Incorporating principles of the collaborative contextualised intervention approach with the empirical study of learning and communication in traumatic brain injury

ABSTRACT

Background: Ylvisaker et al. argue that traumatic brain injury (TBI) intervention is most effective using a collaborative contextualised approach. However, few research protocols have implemented the principles of this approach in empirical studies. The development of such research paradigms would promote tighter integration of empirical findings with theoretical models and between research and current clinical practice.

Aims: This preliminary study sought to examine learning and communication in social interaction in individuals with TBI interacting with their familiar partners using a research protocol that incorporates many principles of the collaborative contextualised intervention approach and that has been shown to promote learning and social interaction in patients with circumscribed memory impairments.

Methods & Procedures: Using a collaborative referencing task presented as a matching game, we assessed the ability of five individuals with moderate to severe TBI and five matched healthy comparison participants to engage in repeated social interaction with a familiar partner. Quantitative and qualitative measures of learning and social communication success were used to assess the development and use of referential labels for novel shapes during the sessions.

Outcomes & Results: All pairs successfully completed the task. As a group, the performance of four of the five TBI pairs did not differ from healthy comparison pairs on any measures. Participant 3591, however, differed from all other pairs on both quantitative and qualitative measures. Speculating Participant 3591’s partner contributed to their poor performance, we assigned Participant 3591 a new partner in a subsequent study. The results were striking: Participant 3591 and her new partner were as successful as other pairs on all learning measures.

Conclusions: Given the complex and often heterogeneous nature of impairment associated with TBI, the findings here that all participants with TBI were successful provide further evidence that these interactive sessions can be potent learning environments and suggest that this may be a fruitful way to deploy Ylvisaker’s contextualised intervention approach in more controlled research settings. Furthermore, these results demonstrate the important role partners play in the communicative successes and failures of individuals with TBI in everyday interactions.

KEYWORDS:

• Traumatic brain injury
• collaborative referencing
• social interaction
• communication
• partner effects

Acknowledgements

We thank the Duff Communication and Memory Laboratory for assistance with transcribing and coding the sessions. This study was supported by start-up funds to Melissa Duff from the University of Iowa.

Disclosure statement

No potential conflict of interest was reported by the authors.