Evaluating social skills following traumatic brain injury: the BRISS as a clinical tool

Deficits in social behaviour are a major obstacle to the reintegration into the community of traumatically brain-injured (TBI) individuals. Recognition of the importance of social skill remediation has highlighted the need for a suitable assessment tool. The TBI population presents particular requirements with respect to the special nature of deficits which commonly occur as a result of frontal lobe impairment. The Behaviorally Referenced Rating System of Intermediate Social Skills (the BRISS) has been shown to have good psychometric properties with a TBI population. It also provides a measure of particular social skills associated with frontal lobe functioning. This study examines the ability of the verbal scales of the BRISS to identify social skill deficits at the individual client level and to detect significant changes in skills following an intervention programme involving five chronic TBI males. In the case of one client, who demonstrated significant clinical improvement in social behaviour, the BRISS was found to identify specific areas of apparent change. The difficulty of using the BRISS as a sole measure of social skills is discussed in the light of relatively large pre-intervention within-subject variability which was found with respect to some behaviours.