A modified multimodal communication treatment for individuals with traumatic brain injury

People living with the effects of traumatic brain injury (TBI) might use augmentative and alternative communication (AAC) due to cognitive-communication disabilities and/or co-occurring motor speech disorders. However, the most effective method for teaching people with TBI to use AAC strategies and resolve communication breakdowns is unknown. Prior research conducted with people with aphasia suggests an integrated multimodal treatment improved the use of AAC to resolve communication breakdowns. In this study, the researchers measured the effectiveness of a modified Multimodal Communication Treatment designed to increase communication breakdown resolution and use of AAC strategies by two individuals with TBI. A multiple baseline, single-case design was used to measure outcomes for the two participants who had motor speech disorders and cognitive-communication impairments. They completed four pre-treatment sessions, 20 treatment sessions, and three post-treatment sessions. Dependent variables included the number of AAC strategies produced during a modality probe task and two measures of communication breakdown resolution during a structured, functional task. Both participants increased use of AAC strategies during modality probes, but demonstrated minimal changes in communication breakdown resolution variables, potentially due to their impairments in executive function and memory. Results indicate that modifications to MCT may improve the use of AAC strategies for communication breakdown resolution for some people with TBI.