Communicating after brain injury

31 July, 2013

Unwittingly, carers of people living with a traumatic brain injury (TBI) can over-compensate and speak too slowly or ask questions like a school teacher, states Professor Leanne Togher, a communications disorder specialist at the University of Sydney's Faculty of Health Sciences.

"Seventy percent of severe TBI cases are due to road traffic crashes with most victims being young men," states Professor Togher.

Given these statistics it is not uncommon to find that the primary carer of a person with a TBI is their wife or mother, she says. Often relationships after the traumatic event can be stressful with poor communication underlying family break-ups and a feeling of isolation for the person living with a TBI.

Professor Togher says: "Sometimes carers do not give the injured individual an opportunity to communicate or fail to develop or continue with topics introduced by the person with TBI."

Results of a three-year controlled trial led by Professor Togher, published this month in the Journal of Rehabilitation Medicine, reveals that simultaneously teaching family members of people living with TBI and the person with the injury how to communicate more collaboratively is far more effective than focussing only the individual who has sustained the injury.

"Family and friends are faced with the challenge of how to interact with the person living with a TBI, and in the absence of training, they may adopt ways of speaking that can make matters worse. People who have sustained a traumatic brain injury often have difficulty with communication which can lead to a breakdown in pre-injury relationships, and problems returning to work or study."

Forty-four outpatients from three brain injury rehabilitation centres in the Sydney metropolitan area participated in the study that included a 10-week training program combined with a six month follow-up. The study aimed to boost conversational skills of all stakeholders. Improved communication outcomes were maintained six months after the training.

"In the study we investigated two avenues of intervention. One involved training people with TBI with the skills necessary for successful social interaction," says Professor Togher.

"The second and more successful approach focussed on training the partners and family of people with TBI to use strategies for promoting more successful and collaborative interactions."

Using 'real life' transcripts from participants in the study, Professor Togher's team produced a free website which has training videos to assist relatives of people with a TBI and training manual called TBI Express partner training for clinicians and families.

"TBI Express, which focused on developing more positive and interesting interactions between people with TBI and their communication partners represents a significant step forward in this area. It is the first communication training program to assist families of people with TBI in the world," concludes Professor Togher.