General lack of awareness regarding neurogenic communication disorders generally, and cognitive-communicative disorders following a traumatic brain injury (TBI) specifically has resulted in pervasive environmental and attitudinal barriers for these individuals. Paradigm shifts within the rehabilitation context have been highlighted which aim to remove barriers, provide social supports, and thereby enhance their participation in all aspects of life. While collaborative communication partner training programs have been advocated as a means to achieve this, a dearth of published programs is evident within the field of TBI, leading to the need for such programs to enhance the awareness and skill of the communication partner, and reduce barriers for the individual. Transformations are likewise apparent in the corporate context, where in spite of legislative changes encouraging diversity awareness programs for employees, few training programs exist worldwide, and in South Africa particularly, which remove barriers between employees and customers with a communication disability, and a TBI specifically. The current research targeted the retail supermarket environment as a context in which a significant number of everyday communicative exchanges take place. The study investigated the ability of a group of sales assistants to identify barriers to, and facilitators of interaction involving customers with a cognitive-communication disorder, using a control group design. This was achieved by the development and administration of 2 questionnaires on 2 different occasions to determine the confidence and skill with which they identified barriers and facilitators during videotaped sales interactions. A once-off training session was developed and conducted with the experimental group participants, in order to increase their confidence and skill in identifying barriers and facilitators of such interactions. The training session employed a number of customized components considered to be powerful contributors to the positive outcome of the study. These included: extensive use of customized video material professionally produced and comprising real interactions involving individuals with a TBI as “customers” in various stores of the participating national supermarket chain during operating hours. Collaboration with an individual with a TBI in the training, together with use of adult learning and diversity awareness principles were considered effective in shifting previous attitudes and fostering new learning. Inter-and-intra-group results on the confidence and skill constructs of the pre-and-post questionnaires were examined. All pointed consistently to the impact of the training session on the improvement demonstrated in the experimental group as compared to the control group on the post-questionnaires as compared with the pre-questionnaires. In addition all subjective training session evaluations by the experimental group participants were consistently highly rated, reflecting the active participation observed during training. The need for companies to expand their concept of customer service to include an acknowledgement of the customer with a disability is emphasized. Training programs empowering their employees to interact with greater awareness and confidence with customers with a TBI specifically will potentially facilitate deeper participation for both. The current research lays the groundwork for more in-depth research that can be generalized beyond this specific population of individuals with a communication disorder.
Thesis (DPhil (Communication Pathology))--University of Pretoria, 2007.