Remediation of social communication impairments following traumatic brain injury using metacognitive strategy intervention: a pilot study

ABSTRACT

Objective: To perform a pilot study to evaluate whether a novel metacognitive, goal-based intervention improved and maintained the social communication skills of adults with traumatic brain injury (TBI).

Method: Eight community-dwelling participants with TBI completed three study phases: (1) baseline, (2) eight-week intervention targeting social communication impairments and (3) follow-up. Participants completed the Profile of Pragmatic Impairment in Communication (PPIC), LaTrobe Communication Questionnaire (LCQ) and Goal Attainment Scaling (GAS) at the commencement of baseline phase, pre- and post-intervention and completion of the follow-up phase. During the intervention programme phase, participants attended two 1-hour therapy sessions (one individual; one group) per week focusing on remediating impaired social communication skills using metacognitive strategy intervention and goal-based therapy.

Results: Variable changes in PPIC feature-summary scores were observed post-intervention. A non-significant improvement in LCQ scores was also observed. There was a significant increase in GAS goal T-scores following the intervention, with six of the eight participants achieving or exceeding their expected level of performance on all goals.

Conclusion: A goal-driven, metacognitive approach to intervention may assist individuals with TBI to achieve their personal social communication goals, with benefits reported by participants and observable during conversations. Further research is required.

KEYWORDS:

• Traumatic brain injury
• metacognitive strategy intervention
• metacognition
• cognition
• social communication
• pragmatics
• goal

Acknowledgements

The authors would like to thank Alison McGann and Rebekah Dewberry from Red Soup Speech Pathology, and the Princess Alexandra Hospital Speech Pathology Department for their assistance with the study. The authors would also like to thank all the participants and their significant others who gave up their valuable time to participate in the study.

Declaration of interest

The authors have no conflicts of interest to report. This research project was supported by a Princess Alexandra Hospital Research Support Scheme Small Project Grant.