Communication after mild traumatic brain injury: a spouse’s perspective

Abstract

Mild traumatic brain injury (MTBI) has gained increasing attention over recent years with much research directed at the nature of persisting symptoms experienced by individuals with MTBI. Owing to the subtle nature of cognitive-communicative difficulties after MTBI, as well as the lack of sensitivity of traditional assessment tools in identifying these difficulties, individuals with MTBI are seldom referred for speech-language therapy services. The need has therefore arisen for the communicative abilities of individuals with MTBI to be assessed in ways other than through the implementation of traditional assessment tools. This preliminary study, for which a qualitative approach with a multiple case study design was adopted, aimed to investigate communication following MTBI from the perspective of a spouse. The spouses of three individuals with MTBI were selected to participate in this study. Semi-structured interviews consisting of two open-ended questions were held with each spouse. The content obtained from the interviews was subjected to a discourse analysis (DA) and the themes that were identified were interpreted within the Model of Social Communication (Hartley, 1995). The results of this study revealed that each of the participants perceived changes in the communication of their spouses since the MTBI. When interpreted within the Model of Social Communication (Hartley, 1995), these communication difficulties were considered to be either the result of impaired internal processes (including impairments in executive control, stored knowledge, subcortical and limbic input or cognition) or the interaction between these impaired internal processes and the environment. The implications of these results regarding the role of the speech-language therapist in MTBI are highlighted. The potential value of the spouse, and the use of DA as both a methodological and clinical tool in the field of speech-language therapy are discussed. Recommendations for future research are made.