Telehealth Helps Traumatic Brain Injury Patients Recover Communication Skills

The ability to communicate with family members and other loved ones can be extremely difficult for patients suffering from a traumatic brain injury (TBI).

While in-person training for both the patient and communication partner has shown benefits in the past, with the advent of new technology, telehealth might be another option.

A team, led by Rachael Rietdijk, BAppSc, Faculty of Health Sciences, The University of Sydney,investigated the efficacy of telehealth-based and in-person social communication skills training for individuals with moderate-to-severe traumatic brain injuries based on outcomes reported by the survivor and a close communication partner.

The standard program often involves 35 hours of intervention consisting of a combination of group sessions and dyad sessions that are attended by both the injured patient and their communication partner. However, telehealth could allow a more expansive therapy service be reducing some of the time constraints linked to in-person training.

The partially randomized controlled trial contained a telehealth intervention group using a program called TBIconneCT, an in-person intervention group that uses the TBI Express therapy program, and a historical control arm.

The investigators examined 51 adults at least 6 months following a moderate or severe traumatic brain injury. Each patient had exhibited some communication skills deficits. The investigators also utilized communication partners, including family members, friends, and paid care of the injured individual.

The investigators sought main measures of La Trobe Communication Questionnaire total score, as well as the number of items with perceived positive change.

The researchers found trained participants had significantly more items with perceived positive change than the historical controls did. There was also a medium effect size in the sample observed for improvements in total score reported by trained communication partners following treatment.

Comparisons between telehealth and in-person groups showed medium to large effect sizes in the sample. This favored the telehealth group on certain La Trobe Communication Questionnaire variables.

“Whether delivered via telehealth or in-person, social communication skills training led to perceived positive change in communication skills,” the authors wrote. “It was unexpected that outcomes for the telehealth group were better than for the in-person group on some variables.”

Providing communication partners with skills can help enable those suffering from traumatic brain injuries to have effective conversations and create a more positive daily communication environment.

This training involves focusing on addressing negative patterns that communication partners may use in conversations with patients with TBI, including failing to follow up on the person's contributions, not giving enough information to support the person's comprehension, using questions designed to test the person's memory rather than asking for meaningful information, and querying the person's accuracy.

Training can facilitate collaborative interactions between the person with TBI and communication partners.

The study, “A Clinical Trial Investigating Telehealth and In-Person Social Communication Skills Training for People With Traumatic Brain Injury: Participant-Reported Communication Outcomes,” was published online in The Journal of Head Trauma Rehabilitation.