A modified multimodal communication treatment for individuals with traumatic brain injury

Abstract

People living with the effects of traumatic brain injury (TBI) might use augmentative and alternative communication (AAC) due to cognitive-communication disabilities and/or co-occurring motor speech disorders. However, the most effective method for teaching people with TBI to use AAC strategies and resolve communication breakdowns is unknown. Prior research conducted with people with aphasia suggests an integrated multimodal treatment improved the use of AAC to resolve communication breakdowns. In this study, the researchers measured the effectiveness of a modified Multimodal Communication Treatment designed to increase communication breakdown resolution and use of AAC strategies by two individuals with TBI. A multiple baseline, single-case design was used to measure outcomes for the two participants who had motor speech disorders and cognitive-communication impairments. They completed four pre-treatment sessions, 20 treatment sessions, and three post-treatment sessions. Dependent variables included the number of AAC strategies produced during a modality probe task and two measures of communication breakdown resolution during a structured, functional task. Both participants increased use of AAC strategies during modality probes, but demonstrated minimal changes in communication breakdown resolution variables, potentially due to their impairments in executive function and memory. Results indicate that modifications to MCT may improve the use of AAC strategies for communication breakdown resolution for some people with TBI.

Keywords:

• Traumatic brain injury
• AAC
• multimodal communication treatment

Acknowledgements

This study was funded by the LSVT Global through the Small Student Grants Award and was completed as part of the first author’s PhD requirements. Thanks to our research assistant, Joanne Kinney, and the student volunteers who served as communication partners. Most importantly, our thanks to the participants and their caregivers who made this study possible.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Notes

1 Predictable is a product of Therapy Box Limited, and is used as the text-to-speech mobile communication application in this study.

2 Ibid.

3 iPad Air^® is a product of Apple Inc. An iPad Air^® Version 8.4 was used as the platform for the text-to-speech application (www.apple.com).