Joint Video Self-Modeling as a Conversational Intervention for an Individual with Traumatic Brain Injury and His Everyday Partner: A Pilot Investigation

Abstract

Impairments in social discourse and self-awareness often compromise exchanges between individuals with traumatic brain injuries (TBI) and their everyday partners [1,2]. Individuals with TBI present with poor presupposition, unclear referents, problems initiating and maintaining topics, topic repetitiveness, interruptions, tangential topic shifts, verbosity or terseness, vague or overly specific explanations, perseverations, and other inappropriate social behaviors [3][4][5][6][7][8][9]. Those pragmatic impairments break social Purpose: This investigation examined the effects of joint video self-modeling (VSM) as an intervention for social interactions by individuals with traumatic brain injuries (TBI) and their close communication partners.Methods: One person with TBI and his everyday communication partner attended 16 intervention sessions, jointly reviewing recordings of conversations from their home and community under the guidance of a coach. Self-reflection was prompted using a hierarchy of prompts ranging from open-ended to direct. Sessions were transcribed and coded based on the conversational purpose of each statement. A mixed methods design was used to collect quantitative and qualitative outcomes.Results: Participants generated appropriate self-assessments of communication behaviors when viewing recorded interactions following prompts from a coach. Pre-and post-measures of social communication identified improvements in self-awareness and self-regulation. While partner' LaTrobe Communication Questionnaire remained stable, ratings increased for the participant with TBI, indicative of increased self-awareness. Measure of Participation in Conversation (MPC) scores for interaction and transaction both improved for the participant with TBI. Likewise, Measure of Skill in Supported Conversation (MSC) scores for acknowledging and revealing competence increased for the partner. Seven broad categories of discourse statements emerged.Conclusions: While this investigation is preliminary, VSM appears to hold potential for increasing self-awareness and improving communication interactions for individuals with TBI and their partners. A reduction in less desirable behaviors by the individual with TBI suggests that prompting self-assessment may foster self-regulatory behaviors. The partner increased positive conversational supports and a reduced set-ups and antagonistic statements.

Description and Effectiveness of Communication Partner Training in TBI: A Systematic Review

“…Of these, one study had 200 participants, 32 two studies had 20-29 participants 33,34 and four studies had five or fewer participants. 30,[37][38][39] The remaining study did not include any people with TBI. 31 There was considerable heterogeneity in sample characteristics.…”

“…Across the eight studies, one study had 200 participants, 32 four studies had 10-64 participants 30,31,33,34 and three studies had fewer than five participants. [37][38][39] Of these, 226 were familiar communication partners (208 spouses/partners of people with TBI, 14 parents, 2 friends and 2 siblings) and 102 were unfamiliar (64 shop assistants,…”

“…Studies used five group designs reported across seven articles [30][31][32][33][34][35][36] and three single-case experimental designs (SCEDs). [37][38][39] The studies were conducted in Australia, [33][34][35][36][37][38] Poland, 32 South Africa, 31 United Kingdom 30 and the United States. 39…”

“…[37][38][39] The studies were conducted in Australia, [33][34][35][36][37][38] Poland, 32 South Africa, 31 United Kingdom 30 and the United States. 39…”

Protocol for a clinical trial of telehealth-based social communication skills training for people with traumatic brain injury and their communication partners

“…A study using the same training programme with support staff found that trained carers were able to facilitate more positive conversations with people with TBI than untrained carers (Behn, Togher, Power, & Heard, 2012). A single case study involving one person with TBI and his spouse using video selfmodelling to target communication partner behaviours (decreased use of testing questions and increased use of memory supports) also showed improvements in the quality of conversations (Hoepner & Olson, 2018).…”