A novel combined visual scanning and verbal cuing intervention improves facial affect recognition after chronic severe traumatic brain injury: A single case design

ABSTRACT

A single case design (AB with follow up) was used to determine the effect of a combined visual scanning and verbal cuing intervention technique in improving facial affect recognition after traumatic brain injury (TBI). A 35-year-old male (BR) with impaired ability to recognize facial emotions as a result of severe TBI participated in the study over a 3-month duration. BR's mean accuracy across six universal static facial expressions of emotion improved significantly during intervention and was maintained at follow up. BR was most impaired in labelling negative (sad, angry, disgusted, anxious) versus positive facial expressions (surprised, happy). BR's accuracy to negative facial affect significantly improved during intervention. No further improvement was possible for positive expressions because a ceiling effect was observed at baseline. Overall BR's mean response times across emotions was reduced at baseline but increased significantly during intervention. This was also recorded for both positive and negative expressions, respectively. This novel combined intervention has potential to improve facial affect recognition after TBI. Further evaluation using a multiple-baseline design is recommended. Additional research is needed to determine whether improved facial affect recognition following training translates to improvements in social function and communication in people with TBI.

KEYWORDS:

• Facial affect recognition
• Single case design
• Traumatic brain injury
• Response times
• Emotion

Acknowledgements

The authors thank BR whose enthusiasm and willingness to give so freely of his time enabled this work to be possible. We would also like to gratefully acknowledge the helpful feedback that we received from the review process of this manuscript. Orthoptists Jessica Boyle and Sian Leigh Cooper provided assistance with data collection. We thank the authors of the Radboud Faces Database (RaFD) (Langner et al., 2010) for granting permission to use their stimuli. We acknowledge the School of Allied Health, Human Services & Sport (formerly School of Allied Health), and Orthoptics Australia (Victorian Branch) for financial support.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This research was supported by funding to Suzane Vassallo from the School of Allied Health, Human Services & Sport, La Trobe University (Research Starter Grant), and from Orthoptics Australia (Victorian Branch).