Cognitive-Communication Screening and Early Therapy for Adults With Mild TBI
| Status: | Recruiting |
|---|---|
| Conditions: | Neurology, Neurology |
| Therapuetic Areas: | Neurology |
| Healthy: | No |
| Age Range: | 18 - 65 |
| Updated: | 8/23/2018 |
| Start Date: | January 2017 |
| End Date: | December 2020 |
| Contact: | Kerri E. Byrd |
| Email: | Kerri.Byrd@nau.edu |
| Phone: | (928)523-6466 |
Cognitive-Communication Screening and Early Therapy for Adults With Concussion/Mild Traumatic Brain Injury
Approximately 15-20% of patients diagnosed with a concussion/mild traumatic brain injury
(mTBI) have persistent symptoms that continue up to six months or longer. Typical problems
identified by these patients include difficulty with memory, multi-tasking, the ability to
complete tasks quickly, and higher executive functions (e.g., inhibition, initiation,
insight, motivation) (Belanger & Vanderploeg, 2005; Mott, McConnon, & Rieger, 2012,
Rabinowitz & Levin, 2014). If these symptoms persist they can not only affect thinking, but
also communication abilities (e.g., verbal and nonverbal interactions, reading, and writing)
(ASHA, 2007). Therefore, it is hypothesized that screening measures that evaluate both
thinking and communication can better identify individuals at-risk for persistent symptoms at
two week and four weeks post-injury. Also, if cognitive-communication therapy was
administered earlier post-injury, then outcomes related to return to daily activities, work,
and/or the academic setting could possibly change. This study intends to investigate the use
of cognitive and communication screening measures for the identification of persistent
symptoms and the provision of early cognitive-communication therapy if problems persist.
(mTBI) have persistent symptoms that continue up to six months or longer. Typical problems
identified by these patients include difficulty with memory, multi-tasking, the ability to
complete tasks quickly, and higher executive functions (e.g., inhibition, initiation,
insight, motivation) (Belanger & Vanderploeg, 2005; Mott, McConnon, & Rieger, 2012,
Rabinowitz & Levin, 2014). If these symptoms persist they can not only affect thinking, but
also communication abilities (e.g., verbal and nonverbal interactions, reading, and writing)
(ASHA, 2007). Therefore, it is hypothesized that screening measures that evaluate both
thinking and communication can better identify individuals at-risk for persistent symptoms at
two week and four weeks post-injury. Also, if cognitive-communication therapy was
administered earlier post-injury, then outcomes related to return to daily activities, work,
and/or the academic setting could possibly change. This study intends to investigate the use
of cognitive and communication screening measures for the identification of persistent
symptoms and the provision of early cognitive-communication therapy if problems persist.
Approximately 15-20% of patients with concussion/mild traumatic brain injury (mTBI) have
persistent cognitive symptoms up to six months or longer. Problems with working memory,
divided attention, processing speed, and executive function are common (Belanger &
Vanderploeg, 2005; Mott, McConnon, & Rieger, 2012, Rabinowitz & Levin, 2014). Patients often
report how these problems negatively impact daily communication. Although neurocognitive
tests are frequently used to identify patients at-risk for persistent symptoms, perhaps tests
that not only assess cognition, but also communication would be better at identifying more
functional deficits. Patients at-risk for persistent symptoms could then begin therapy
earlier to address problems affecting work, school, or everyday activities. Speech-language
pathologists are uniquely qualified to evaluate and treat patients with concussion/mTBI and
cognitive-communication disorders (ASHA, 2005; Cicerone, et al.; Cornis-Pop et al., 2012).
Cognitive-communication is the relationship between cognition and its influence on verbal and
nonverbal communication, reading, and writing (ASHA, 2007). At this time, practice guidelines
are emerging for cognitive-communication intervention related to concussion/mTBI (Cornis-Pop
et al., 2012), yet there is still much research to be done. Typically, in recovery following
a concussion/mTBI, patients are referred for cognitive-communication intervention if they are
failing or struggling at work, school, or in daily activities. Some patients will not be seen
for up to six months based on the assumption by healthcare professionals that most persistent
cognitive and communication symptoms will resolve on their own. The wait period before
referral for additional services is currently being investigated in the literature.
Additionally, therapy for cognitive-communication will only be provided if patients report
difficulties to their physicians and are referred for services. If services are not sought
out, problems in cognitive-communication will go unrecognized as being a result of the
concussion/mTBI.
The specific aims of this study are: 1) Determine if screening measures that evaluate
symptoms of concussion/mTBI frequently used by speech-language pathologists administered two
and four weeks post-injury will be able to predict individuals at-risk for persistent
cognitive and communication symptoms, and 2) Will an early treatment group with persistent
cognitive-communication deficits one month after injury differ in pre- and post-therapy
functional outcome measure scores as compared to a delayed therapy group beginning services
at two months post-injury?
Significance: Results of this study will increase the understanding in the use of cognitive
and communication screening measures frequently administered by speech-language pathologists
to identify patients at-risk for persistent symptoms related to concussion/mTBI and provide
information about the outcomes of cognitive-communication intervention delivered early in
recovery.
persistent cognitive symptoms up to six months or longer. Problems with working memory,
divided attention, processing speed, and executive function are common (Belanger &
Vanderploeg, 2005; Mott, McConnon, & Rieger, 2012, Rabinowitz & Levin, 2014). Patients often
report how these problems negatively impact daily communication. Although neurocognitive
tests are frequently used to identify patients at-risk for persistent symptoms, perhaps tests
that not only assess cognition, but also communication would be better at identifying more
functional deficits. Patients at-risk for persistent symptoms could then begin therapy
earlier to address problems affecting work, school, or everyday activities. Speech-language
pathologists are uniquely qualified to evaluate and treat patients with concussion/mTBI and
cognitive-communication disorders (ASHA, 2005; Cicerone, et al.; Cornis-Pop et al., 2012).
Cognitive-communication is the relationship between cognition and its influence on verbal and
nonverbal communication, reading, and writing (ASHA, 2007). At this time, practice guidelines
are emerging for cognitive-communication intervention related to concussion/mTBI (Cornis-Pop
et al., 2012), yet there is still much research to be done. Typically, in recovery following
a concussion/mTBI, patients are referred for cognitive-communication intervention if they are
failing or struggling at work, school, or in daily activities. Some patients will not be seen
for up to six months based on the assumption by healthcare professionals that most persistent
cognitive and communication symptoms will resolve on their own. The wait period before
referral for additional services is currently being investigated in the literature.
Additionally, therapy for cognitive-communication will only be provided if patients report
difficulties to their physicians and are referred for services. If services are not sought
out, problems in cognitive-communication will go unrecognized as being a result of the
concussion/mTBI.
The specific aims of this study are: 1) Determine if screening measures that evaluate
symptoms of concussion/mTBI frequently used by speech-language pathologists administered two
and four weeks post-injury will be able to predict individuals at-risk for persistent
cognitive and communication symptoms, and 2) Will an early treatment group with persistent
cognitive-communication deficits one month after injury differ in pre- and post-therapy
functional outcome measure scores as compared to a delayed therapy group beginning services
at two months post-injury?
Significance: Results of this study will increase the understanding in the use of cognitive
and communication screening measures frequently administered by speech-language pathologists
to identify patients at-risk for persistent symptoms related to concussion/mTBI and provide
information about the outcomes of cognitive-communication intervention delivered early in
recovery.
Inclusion Criteria:
- diagnosed with concussion/mTBI by ER physician
- speak English as the primary language
- have functional hearing and vision to take the screening measures
- have no prior history of a TBI requiring hospitalization and/or rehabilitation
- have no history of other neurological or psychological diagnoses that would prevent
the completion of the screening measures
- mild to moderate hearing loss with aided amplification
- reading glasses to correct their vision
- bilingual subjects whose primary language is English will be included
Exclusion Criteria:
- do not live in Flagstaff, AZ or the surrounding area making them unavailable for
follow-up screening or therapy
- English is not spoken as the primary language
- have severe hearing loss or vision problems which cannot be corrected with hearing
aids or glasses
- prior history of a traumatic brain injury requiring hospitalization and/or
rehabilitation
- history of other neurological or psychological diagnoses preventing the completion of
the screening sessions
We found this trial at
1
site
Flagstaff, Arizona 86011
Principal Investigator: Emi Isaki, Ph.D.
Phone: 928-523-6117
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