Article

OBJECTIVE: To determine whether behavioral interventions are beneficial for
adults with social communication difficulties after traumatic brain injury (TBI).
DATA SOURCES: Electronic databases were searched through October 2013 to find
behavioral intervention trials. Keywords used in our search were intervention,
therapy, treatment, and program combined with pragmatic disorder, pragmatic
impairment, social communication disorder/impairment, conversation
disorder/impairment, social disorder/impairment, cognitive-linguistic and
cognitive-communication deficit; adult; and traumatic brain injury, head injury,
and brain injury. Hand searches of the reference lists of relevant articles were
also conducted. STUDY SELECTION: To be selected for detailed review, articles
found in the initial search were assessed by 2 reviewers and had to meet the
following criteria: (1) population (adults with TBI); (2) intervention
(behavioral intervention); and (3) outcomes (changes in social communication).
Articles needed to describe interventions that were delivered directly to adults
with TBI with or without other people (such as significant others) involved. Of
the 2181 articles initially identified, 15 were selected for detailed review.
DATA EXTRACTION: Data were independently extracted by members of the research
team, then collated and reviewed by the team. DATA SYNTHESIS: Of the 15
publications that met the study criteria, 7 were single-case design studies, 3
were randomized controlled trials, 1 was a nonrandomized controlled trial, and 4
were cohort studies. The methodological qualities of eligible articles were
examined using the Physiotherapy Evidence Database and Single-Case Experimental
Design rating scales. The interventions described in the studies fell into 2
broad categories: those addressing a specific impairment in social communication,
and context-specific interventions with a holistic focus on social communication
skills. Studies using context-sensitive approaches had been published more
recently and were generally group studies with higher methodological quality.
CONCLUSIONS: Overall, interventions addressing social communication skills for
people with TBI were found to be beneficial irrespective of treatment approach
used. While the evidence base is small and with varying levels of scientific
rigor, there is a body of quality evidence that supports the use of
context-sensitive approaches. Further research is still required to determine the
role of impairment-specific versus context-specific interventions when treating
individuals with social communication difficulties after TBI to inform clinical
decision-making.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS