Table Appendices: (Table 7.4)

Social Communication and Pragmatics

Individual Studies

Table 7.4 Treatment to improve Social Communication and Pragmatics Post ABI

Pragmatics and Social Communication Interventions

Author/Year/
Country/Study design/ PEDro & D&B Score

Methods

Outcomes

Radice-Neumann et al.,

(2009)

RCT

PEDro=5

D&B=20

N=19 Ten subjects were randomly assigned to receive the facial affect recognition (FAR) intervention, while the remaining 9 received the stories of emotional inference training (SEI). Both groups received 2 pre-tests one week apart.  Once completed subjects were subjected to one-on-one session, 3 times each week and 1 hour each session for 2 to 3 weeks.  Emotional inference from context, facial and vocal affect and affect recognition were measured. Social emotional behaviour was also measured.

 

Scores on the evaluation tools used indicated both the FAR and the SEI groups improved from pre-test 1 to the post test.  On the DANVA2-AF those in both groups, showed improvement in recognizing facial affect. Subjects in the FAR group achieved a score within normal range after the intervention. Result of the DANVA2-AP showed no significant improvement over time for either group. The EET scores indicated the neither groups improved significantly in their ability to infer emotions from the video presentations. The LEAS results showed the FAR group showed significant improvement in their ability to infer how they would feel in certain situations. The SEI group showed no significant changes. Care givers, indicated those in the FAR group showed improvement in emotionality, aggression, social monitoring and empathy. Caregivers for the SEI groups did not notice any significant changes.

Remediation of Emotional Parody

Author/Year/Country/
Study design/

PEDro & D&B Score

Methods

Outcomes

McDonald et al.,

(2012)

Australia

RCT

PEDro=6

D&B=24

N=20 Individuals were randomized to either the treatment group (n=10) or the control group (n=10). Treatment group attended 2-hr weekly treatment sessions for 3 wks. Sessions consisted of a therapist and 2 participants. All were tested pre and post intervention (immediately following treatment and one month later). Following the second assessment period, those in the control group were offered treatment. The program was tailored to focus on prosodic cues that may be seen in expressions of emotions. A varied of techniques were used. Awareness of social interference test form B-Part 1 (audio presentation); Prosodic emotion labelling task; andquestionnaires completed by participants and family.

No significant effects were noted for those in the treatment group at either the initial post test assessment or at one month follow-up. Communication competence was not found to improve significantly as a result of treatment. Individually 5 improved on one measure and 1 improved on 3. None in the control group were found to improve on any of the measures used.

Social Communication Skills Training

Author/Year/Country/
Study design/
PEDro & D&B Score

Methods

Outcomes

Dahlberg et al., (2007)

USA

RCT

PEDro=6

D&B=22

N=52 Individuals with a moderate to severe ABI were participated in 12 sessions (to improve communication skills) with each session lasting 1.5 hours. The experimental group received treatment while the control group waited 3 months before undergoing treatment.  The experimental group worked on social communication skills (listening to others, communicating needs, regulating their emotions during social interactions).  Individuals were assessed using a variety of instruments, however, the two primary outcomes were the profile of functional impairment in communication (PFIC), social communication skills questionnaire-adapted (SCKQ-A).

Results of the PFIC rating scale showed a significant improvement (p<0.001) in 7 of the subscales included on the PFIC for the treatment group only.  Result of the SCSQ-A also showed significant improvement (p<0.005) for the treatment group compared to the control group, before and after intervention.  At the 6th month period, significant improvement was noted between baseline scores and post-treatment scores on the PFIC (21 of the 30 subscales (p<0.012 to p<0.001)). On the self-reported ratings scales, significant improvement was noted on the SCSQ-A (p<0.001).  Baseline scores compared to those recorded at 9 mths post interventions, significant improvement could only be seen on 5 of the subscales of the PFIC scale (P<0.034- p<0.001). Significant improvement could also be seen on the self-report ratings and the SCSQ-A (p<0.002).

Group Treatment

Author/Year/Country/Study design/ D&B Score

Methods

Outcomes

Braden et al.,

(2010)

UK

Cohort

D&B=19

N=30 Participants were divided into 1 of 4 groups.  For those in groups 1 and 2 treatment was provided at the rehab facility, for those in groups 3 and 4 treatment was provided in the community. A treatment workbook was given to each participant regardless of the group they were assigned to.  The workbook was originally developed for “group interactive structured treatment for social competence (GIST)”. Each group member was asked to attend 13 1.5 hr weekly sessions to discuss various topics related to effective communication. To assess the participants’ improvement the following tools were used: the profile of pragmatic impairment in communication (PPIC); social communication skills questionnaire-adapted (SCSQ-A); goal attainment scale; satisfaction with life scale (SWLS); Latrobe communication questionnaire (LCQ); awareness questionnaire (AQ); Participation assessment with recombined tools (PARTS).

Social communication skills improved significantly pre to post assessment (p<0.05). At the 6 month post treatment assessment significant improvement (p<0.05) was also noted. For those in the TBI plus group (those with a substance disorder, a psychiatric disorder, or other neurological complications) significant improvement was noted on their SCSQ-A, GAS, SWLS scores (p<0.002, p<0.000 and p<0.01 respectively).  Of note scores on the PPIC, although improvement was noted, they did not reach significance. Overall improvement was also noted when assessing the gains made during the social skills treatment phase and satisfaction with life. Having a family member or friend involvement with the training did not lead to any significant changes in the results of the PPIC.  Overall results suggest that the GIST is beneficial to individuals with a TBI.

PEDro = Physiotherapy Evidence Database rating scale score (Moseley et al., 2002).

D&B = Downs and Black (1998) quality assessment scale score.