It's a changing landscape: Complexity and innovation in cognitive‐communication rehabilitation for people with acquired brain injury (ABI)

Abstract

An acquired brain injury (ABI) has an impact across almost all areas of an individual's life, including their relationships, community engagement, education and vocational participation. Cognitive-communication disorders (CCD), defined as communication dysfunction resulting from underlying cognitive impairments (Togher et al., 2023), present a major barrier to people with ABI participating in successful and enjoyable communication across family, social and work contexts. It has been estimated that CCD are experienced by over 75% of people with an ABI (MacDonald, 2017), and present predominantly as social communication difficulties ranging from impoverished communication through to excessive talkativeness (Togher et al., 2023). At a global level, it is estimated that 50 million people worldwide sustain a traumatic brain injury (TBI) each year (Maas et al., 2017) and that 12.2 million people have a stroke each year (Feigin et al., 2022), which are the two most common aetiologies of ABI. At an individual and at a global level, there is an urgent need to deliver appropriate, evidence-based and accessible clinical services to support people with CCD. There are several factors that create complexity in addressing this need. Firstly, CCD are heterogeneous, chronic conditions with a longterm impact on a person's life, which require a flexible and individualised approach. Furthermore, rehabilitation for CCD involves complex interventions (Campbell et al., 2007) involving different components which may be interdependent, and which may not be well-defined. Finally, there can be challenges in implementation of evidencebased interventions into real-world clinical contexts, due to contextual or systemic barriers. This special issue of the International Journal of Language and Communication Disorders reports on research studies that have engaged with these complexities and highlighted potential new pathways towards improved support for people with ABI.