An international survey of assessment and treatment practice for discourse in paediatric Acquired Brain Injury

Abstract

Purpose

Guidelines recommend routine discourse assessment and treatment in paediatric acquired brain injury (ABI) but provide little guidance for clinical practice. The degree to which this has influenced the nature of discourse assessment and treatment in clinical practice has not been examined in detail.

Method

Speech-language pathologists working in paediatric ABI (clients aged <18 years) in Australia, New Zealand, the UK, the USA, Canada, and the Asia Pacific region were invited to complete a survey of discourse assessment and intervention practices (n = 77).

Result

Clinicians from Australia and New Zealand comprised over half of a responses (53%). The largest proportion had over 10 years’ experience (60%), worked in the metropolitan area (58%), and with secondary school-age children (64%). Routine discourse assessment was undertaken by 80% of respondents, focussing on a limited range of genres. No preferred intervention approach was identified. One-quarter of clinicians routinely considered holistic factors during clinical decision-making. Limited normative data and treatment evidence, insufficient time and training were identified as clinical barriers.

Conclusion

Assessment practices were consistent with guidelines, yet interventions were highly variable, reflecting limited evidence, client heterogeneity, time constraints, and limited training. A biopsychosocial approach to practice was evident, yet a focus on impairment level factors was prominent. Findings support the need for standardised discourse assessment and discourse intervention methods. Translation into practice guidelines would promote consistency and confidence in clinical practice.

Keywords:

• discourse
• assessment
• treatment

Declaration of interest

No potential conflict of interest was reported by the authors.

Supplementary material

Supplemental data for this article can be accessed at https://doi.org/10.1080/17549507.2022.2079724.

Additional information

Funding

Dr Elizabeth Hill was supported by an Australian Postgraduate Award and Curtin University Postgraduate Scholarship. Associate Professor Mark Boyes is supported by the National Health and Medical Research Council, Australia (Investigator Grant 1173043).