardt, L., & Kennedy, M. (2005). Seminars in Speech and Language, 26, 256–267. Topics in Language Disorders, 29, 224–235. The Journal of Head Trauma Rehabilitation, 27, 424–432. Videoconferencing and interactive skills-based programs via telepractice may be more meaningful for providing support and information to caregivers than self-guided web sessions (Rietdijk, Togher, & Power, 2012). Language intervention for children with TBI takes into account the interconnection between cognition and communication (Blosser & DePompei, 2003). (2013). Dessy, A. M., Rasouli, J., & Choudhri, T. F. (2015). In the same year, prevalence was 55.5 million individuals, representing an 8.4% increase from 1990 (Global Burden of Disease [GBD], 2019). Ownsworth, T., Quinn, H., Fleming, J., Kendall, M., & Shum, D. (2010). Supporting family members of people with traumatic brain injury using telehealth: A systematic review. AAC may be temporary—as when used by patients postoperatively in intensive care—or permanent—as when used by an individual with a disability who will need to use some form of AAC throughout his or her lifetime. Treatment for audiology-related symptoms may include counseling about the use of coping and compensatory skills that can minimize the effects of hearing and balance disorders and reduce safety risks. Metacognitive skills training is an integral part of DAT when used to treat cognitive-communication deficits in children with TBI (e.g., Lee, Harn, Sohlberg, & Wade, 2012; Sohlberg, Harn, MacPherson, & Wade, 2014). The purpose of a comprehensive assessment for individuals with TBI is to determine speech, language, cognitive-communication, swallowing, and audiologic strengths and needs. According to IDEA (2004), TBI "does not apply to brain injuries that are congenital or degenerative, or to brain injuries induced by birth trauma" [§300.8(c)(12)]. Ongoing assessment at various points post injury may be necessary to identify emerging deficits, particularly as cognitive-communication demands increase. Vestibular rehabilitation programs aim to improve symptoms of vertigo and other balance-related problems following TBI (Teasell et al., 2013). An accommodation may be required as part of a Section 504 plan or an individual family service plan (IFSP) or IEP. See ASHA's resource on transitioning youth. Augmentative and alternative communication (AAC) involves supplementing or replacing natural speech and/or writing with aided symbols (e.g., Picture Exchange Communication System [PECS], line drawings, Blissymbols, speech-generating devices, and tangible objects) and/or unaided symbols (e.g., manual signs, gestures, and finger spelling). The role of the SLP in the transition from hospital setting to school setting is key in identifying students who qualify for services and helping them access these services and any other necessary educational supports (Allison, Byom, & Turkstra, 2017; Allison & Turkstra, 2012; Denslow et al., 2012; Glang et al., 2008; Haarbauer-Krupa, 2012b; Savage, Pearson, McDonald, Potoczny-Gray, & Marchese, 2001). Brain Injury, 20, 879–888. Turkstra, L. (2014). (See ASHA's Practice Portal pages on Permanent Childhood Hearing Loss and Hearing Loss: Beyond Early Childhood.). Gloriajean Wallace, PhD, CCC-SLP, BC-ANCDS. The CDC (2019) identified the following leading causes: Falls were the leading cause of hospitalizations among adults 55 years of age and older (CDC, 2014). Turkstra, L. S., Gamazon-Waddell, Y., & Evans, J. This alphabetized list is not exhaustive, and inclusion of any specific treatment does not imply endorsement by ASHA. Intensity and frequency of stimulation can be tailored to a child's threshold in order to elicit a meaningful behavioral response following TBI and to monitor changes in responsiveness during recovery (Hotz et al., 2006). Intervention may differ when balance and dizziness symptoms are due to post-concussion syndrome versus peripheral vestibular dysfunction; differential diagnosis is key to management and recovery (Doettl, 2015). (2012). Brain Injury, 26, 1033–1057. Rietdijk, R., Togher, L., & Power, E. (2012). When rehabilitation incorporates accommodations, modifications, and supports in everyday settings, SLPs often provide (a) information to help communication partners understand the child's needs and (b) training in how to use strategies to facilitate communication. Family-centered practice is the foundation of intervention for pediatric TBI. ), Mild traumatic brain injury in children and adolescents (pp. This binder contains: 1. Pediatrics, 128, 946–954. Shum, D., Fleming, J., Gill, H., Gullo, M. J., & Strong, J. Acquiring a brain injury may predispose an individual to additional brain injuries before symptoms of the first have resolved completely; the second impact is more likely to cause brain swelling and widespread damage (Dessy, Rasouli, & Choudhri, 2015). Bonelli, P., Ritter, P., & Kinsler, E. (2007, November). Audiologists are also involved in the management of tinnitus associated with TBI. Moderate to severe injuriesoften lead to lifelong disability. The comprehensive assessment typically results in one or more of the following: Assessments are sensitive to cultural and linguistic diversity and are completed in the language(s) used by the individual with TBI (see ASHA's Practice Portal pages on Bilingual Service Delivery, Cultural Competence, and Collaborating With Interpreters ). Burns, M. S. (2004). Family members and caregivers can be frightened, stressed, and overwhelmed by the magnitude of the medical situation, changes in the child they once knew, and the process of learning to care for a child with TBI (Wade et al., 2006). Treatment is also sensitive to linguistic diversity and is completed in the language(s) used by the individual with TBI (see ASHA's Practice Portal pages on Bilingual Service Delivery, Cultural Competence, and Collaborating With Interpreters). Teasell, R., Marshall, S., Cullen, N., Bayley, B., Rees, L. Weiser, M., . These variations are often due to differences in participant characteristics (e.g., ages included), diagnostic classification criteria within and across subtypes (e.g., mild TBI vs. severe TBI), and sources of data (e.g., hospital admissions, emergency room visits, general practitioner visits). Pediatric traumatic brain injuries (TBI) are underreported, which means that many children and teens are not getting needed services to help with post-injury cognitive issues that, though often mild, can cause academic and other difficulties. In developing a treatment plan, clinicians consider age, previous levels of function, and developmental status as well as functioning in related areas, such as sensory and motor skills. Hearing screening and otoscopic inspection occur prior to screening for other deficits. Anderson, V., Catroppa, C., Morse, S., Haritou, F., & Rosenfeld, J. V. (2005). Lorenzen, B., & Murray, L. L. (2008). Identifying students that may have a previously undiagnosed TBI. See also ASHA's resource on family-centered practice. Spell. Sim, P., Power, E., & Togher, L. (2013). Repetitive drills practice assumes that neural networks underlying performance are strengthened by repeated activation (Sohlberg et al., 2014). Ownsworth, T., Fleming, J., Tate, R., Shum, D. H., Griffin, J., Schmidt, J., . Keenan, H. T., & Bratton, S. L. (2006). TBI may affect each language used by the child in different ways. Zaloshnja, E., Miller, T., Langlois, J. For infants and toddlers, acute deficits following TBI tend to be in skill areas that are developing at the time of injury. Perspectives on School-Based Issues, 5, 14–19. This approach to care incorporates individual and family preferences and priorities and offers a range of services, including providing counseling and emotional support, providing information and resources, coordinating services, and teaching specific skills to facilitate communication. Individuals with TBI may rely on assistive technologies to compensate for their cognitive impairments in the absence of linguistic or motor speech disorders (Fried-Oken, Beukelman, & Hux, 2011). A pilot study evaluating attention and strategy training following pediatric traumatic brain injury. Returning to learning following a concussion. (2004). Boca Raton, FL: CRC Press. Covassin, T., Moran, R., & Elbin, R. J. Non-standardized assessment approaches for individuals with cognitive-communication disorders. Injuries to the frontal lobe can result in behaviors such as agitation, aggression, impulsivity, and self-injury that interfere with a child's functioning in home, community, and school environments and his or her ability to communicate effectively. Developmental Medicine and Child Neurology, 57, 217–222. DePompei, R., Gillette, Y., Goetz, E., Xenopoulos-Oddsson, A., Bryen, D., & Dowds, M. (2008). The ASHA Action Center welcomes questions and requests for information from members and non-members. . There are a limited number of standardized cognitive-communication assessments specifically for children and adolescents with TBI (Chevignard, Soo, Galvin, Catroppa, & Eren, 2012; Turkstra et al., 2015). Forming and collaborating with TBI/concussion teams to collect baseline and post-concussion cognitive data and make "return to learn/play" recommendations. See ASHA's Practice Portal pages on Bilingual Service Delivery and Collaborating With Interpreters, Transliterators, and Translators. Can the student prioritize tasks or manage more than one task at a time? (2004). Executive function and conversational strategies in bilingual aphasia. See ASHA's Practice Portal pages on Hearing Loss—Beyond Early Childhood, Tinnitus and Hyperacusis, and Balance System Disorders. The Journal of Head Trauma Rehabilitation, 26, 138–149. Traumatic brain injury: Diagnosis, acute management and rehabilitation. Telepractice can focus on improving the child's functional abilities while offering support and training to caregivers, teachers, and employers in functional, everyday environments. See ASHA's Practice Portal pages on Aphasia, Spoken Language Disorders, Written Language Disorders, and Social Communication Disorder. Worldwide, in 2016, there were approximately 27 million new cases of TBI with an age-adjusted incidence rate of 369 per 100,000—representing a 3.6% increase from 1990. A. See also ASHA's Practice Portal page on. Time-limited residential programs and community-based programs are available in some areas to foster community integration and provide peer support. The individual's premorbid proficiency in the languages they speak can influence their ability to maintain the target language. ASHA extends its gratitude to the following subject matter experts who were involved in the development of the Traumatic Brain Injury page. Self-regulation after traumatic brain injury: A framework for intervention of memory and problem solving. Following time in acute-care hospital and rehabilitation settings, young children with TBI return home to receive services through early intervention, preschool, or community-based programs. Adults ( ages 18 years and older ) individual from discrimination based on disability... Seek medical care information from members and significant others play a critical in. Tbi by training communication partners of people with traumatic brain injury long-term rehabilitation services are provided (,! Acute or rehabilitation hospitals will look much different from those that are developing the... Evidence-Based Practice for SLPs student prioritize tasks or manage more than one task a... 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