Article

Communication deficits may play a critical role in maintaining
employment after traumatic brain injury (TBI), but links between specific
communication deficits and employment outcomes have not been determined. This
study identified communication measures that distinguished stably employed versus
unstably employed adults with TBI. METHODS: Participants were 31 adults with
moderate-severe TBI who were employed full-time for at least 12 consecutive
months before injury in skilled jobs and had attempted return to skilled jobs
after injury. Sixteen had achieved stable employment (SE) post-injury, defined as
full-time employment for >/=12 consecutive months; and 15 had unstable employment
(UE). Participants completed a battery of communication tests identified in a
prior qualitative study of communication skills required for skilled work.
RESULTS: Measures of spoken language comprehension, verbal reasoning, social
inference, reading and politeness in spoken discourse significantly discriminated
between SE and UE groups. Two nested models were completed and compared. The
first model excluded discourse data because of missing data for two UE and one SE
participant. This model revealed that measures of verbal reasoning speed (beta =
-0.18, p = 0.05) and social inference (beta = 0.19, p = 0.05) were predictive
independent of the overall model. The second model included discourse politeness
data and was a better overall predictor of group membership (Likelihood ratio
test, Model 1: 3.824, Model 2: 2.865). CONCLUSION: Communication measures were
positively associated with SE in skilled jobs after TBI. Clinicians should
include assessment of communication for adults attempting return to work after
TBI, paying specific attention to social inference and speed of verbal reasoning
skills. Implications for Rehabilitation Traumatic brain injury (TBI) often
results in communication impairments associated with the cognitive skills
underlying interpersonal skills. Communication impairment after TBI has been
anecdotally associated with job instability. This research associate
communication functioning with work stability after TBI in skilled jobs. These
findings indicate that communication impairment should be assessed in persons
with TBI returning to skilled employment after injury.

Langue : ANGLAIS