The success of communication interventions often relies on the understanding, compliance and competence of communication partners. Training of communication partners has become a central component of communication interventions with many populations. This development is consistent with the World Health Organization (2001) emphasis on context (environmental and attitudinal) as a determinant in health and disability outcomes. Training of communication partners has been shown to have a positive effect on communication effectiveness and re-acquisition of communication skills in toddlers and preschoolers with language disorders and developmental disabilities (Girolametto et al., 1994), adults with aphasia (Kagan et al., 2001) adults with dementia (Ripich et al., 1999) and adults with ABI (Togher et al., 2004).
Difficulties Sustained Post ABI
- Post ABI, individuals may have difficulty engaging in meaningful conversation with others.
Goals of Treatment
- To assist others in successfully facilitating communication with those with moderate to severe ABI
- Short, simple sentences
- Asking patient to repeat messages
- Asking patient to clarify they have understood the information
- Allowing time to answer
- Writing information down
- Reducing distractions
- Making eye contact
- Presenting choices
- Repeating information
- Clarifying intent of message
- Announcing topic/activity change
- Use of a variety of modes in communicating
- Use of nonverbal communication techniques or devices
In a RCT conducted by Togher et al. (2004), a small group of police officers (n=20) were trained to respond to individuals with a traumatic brain injury; the remaining officers who volunteered did not participate in the training. Individuals with ABI called the police department to inquire about regaining their driver’s licenses. Officers in the experimental group received 2 hours of communication strategies training while those in the control group received standard baton and weapons training. Overall, it was noted that those in the experimental group significantly reduced the number of moves (inquiries) required to gain the necessary information from their callers. The experimental group (compared tothe control group) following the training sessions spent less time establishing the nature of the service request and more time answering the questions being presented to the officers by those with a ABI.
Behn and colleagues (2012) investigated the effectiveness of a communication-training program aimed at caregivers to help them improve their abilities to engage in conversation with those who had sustained an ABI. Those in the treatment group (n=5) used a number of didactic and performance-based approaches such as modeling, role-playing, feedback and rehearsal to improve their communication skills. Strategies used were both elaborative and collaborative. Results suggest paid caregivers may improve their communication skills, thus allowing individuals to express themselves more easily (Behn et al., 2012).
The reader is encouraged to review the aforementioned studies within Table 7.6 at the end of this module for further details.
There is Level 2 evidence to support the effectiveness of interventions that focus on training the communication partners of individuals with severe ABI (Togher et al., 2004).
There is Level 2 evidence supporting the training of paid caregivers to allow them to communicate more effectively with those who sustain an ABI; thus allowing those with ABI to improve their communication skills (Behn et al., 2012)
Training of communication partners including paid caregivers may improve the communication efficiency of people with severe ABI.