Assessment and Treatment of TBI

what are slp assessment components?

case history, non speech exam, speech, language, cog communication, swallowing

what would case history look at?

injury details, medical history, language background, goals

what does the non-speech exam involve?

oral-motor function, DDK, tone, movement accuracy

when looking at speech, what should you keep in mind?

quality, intelligibility, stress testing, apraxia markers

with language, what should be looked at?

expressive/receptive, pragmatics, written modality

what would cog-communication look like?

attention, memory, exec function, organization

how might one focus on swallowing?

trials with various textures, safety, oral/pharyngeal phases

what does audiologic and vestibular assessment look at?

reviewing hearing and balance history

behavior

vestibular

auditory processing

behavior testing includes

audiometry, otoacoustic emissions, ABR

why would audiometry, otoacoustic emissions, ABR be behavioral testing?

results are determined based off how the person physically responds such as raising a hand from hearing a sound

what are some vestibular tests?

Dix-Hallpike, VEMP, VNG, Canal function

when you assess auditory processing, what does that involve?

binaural, temporal, speech-in-noise

T or F: you should account for depression, medications, trauma, CTE risk

TRUE; this could influence choice of assessment or treatment

What are other considerations you should think of?

don’t overtest

complete ongoing assessments to track progress and recovery

consider arousal level, motor/sensory limits

with cultural and linguistic assessments, what should you account for?

select tests that respect language/culture background

use descriptive reporting when norms do not apply

assess premorbid proficiency and language use in context

T or F: when applying accommodations, its unnecessary to document them

FALSE: you should document all testing accommodations for the patient to ensure it is accounted for especially for future assessments

TBI treatment principles

promote highest level of independence

ICF-based

account for context/personal factors

modify environment

what would ICF-based principles include?

address body function, activity, and participation

how might you apply person/family centered care?

involve family in goal setting and counseling

incorporate preferences and priorities

provide emotional support and education

make it collaborative

cognitive communication interventions include

sensory stimulation, dual-task training, computer-assisted treatment, metacognitive and strategy based-intervention

dual-task training helps to rebuild _____

executive functioning

compensatory strategies

internal aids

external aids

errorless learning

internal aid examples

mnemonics, visualizations, chunking

external aid examples

calendars, alarms, phones, notebooks

errorless learning examples

model first, list mistakes, fade cues overtime

when training pragmatic skills, what could that look like?

turn-taking strategies, staying on topic

social communication treatments provide

situational coaching/peer training, communication partner training, promote self-identity

speech, voice and swallowing treatment works to

treat dysarthria, apraxia, resonance issues

address neurogenic and psychogenic voice impairments

____ and ______ may affect strategy use

cognition, behavior

how would hearing and balance be treated?

provide amplification/assistive tech/counseling

work on strategies for balance

coping strategies to manage symptoms

Section 504 protections apply in _____

work/school

reintegration in work and school would be performed through

assessing functional impact of deficits

training job and academic skills

promoting self advocacy

how can format vary?

individual, group, or tele practice

can the provider of services be different?

YES; slp, trained caregiver, communication partner

the dosage of treatment can vary based off

tailored to fatigue, in recovery stage, tolerance level

timing and setting of treatment varies on if its _____

inpatient, outpatient, community-based