Purpose Language and cognitive disruptions following traumatic brain injury (TBI) can negatively affect written expression and may result in increased difficulty achieving academic, vocational, social, and personal goals; however, scarce literature exists about TBI's effect on writing abilities. The purpose of this qualitative study was to describe the experiences and perceptions of people with TBI regarding their engagement in writing activities. Method A transcendental phenomenological design structured the research. Data collection from 11 adults with TBI included gathering demographic and background information, completion of a TBI Symptom Checklist, and engagement in semistructured interviews. Results Four major themes and 21 subthemes about postinjury writing recovery and current writing status emerged from the data analysis. Participants reported the extent to which writing difficulties interfered with daily activities and identified support strategies used to address persistent challenges. Conclusion Understanding the writing experiences and perceptions of people with TBI can guide professionals in designing assessments and interventions to facilitate educational, vocational, social, and personal success following injury.
Students sustaining mild traumatic brain injuries (mTBIs) face a variety of physical and cognitive difficulties immediately postinjury. Most students overcome these difficulties within a few months, but a portion experience long-term effects (
Purpose: Writing challenges can cause ongoing distress and limit resumption of pre-injury activities following traumatic brain injury (TBI); however, little TBI research or clinical practice addresses written communication. Understanding the writing perceptions and experiences of adults engaged in intensive, inpatient rehabilitation following hospital discharge for TBI is an initial step in addressing this situation. Method: Transcendental phenomenology served to structure this qualitative research. Six adults between 2 and 6 months post-TBI participated in a common experience of writing about a personal memorable event. Standardized test scores and symptom ratings provided descriptive information about participants. Additionally, participants completed the Neurobehavioral Symptom Inventory and NASA Task Load Index and engaged in semistructured interviews to describe writing perceptions and experiences. Results: Data analysis revealed themes and subthemes about writing perceptions, challenges, and support strategies. Participants varied in their perceptions of post-injury writing changes. Test results revealed areas of challenge for all participants, but only half reported awareness of writing changes. Those aware of changes differed from other participants regarding word retrieval, memory, and concentration as well as overall effort expended, frustration, and performance quality. Although all participants relied on writing supports, only one had adjusted multiple writing strategies following injury. Conclusions: Some adults with TBI are aware of writing changes while receiving posthospital, inpatient rehabilitation services, but others deny such changes. This differs from reports concerning later recovery stages, perhaps because few functional writing opportunities arise during rehabilitation. Application of compensatory strategies specific to post-injury writing challenges is unlikely while awareness remains limited.
EmPOWER is a six-stage writing intervention designed by speech-language pathologists to improve the expository writings of school-aged children with language learning and executive function disabilities. The intervention uses scaffolded instruction to transform struggling students into independent and self-regulating writers by training the students to use a variety of supports (e.g., graphic organizers, checklists) and strategies (e.g., referring back to the writing prompt) throughout the writing process. Many key features of the EmPOWER approach to writing instruction directly support components described in cognitive models of writing, which indicates that EmPOWER is a theory-guided writing intervention that may benefit a wide range of individuals beyond just school-aged children. Thus, this analysis provides an overview of the EmPOWER approach, compares the intervention's key features to the most recent conceptualization of the cognitive mechanisms involved in the writing process, and provides a discussion for adapting EmPOWER to a specific population (i.e., people with aphasia).
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