The purpose of this study was to examine the use of a descriptive taxonomy for assessment of communicative abilities, the Pragmatic Protocol, in a rehabilitation setting with brain-injured children and adolescents. Eight severely brain-damaged children/youths were assessed with the Pragmatic Protocol during an intensive 6-week rehabilitation period. The nature and extent of communicative functioning was rated independently by a speech language pathologist and a rehabilitation assistant. The data suggests that the number of inappropriate pragmatic behaviours is relatively high, above all regarding aspects of speech/language and nonverbal communication. Interrater agreement reached approximately 95% considering nature of the communicative dysfunction in each patient. Results indicate the use of the Pragmatic Protocol as a useful tool to trace aspects of communicative competence in need of further, detailed exploration. Information concerning intact abilities is clarified and can be used in designing treatment.

Communication in everyday life can be severely affected in adolescence after a traumatic brain injury (TBI). Abilities associated with vocal verbal response, gesture, gaze, facial expression and posture are frequently impaired. While much effort is often invested in clinical assessments, altered communicative functions in a real life setting are explored to a much lesser extent. In this case study, we discuss the usability of a triangulation of methods for analysis, involving a 16-year-old adolescent with TBI. Communication Management (CM) is explored, based on self-evaluation by the participant in video recordings of dyadic and triadic conversations. Ratings created independently by the subject and his parents on The Communicative Effectiveness Index (CETI) are analysed. A comparison is made with a selection of clinical test results on cognition, speech and language. We discuss how the methods can be applied to analyse communicative functions that are not readily detected in a clinical environment.

Communication participation in adolescents with acquired brain injuries (ABI) has received limited attention. The aim of the present study was to investigate the views of the adolescents themselves (N = 8), in comparison to parent evaluations (N = 11) of daily communication, using the Communicative Effectiveness Index in combination with individual interviews. Two frameworks for analyses, Activity based Communication Analyses and the distributed cognition approach, identified three main areas of interest: Situations where communication difficulties occur, Coping behaviours used by participants to manage communication difficulties, and, Causes of the communication difficulties. An overall high agreement between the adolescent and parent assessments was shown. However, complex communicative situations more frequently received lower scores in the parent ratings. The results of the study point to the usability of a systematic comparison of the shared points of views on communication after ABI in adolescence, to increase knowledge about the participation perspective in real life communication.