Tutorial: The Speech-Language Pathologist's Role in Return to Work for Adults With Traumatic Brain Injury

Purpose: Return to work (RTW) is a major life participation metric used for persons with a traumatic brain injury (TBI). Speech-language pathologists (SLPs) have clinical expertise in the cognitive-communication aspects of TBI. This clinical focus article aims to support the clinical practice of SLPs by summarizing key interprofessional vocational rehabilitation (VR) models and illustrating the role of the SLP throughout the RTW process with a case study. Method: This clinical focus article was written by the Academy of Neurologic Communication Disorders and Sciences TBI Research Group along with a VR expert. Authors engaged in deliberative, agenda-based discussions beginning with a literature review based on previous systematic studies. Discussions explored relevant VR and SLP practices. Results: This clinical focus article presents key VR models in parallel with SLP assessment and treatment to illustrate best practice patterns in an RTW field with a dearth of SLP-specific literature. We summarize general VR approaches and four evidence-supported VR models for adults with TBI. We highlight how a model of interprofessional assessment can assist with planning and communication of important work-related concerns. We illustrate how the chronological model of work return can assist with developing goals and planning treatment. Conclusions: SLPs play an important role in identifying, managing, and collaborating with an RTW team following TBI. A working knowledge of VR models can assist with improving the dialogue between SLPs and VR professionals and can inform practice when working with persons with TBI who have work return as a goal.

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Overcoming Knowledge Barriers for Inclusion of School-Based Speech-Language Pathologists in the Management of Students with Mild Traumatic Brain Injury

Seminars in Speech and Language ◽

10.1055/s-0040-1701687 ◽

2020 ◽

Vol 41 (02) ◽

pp. 195-208

Author(s):

Katy H. O'Brien

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Mild Traumatic Brain Injury ◽

Best Practice ◽

Speech Language Pathologists ◽

School Based ◽

Assessment And Treatment ◽

Knowledge Barriers ◽

Flexible Knowledge

AbstractSchool-based speech-language pathologists (SLPs) can play an important role in the recovery of children who have sustained a mild traumatic brain injury (mTBI). Two types of knowledge barriers are described here that impact the beliefs and ability of SLPs to respond to the needs of these students. Foundational knowledge is relatively stable over time, and encompasses basic definitions and understanding of the injury. In contrast, flexible knowledge addresses clinical management, including assessment and treatment, and should be regularly updated to align with current best practice recommendations. Clinicians are sensitive to this difference, seeking clinically applicable continuing education. However, general poor understanding of pediatric mTBI paired with rapidly advancing research in the field has led to widespread inaccuracies in both foundational and flexible knowledge. Suggestions are provided for educational initiatives and for advocacy of the role of SLPs in the care of students with mTBI.

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Factors associated with return to work in men and women with work-related traumatic brain injury

Disability and Health Journal ◽

10.1016/j.dhjo.2015.12.002 ◽

2016 ◽

Vol 9 (3) ◽

pp. 439-448 ◽

Cited By ~ 18

Author(s):

Chen Xiong ◽

Tickalyn Martin ◽

Aneesha Sravanapudi ◽

Angela Colantonio ◽

Tatyana Mollayeva

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Return To Work ◽

Men And Women ◽

Factors Associated ◽

Work Related

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Return to work after work-related traumatic brain injury

Neurorehabilitation ◽

10.3233/nre-161370 ◽

2016 ◽

Vol 39 (3) ◽

pp. 389-399 ◽

Cited By ~ 6

Author(s):

Angela Colantonio ◽

Sara Salehi ◽

Vicki Kristman ◽

J. David Cassidy ◽

Angela Carter ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Return To Work ◽

Work Related

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Assessment of Cognitive-Communicative Disorders of Mild Traumatic Brain Injury Sustained in Combat

Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders ◽

10.1044/nnsld19.2.47 ◽

2009 ◽

Vol 19 (2) ◽

pp. 47-57 ◽

Cited By ~ 10

Author(s):

Christine Parrish ◽

Carole Roth ◽

Brooke Roberts ◽

Gail Davie

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Mild Traumatic Brain Injury ◽

Psychological Health ◽

Communication Disorders ◽

Service Members ◽

Patient Questionnaire ◽

Speech Language Pathologists ◽

Test Protocol ◽

Communication Deficits

Abstract Background: Mild traumatic brain injury (mTBI) is recognized as the signature injury of the current conflicts in Iraq and Afghanistan, yet there remains limited understanding of the persisting cognitive deficits of mTBI sustained in combat. Speech-language pathologists (SLPs) have traditionally been responsible for evaluating and treating the cognitive-communication disorders following severe brain injuries. The evaluation instruments historically used are insensitive to the subtle deficits found in individuals with mTBI. Objectives: Based on the limited literature and clinical evidence describing traditional and current tests for measuring cognitive-communication deficits (CCD) of TBI, the strengths and weaknesses of the instruments are discussed relative to their use with mTBI. It is necessary to understand the nature and severity of CCD associated with mTBI for treatment planning and goal setting. Yet, the complexity of mTBI sustained in combat, which often co-occurs with PTSD and other psychological health and physiological issues, creates a clinical challenge for speech-language pathologists worldwide. The purpose of the paper is to explore methods for substantiating the nature and severity of CCD described by service members returning from combat. Methods: To better understand the nature of the functional cognitive-communication deficits described by service members returning from combat, a patient questionnaire and a test protocol were designed and administered to over 200 patients. Preliminary impressions are described addressing the nature of the deficits and the challenges faced in differentiating the etiologies of the CCD. Conclusions: Speech-language pathologists are challenged with evaluating, diagnosing, and treating the cognitive-communication deficits of mTBI resulting from combat-related injuries. Assessments that are sensitive to the functional deficits of mTBI are recommended. An interdisciplinary rehabilitation model is essential for differentially diagnosing the consequences of mTBI, PTSD, and other psychological and physical health concerns.

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