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TBI Intervention
TBI Intervention, Treatment, & Management
| Taget | Things you can do |
|---|---|
| Orientation to person, place, & time | -provide environmental cues (eg. name tags) -ask questions -SLP starts off directive and becomes less throughout (ex. look at page 5 -> where might you find that?' |
| Attention to & memory for surrounding, events, & communication partners | -name other team members -direct client's attention to distinguishing features -direct client to record events & names -direct client to review written records -ask to converse about people -record progress & provide feedback |
| Memory logbook training | -train client to take logbook to all activities & make entries at the end (minimal -> complete) -train client where to find entries in logbook |
| Memory retention & retrieval stratagies | -train client to use cognitive frameworks (ex.5 WH + H) for listening/reading comprehension -train client to use chunking & imagery to remember sequences (ex. telephone numbers) |
| Comprehension of spoken language | -gain client's attention as naturalistically as possible -Introduce topics of convo before starting/shifting topics -train client to restate to summarize, and ask questions -train convo partners to speak slower |
| Discourse production skills | -make turn-taking & story components explicit -train clients to organize what they want to say prior to speaking -call out when client repeat themselves/go off topic -ask Qs to clarify/provide more details |
| Irrelevant, appropriate, tangential responses | -tell clint what was irrelevant/inappropriate -tell client to stop inappropriate behaviours & remove yourself from close contact -reinforce socially appropriate behaviours |
| Speech production difficulties | -select appropriate interventions for dysarthria/apraxia of speech -Interventions for dysarthria can be direct(target on respiration & increase duration of vowels)/indirect (alphabet board)/environmental (eliminate distracting sounds) |
| Augmentative & Alternative communication Systems | -consider needs, abilities, & affordability of client -does the system need to be upgraded? replaced? alternatives? -work w/ client to select most appropriate device -convo partners need to know how/encourage/understand use |
| Written expression/email/social media use | -formulate written texts -choose written texts of relevance/importance to client -have them practice organizational strategies to formulate written tests -have client practice proofreading on written texts |
| Problem solving, reasoning, executive function skills | -make components of problem-solving & decision making process explicit (identify, apply, pros/cons) -train client to self-monitor themselves through Qs and listen carefully to what they say -ask them to rate their performance on tasks |
| Compensatory strategies | -make certain cognitive activities explicit -ask others to speak slower/write things down -use timers, phones, (physical) signs, sticky notes -keep easily misplaced items in specific places -cover part of written material to focus on one part |
| Establishing routines/positive behaviour supports | -positive momentum (start w/ preferred tasks) -reduction of errors (modify expectations) -escape communication (model & reinforce positive convos ex. 'I need a break') -graphic advance organizers -goal-plan-do-review routine |
| social communication/social skills training | -Interpersonal process recall can be effective -Involves rewire of video samples of client, partner, & sap -Involves identification & modelling of alternative behaviours & guided rehearsal |
| Issues unique to children & adolescents with TBI | -developmental stages must be considered -parents, siblings, grandparents, friends, teachers also affected -specialty paediatric cognitive rehabilitation programs less commons for adults |
| Group Therapy | -most applicable for working on social communication skills & mental health -group size must be manageable for clinicians -members can have different goals -must choose objective, measurable targets & measured at baseline as well throughout |
| Community Re-entry | -difficult for many w/ moderate-sever TBI (cognitive-communication disorders typically persist, lead to family breakdowns) -must be developed into plan of care -must understand client's goals for re-entry, help transitions educate people they interact |
Created by:
mariablv1999
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