Dr Joanne Steel

© 2017 Taylor & Francis Group, LLC. Background: There has been limited empirical speech¿language pathology (SLP) study of language and cognitive communication during post-traumatic amnesia (PTA) and the early stages after TBI. The purpose of the current research was to explore the potential means and utility of assessing cognitive communication during PTA and the post-acute recovery period. Method: This research used a longitudinal mixed methods design to describe language and cognitive communication assessment and recovery profiles of three patients with TBI. Cognitive communication was assessed with repeated standardised and non-standardised methods during PTA (rated with Westmead PTA Scale) and at follow-up 3¿months after PTA emergence. Results: All participants demonstrated a profile of language and cognitive communication strengths and weaknesses during PTA and the post-acute period, also evident at follow-up. Improvement occurred gradually throughout PTA, although with individual fluctuation across test occasions. There was no marked change in communication function immediately before and after PTA emergence, indicating that cognitive communication ability and those functions measured on the Westmead PTA Scale (memory and orientation) did not recover at the same rate. Conclusion: It was feasible to assess language and cognitive communication throughout PTA and the post-acute period, and early assessment results were relevant to the patient¿s ongoing communicative function. It is suggested that early and repeated SLP assessment may contribute to the prediction of persisting cognitive communication issues.

© 2015 - IOS Press and the authors. All rights reserved. BACKGROUND: There is minimal speech pathology literature on communication presentation during post-traumatic amnesia (PTA) and the early recovery period after traumatic brain injury. While a body of research reports on other cognitive and behavioural functions during PTA, language and/or cognitive communication are not routinely the primary focus of current research literature. OBJECTIVE: This critical synthesis provides an overview of research to date on communication during PTA to inform speech pathology assessment practice and to assist with information provision to the multidisciplinary team and family members. METHODS: A search was conducted of studies reporting on language, cognition, and cognitive communication during the acute, inpatient and early recovery period after TBI. These were examined for relevance to speech pathology practice during PTA and acute confusional state. RESULTS: Historic and recent literature has described types of language and communication impairment during PTA and early recovery after TBI. Recently, aspects of communication impairment during PTA have been found relevant for outcome prediction. Few studies were found originating from speech pathology on communication during PTA. CONCLUSIONS: Communication disruption forms a key feature of PTA. Existing literature indicates that speech pathology monitoring of communication during PTA may be of benefit as part of multidisciplinary team management during early recovery.