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Traumatic Brain Injury l: Introduction

Traumatic Brain Injury l: Introduction

DefinitionTraumatic brain injury, or TBI, is a disturbance of normal brain function induced by an external mechanical force, such as a direct blow to the head or a penetrating injury. It can affect both brain structure and function, producing a wide range of clinical outcomes. TBI is a heterogeneous condition, meaning its effects may differ based on the type, location, and severity of the injury.Basis of ClassificationTBI is classified based on severity, injury mechanism, or pathophysiology. In...

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Factors Influencing Speech-Language Pathology Referral and Utilization in Mild Traumatic Brain Injury: An Exploratory

Katy H O'Brien¹, Ansley Messina², Yalian Pei³

¹Courage Kenny Rehabilitation Institute, Allina Health, Minneapolis, MN.

American Journal of Speech-Language Pathology

|November 29, 2024

Summary

Speech-language pathology services are crucial for mild traumatic brain injury (mTBI) recovery. Assessments like CCoRI-C and PCSS can help predict which patients need services and how much care they require after concussion.

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Published on: January 20, 2023

Area of Science:

Neuroscience
Rehabilitation Medicine
Speech-Language Pathology

Background:

Mild traumatic brain injury (mTBI), or concussion, can lead to cognitive-communication deficits.
Speech-language pathology (SLP) services are vital for mTBI recovery but may be underutilized in outpatient settings.
Healthcare providers need efficient assessment tools to identify patients requiring SLP services post-mTBI.

Purpose of the Study:

To identify factors associated with SLP service utilization in mTBI patients.
To determine how various assessments predict the amount of SLP services received after mTBI.

Main Methods:

Retrospective chart review of 132 mTBI patients (aged 14-65) treated within 6 months of injury.
Utilized Post-Concussion Symptom Scale (PCSS), Montreal Cognitive Assessment, Standardized Assessment of Concussion, and Cognitive-Communication Referral Indicator for Concussion (CCoRI-C) for referral prediction.
Included Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and Behavior Rating Inventory of Executive Function (BRIEF) scores to predict SLP dosage.

Main Results:

Referrals for SLP services were linked to CCoRI-C, PCSS, imaging, motor vehicle crash injuries, loss of consciousness, and female sex.
Higher CCoRI-C, PCSS, BRIEF, and RBANS scores predicted recommended SLP dosage.
CCoRI-C, BRIEF-Adult Version (BRIEF-A) Behavioral Regulation, and BRIEF-A Metacognition scores correlated with the actual number of SLP sessions attended.

Conclusions:

Cognitive-communication symptoms and executive function are key factors in planning SLP rehabilitation for mTBI.
Further research should explore how assessments, alongside demographic and injury data, can improve decision-making for SLP referrals and service utilization post-mTBI.