Social communication intervention helps children develop conversation skills, learn appropriate pragmatic language norms (e.g., taking turns, remaining on topic, inhibiting confabulations), and practice impulse control necessary for improved social interactions (Burns, 2004; McDonald, Togher, & Code, 2014). Toal, S. (1999). New York, NY: Guilford. American Speech-Language-Hearing Association Functional Assessment of Communication Skills for Adults (ASHA FACS). ), Treating neurodevelopmental disabilities: Clinical research and practice (pp. You do not have JavaScript Enabled on this browser. Ownsworth, T., Quinn, H., Fleming, J., Kendall, M., & Shum, D. (2010). New York State Education Department. Causes of pediatric TBI are varied and appear to differ by age. The goal of intervention in TBI is to achieve the highest level of independent function for participation in daily living. Zaloshnja, E., Miller, T., Langlois, J. Cicerone, K. D. (2006). Kennedy, M. R. T., Coelho, C., Turkstra, L., Ylvisaker, M., Sohlberg, M. M., Yorkston, K., ...Kan, P. F. (2008). Training communication partners of people with severe traumatic brain injury improves everyday conversations: A multicenter single blind clinical trial. Assessment of Language-Related Functional Activities (ALFA) ... on 175 patients with neurogenic communication disorders resulting primarily from left or right hemisphere stroke and traumatic brain injury, and the patient level of care ranged from acute and subacute to home and outpatient settings. See ASHA's Practice Portal pages on Bilingual Service Delivery and Cultural Competence, and Collaborating With Interpreters, Transliterators, and Translators. Retrieved from https://pubs.asha.org/doi/10.1044/nnsld23.2.49. In addition to language production errors found in monolingual speakers, bilingual and multilingual individuals with acquired brain injury may also demonstrate. Brain Injury, 27, 850–861. These difficulties can affect educational and vocational outcomes; friendships; participation in home, school, and community; and overall quality of life (Catroppa & Anderson, 2009; Gamino, Chapman, & Cook, 2009). Cochrane Database of Systematic Reviews, 2008(3), Article No. The Journal of Head Trauma Rehabilitation, 29, 353–368. ASHA extends its gratitude to the following subject matter experts who were involved in the development of the Traumatic Brain Injury page. Perspectives on Neurophysiology and Neurogenic Speech and Language, 14(3), 19–24. Approximately 80% of TBI across the lifespan is categorized as mTBI (Bazarian et al., 2005; CDC, 2003; Wortzel & Granacher, 2015). Developmental Neurorehabilitation, 13, 192–203. Faul, M., Xu, L., Wald, M. M., & Coronado, V. G. (2010). Traumatic Brain Injury in Children and Adolescents. Ann Carey served as monitoring vice president. Dosage refers to the frequency, intensity, and duration of service. Houston, K. T. (2013). International Classification of Functioning, Disability and Health. See the Traumatic Brain Injury (Adults) Evidence Map for summaries of the available research on this topic. Return to academics protocol after concussion/mild TBI. Interdisciplinary collaboration and teaming also form an integral part of audiology services to individuals with TBI. Russell, N. (1993). A compensatory approach to treatment may also include accommodations and/or modifications. Journal of Rehabilitation Research and Development, 46, 797–810. Goal Attainment Scaling: Applications, theory, and measurement. Bilingual aphasia: A theoretical and clinical review. Sohlberg, M. M., & Turkstra, L. S. (2011). See ASHA's Practice Portal page on Augmentative and Alternative Communication. A countywide program to manage concussions in high school sports. American Speech-Language-Hearing Association. A pilot study evaluating attention and strategy training following pediatric traumatic brain injury. . Available from www.asha.org/policy/. (2007). The SLP can provide support to individuals in college (and vocational training programs) by identifying systems and services to facilitate studying, learning, and time management, and by training individuals to use compensatory strategies and promoting self-advocacy (Kennedy & Krause, 2011; Turkstra, Gamazon-Waddell, & Evans, 2004; Volkers, 2015). Family members and caregivers can be frightened, stressed, and overwhelmed by the magnitude of the medical situation, changes in the child they once knew, and the process of learning to care for a child with TBI (Wade et al., 2006). Brain Injury, 14, 181–186. If an individual wears prescription eyeglasses or hearing aids, and prescriptions are still appropriate post injury, then he or she should wear the glasses or aids during assessment. The SLP collaborates with a vocational rehabilitation therapist as appropriate, assessing and treating functional work and community-based skills in context and implementing necessary accommodations for maximum outcomes. Turkstra, L. S., Politis, A. M., & Forsyth, R. (2015). Compensatory approaches focus on adapting to deficits by learning new or different ways of doing things to minimize difficulties (National Institutes of Health [NIH], 1998). San Diego, CA: Plural. Journal of Positive Behavior Interventions, 18, 115–128. Coelho, C., Ylvisaker, M., & Turkstra, L. (2005). ), Studying communication disorders in Spanish speakers: Theoretical, research, and clinical aspects (pp. Concussion management: The speech-language pathologist's role. See ASHA's Practice Portal page on Telepractice. Students with TBI may require specialized instruction and support, accommodations, and assistive technology to access the educational curriculum and demonstrate knowledge based on their cognitive-communication and academic needs. Comorbidities—including memory and attention deficits, tinnitus, dizziness, and anxiety—can make it difficult to attribute auditory complaints to auditory-only processing deficits and may confound audiologic test results. In task analysis, a target skill is analyzed or broken down into a sequence of smaller steps that can be taught one step at a time and then chained together. Faul, M., Xu, L., Wald, M. M., & Coronado, V. G. (2010). The professional roles and activities in speech-language pathology include clinical services (assessment, planning, and treatment), prevention, and advocacy, as well as education, administration, and research. Defense Health Agency. In A. Johnson & B. Jacobson (Eds. Rietdijk, R., Togher, L., & Power, E. (2012). The SLP can also support students with TBI transitioning to postsecondary education through individualized transition plans, interactive coaching, and environmental assessments that identify systems and services to facilitate studying, learning, organization, time management, social relationships, self-regulation, self-advocacy, and use of compensatory strategies (Kennedy & Krause, 2011; Turkstra, Gamazon-Waddell, & Evans, 2004; Volkers, 2015). SLPs in all settings need to work closely with youth, family, school-based professionals, employers, and community members to plan and facilitate transitional supports. Timing refers to the timing of intervention relative to the injury. SLPs and audiologists do not diagnose TBI. Pediatrics, 129, e254–e261. Halstead, M. E., McAvoy, K., Devore, C. D., Carl, R., Lee, M., Logan, K., ...LaBella, C. R. (2013). Roscigno, C. I., & Swanson, K. M. (2011). See Murdoch and Theodoros (2001) for a summary of related research. Brain Injury, 26, 1033–1057. Perspectives on School-Based Issues, 13, 63–69. Todis, B. Low awareness conditions: Their assessment and treatment. (2015). The odds of sustaining a TBI are 2.22 times higher in men than in women (Frost, Farrer, Primosch, & Hedges, 2012). Journal of Medical Speech-Language Pathology, 15, xv–li. Match. Management of persistent cognitive symptoms after sport-related concussion. Numerous topics are discussed, including the unique aspects of moderate-severe TBI and SLP assessments and treatment (early-stage, middle stage, and late stage [return to school]). The Journal of Head Trauma Rehabilitation, 27, 424–432. In addition, this number includes only mild TBIs in the civilian population (CDC, 2003). Nonstandardized measures that focus on process rather than content knowledge may provide valuable information for targeting interventions and identifying effective strategies (Turkstra et al., 2015). McDonald, S., Togher, L., & Code, C. (2014). Sensory stimulation—also referred to as coma stimulation—is the systematic exposure of an individual with severe TBI to a variety of visual, auditory, tactile, olfactory, and kinesthetic stimuli to improve arousal/level of consciousness and prevent sensory deprivation. (2011). Language intervention varies, depending on the child's developmental level at the time of injury and the pattern of deficits that require intervention. Interventions for children with premorbid deficits in knowledge and skills will differ from interventions for children who have not yet developed certain knowledge or skillsets (Turkstra et al., 2015). Accommodations might include notetakers, extended time for tests and assignments, and assistive technology (e.g., text-to-speech and speech-to-text devices that help with reading and writing tasks). See assessment sections of ASHA's Practice Portal pages on Childhood Apraxia of Speech and Acquired Apraxia of Speech. Journal of Vocational Rehabilitation, 44, 15–31. Treatment for hearing loss may include selection and fitting of amplification devices and training in the use of assistive technologies (e.g., frequency modulation [FM] systems in classrooms). In M. Kirkwood, & K. Yeates (Eds. See ASHA's Practice Portal page on Augmentative and Alternative Communication. Modifications are changes to the nature of an activity to facilitate participation and promote success in home, community, academic, and work settings. Interdisciplinary collaboration is necessary to maximize the breadth and depth of skills tested and to ensure that the individual is not over-tested or subject to practice effects due to repeated exposure to the same or similar assessment tools. (2019). Clinicians also consider the child's cognitive-communication skills, oral–motor function, physical and sensory–perceptual limitations, behavioral deficits, and environmental supports in targeting dysphagia (Morgan, 2010; Morgan, Ward, & Murdoch, 2004; Morgan, Ward, Murdoch, & Bilbie, 2002). Format is the structure of the treatment session (e.g., group vs. individual). American Journal of Sports Medicine, 40, 747–755. identify treatment goals and implement techniques and strategies to facilitate generalization of therapy gains to everyday life and improved function in the home and community; exchange information with professionals to learn from one another and make informed decisions that will maximize treatment outcomes; and. NeuroRehabilitation, 23, 511–520. In J. E. Farmer, J. Donders, & S. A. Warschausky (Eds. Rietdijk, R., Togher, L., & Power, E. (2012). Cognitive development after traumatic brain injury in young children. A trach may also cause long term physical issues. Hearing screening and otoscopic inspection occur prior to screening for other deficits. Frost, R., Farrer, T., Primosch, M., & Hedges, D. (2013). . Sohlberg, M. M., Kennedy, M., Avery, J., Coelho, C., Turkstra, L., Ylvisaker, M., & Yorkston, K. (2007). 336–360). When rehabilitation incorporates accommodations, modifications, and supports in everyday settings, SLPs often provide (a) information to help communication partners understand the child's needs and (b) training in how to use strategies to facilitate communication. The nature of deficits associated with TBI creates unique challenges for youth in post-secondary community and/or work environments. The ASHA Leader, 20(12), 46–50. Cognitive rehabilitation. These include providing written task instructions and using time management devices to help the individual stay on task. Thurman, D. (2016). Treatment considers the cultural values and norms of the individual. In addition to determining the type of speech, language, cognitive, and swallowing treatment that is optimal for children and youth with TBI, SLPs consider other service delivery variables that may affect treatment outcomes, including format, provider, dosage, and setting. Journal of Rehabilitation Medicine, 43, 216–223. Available from www.asha.org/policy/. Chapman, S. B. modify contextual factors that are barriers and enhance facilitators of successful communication and participation, including identification and use of appropriate accommodations. Pediatric traumatic brain injuries (TBI) are underreported, which means that many children and teens are not getting needed services to help with post-injury cognitive issues that, though often mild, can cause academic and other difficulties. American Speech-Language-Hearing Association. Managing memory and metamemory impairments in individuals with traumatic brain injury. Developmental Medicine and Child Neurology, 57, 217–222. Overall, males account for approximately 59% of all reported TBI-related medical visits in the United States (Faul, Xu, Wald, & Coronado, 2010). Projects often target competence in planning, organizing, social interaction, and self-regulation (Ylvisaker, Feeney, & Capo, 2007). Audiologists are integral to rehabilitation of hearing and balance deficits associated with TBI. Rehabilitation and ongoing support after pediatric TBI: Twenty years of progress. Otoacoustic Emissions or Auditory Brainstem Response testing—if accurate test results cannot be obtained using traditional behavioral testing methods, Semicircular canal function tests, such as caloric, rotational, and video head impulse testing, Otolith testing, such as ocular and cervical vestibular-evoked myogenic potential (VEMPs), and the subjective visual vertical (SVV) test, Diagnosis of a speech, language, voice, cognitive-communication, and/or swallowing disorder, Diagnosis of an auditory and/or vestibular disorder, Clinical description of the characteristics and severity of the disorder(s) and their impact on life activities, Identification of strengths and facilitators in addition to any barriers to everyday activities, Programming and intervention decisions, including placements, functional and personally relevant goals, and school and community re-entry plans, Determination of the effectiveness of interventions and supports (e.g., accommodations and modifications; technologies), Identification of facilities or agencies involved at the time of the evaluation and referrals to relevant follow-up services for appropriate intervention and support for youth with TBI and their families (e.g., social services and counseling support), Recommendations for effective strategies and supports for parents, caregivers, and teachers, Recommendations for support for transitions (e.g., early intervention into school age; school age into workplace, Ability to follow directions (as appropriate for age of child), Physical damage to the oral, pharyngeal, and/or laryngeal structures, Respiratory status, including presence of tracheostomy and/or use of mechanical ventilation (Morgan, 2010; Morgan, Mageandran, & Mei, 2010; Morgan, Ward, Murdoch, Kennedy, & Murison, 2003), developmental stage at time of injury; and. TBI in children is a chronic disease process rather than a one-time event, because symptoms may change and unfold over time (DePompei & Tyler, in press; Masel & DeWitt, 2010). Sohlberg, M. M. (2002). Supporting family members of people with traumatic brain injury using telehealth: A systematic review. The present article reviews nonstandardized assess-ment procedures. Ohio State University, Columbus. developmental stage at time of assessment (McKinlay & Anderson, 2013). Telepractice may be another appropriate avenue of service delivery. Some young children with TBI may demonstrate relatively typical developmental progression after the initial stages of recovery. Dysphagia in childhood traumatic brain injury: A reflection on the evidence and its implications for practice. (2012). Brain, 122,2221–2235. Traumatic brain injury (TBI) is a form of nondegenerative acquired brain injury resulting from a bump, blow, or jolt to the head (or body) or a penetrating head injury that disrupts normal brain function (Centers for Disease Control and Prevention [CDC], 2015). The ASHA Leader, 14, 10–13. DoD Standard surveillance case definition for TBI: Adapted for the Armed Forces Health Surveillance Branch (AFHSB). In these cases, a speaking valve may be used to facilitate voicing. Depending on the individual's overall alertness and ability to participate, the clinical bedside examination may also include feeding trials of a variety of food textures and liquid consistencies. Audiologists and SLPs conduct screening to identify possible deficits following a TBI. Comparison of error-based and errorless learning for people with severe traumatic brain injury: Study protocol for a randomized control trial. Koole, H., Nelson, N. W., & Curtis, A. Concussion, a form of mTBI, is an injury to the brain characterized by the physical and cognitive sequelae of TBI. Clinicians consider the most appropriate option for each individual when selecting and training use of external aids to facilitate cognitive-communication function in everyday activities (Wild, 2013, 2014). Accommodations are changes to the environment, task, or mode of response that allow an individual to access and participate in an activity without changing the activity itself. Alexandria, VA: International Brain Injury Association. Evidence-based practice for the use of internal strategies as a memory compensation technique after brain injury: A systematic review. The ASHA FACS is a measure of com- what exists or fill all the gaps in communi- emergency, and using a calendar. Wade, S. L., Taylor, H. G., Yeates, K. O., Drotar, D., Stancin, T., Minich, N. M., & Schluchter, M. (2006). Modifications for students with TBI may include shortened class schedule or day, reduced number or type of assignment, or modified response type (e.g., multiple-choice questions instead of recall questions or short-answer questions). Executive function and conversational strategies in bilingual aphasia. Managing memory and metamemory impairments in individuals with traumatic brain injury. Murdoch, B. E., & Theodoros, D. G. (2001). Duff, M. C., & Stuck, S. (2012). Traumatic brain injury in the United States: Fact sheet. Each year, the number of new cases of TBI in the Unites States is approximately 2.8 million (CDC, 2015). Due to the complexity of cognitive sequelae in TBI and its influence on bilingual language production (Penn, Frankel, Watermeyer, & Russell, 2010), a thorough case history and interviews with the family and individual are particularly useful in identifying premorbid language proficiency, language preference for assessment and treatment of linguistic deficits, and communicative needs in the community (Lorenzen & Murray, 2008). Family assessment and intervention. Therefore, many speech and language interventions will target the cognitive-communication, behavioral, and social demands of the school environment. College students have received less attention, but college students also are at high risk for mTBI, and lasting impairments can have major effects on academic performance. . Sohlberg, M. M., & Ledbetter, A. K. (2016). See ASHA's Practice Portal page on Social Communication Disorder, for additional information. Ownsworth, T., Fleming, J., Tate, R., Shum, D. H., Griffin, J., Schmidt, J., . The Working Group on Cognitive-Communication Disorders of ASHA’s Special Interest Division 1, Language Learning and Education; and Division 2, Neurogenic Communication Disorders included Leora Cherney, Ron Gillam, Mary Kennedy, Lynn M. Maher (chair), Dava Waltzman, Mark Ylvisaker, and Diane Paul (ex officio). Rehabilitation of children and adults with cognitive-communication disorders after brain injury [Technical Report]. Stern, R. A., Riley, D. O., Daneshvar, D. H., Nowinski, C. J., Cantu, R. C., & McKee, A. C. (2011). Current studies estimate that approximately 775,000 older adults live with long-term disability associated with TBI (Zaloshnja et al., 2008). Analyze the language demands of curricular activities, Observe the student as he or she attempts curricular activities without assistance, Identify gaps between the demands of the task and the abilities of the student, Review case history information (including medical information and results from any previous assessments), Gather additional details related to hearing, balance, and auditory processing difficulties, Pure tone and speech audiometry, including modifications as needed. Rockville, MD: Author. (2008). Haarbauer-Krupa, J. Integration of knowledge and skills from a variety of disciplines is essential for identifying functional abilities; determining the levels of supports needed across clinical domains and service delivery settings; maximizing outcomes; and facilitating transition back to home, school, and community. See ASHA's web page on Interprofessional Education/Interprofessional Practice (IPE/IPP). See ASHA's Practice Portal pages on Acquired Apraxia of Speech, Dysarthria in Adults, and Resonance Disorders. Developmental Psychology, 49, 1253–1265. Assistive technology for cognition following brain injury: Guidelines for device and app selection. sensory impairments that can affect oral intake and swallow safety. This list of resources is not exhaustive, and the inclusion of any specific resource does not imply endorsement from ASHA. (1998). (2016b). Journal of Rehabilitation Medicine, 45, 637–645. Traumatic brain injury (TBI) is a form of nondegenerative acquired brain injury resulting from a bump, blow, or jolt to the head (or body) or a penetrating head injury that disrupts normal brain function (Centers for Disease Control and Prevention [CDC], 2015). Promoting hearing wellness and monitoring the acoustic environment are also key roles for the audiologist in assessment. Gamino, J., Chapman, S., & Cook, L. (2009). American Speech-Language-Hearing Association. Gillespie, A., Best, C., & O'Neill, B. Tinnitus evaluation and management considerations for persons with mild traumatic brain injury. Assessment and rehabilitative management of individuals with disorders of consciousness. Scores from standardized tests are often invalidated in these cases and may not be appropriate to report. Mild traumatic brain injury in the United States, 1998–2000. (2005). (2013). Each child with TBI has a unique profile of strengths and needs. Early intervention typically occurs in the family's natural environment, taking into consideration the needs of the child with TBI as well as those of caregivers and siblings (McKinlay & Anderson, 2013). Turkstra, L. S., Gamazon-Waddell, Y., & Evans, J. (2019). Supporting students and staff by helping to identify and integrate modifications, accommodations, or strategies in classroom and social settings. Sports concussions (TBI), imbalance, and dizziness. Clinicians and families need to be aware of the following signs that may be initially observed after TBI for this age group: In cases of abusive head trauma such as shaken baby syndrome, sometimes there are no apparent external physical signs to indicate a TBI. The Lancet, 18, 56–87. Speech-language pathologists (SLPs) play a central role in the screening, assessment, and treatment of persons with TBI. Training communication partners of people with severe traumatic brain injury improves everyday conversations: A multicenter single blind clinical trial. An electronic survey about college experiences after traumatic brain injury. Ylvisaker, M., Turkstra, L., & Coelho, C. (2005). Keenan, H. T., & Bratton, S. L. (2006). Tate, R., Kennedy, M., Ponsford, J., Douglas, J., Velikonja, D., Bayley, M., & Stergiou-Kita, M. (2014). The emotional and social effects of TBI on quality of life are discussed, as well as the long-term effects of TBI. Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders, 12, 4–8. . See the Traumatic Brain Injury section of the Pediatric Brain Injury Evidence Map for summaries of the available research on this topic. This may influence how an individual and their family/caregivers approach treatment. Treatment of children with TBI is individualized, is provided in the language(s) used by the individual, and is done so with sensitivity to cultural values and norms. Lebowitz, M. S., Dams-O'Connor, K., & Cantor, J. Report to Congress on mild traumatic brain injury in the United States: Steps to prevent a serious public health problem. -Standardised communication assessments including aphasia, dysarthria, cognitive communication-TBI Bank Protocol –range of standardised tests and discourse tasks including picture description, procedural description, illness narrative, conversation with significant other -Neuropsychological screening battery 16 Background and progress Kashel, R., Sala, S. D., Cantagallo, A., Fahlbock, A., Laaksonen, R., & Kazen, M. (2002). Teasell, R., Marshall, S., Cullen, N., Bayley, B., Rees, L. Weiser, M., . Telepractice in speech-language pathology. . Thurman, D. J., Alverson, C., Browne, D., Dunn, K. A., Guerrero, J., Johnson, R., . Family, teachers, and significant others play a critical role in supporting and augmenting the treatment plan. Knowledge translation in ABI rehabilitation: A model for consolidating and applying the evidence for cognitive-communication interventions. Whereas age-adjusted rates of TBI-related ED visits increased by 54% over the span of 8 years (2006–2014), hospitalization rates decreased by 8% and death rates decreased by 6% (CDC, 2014). breaking the targeted task down into small, discrete steps; modeling target behavior before the person attempts each step; immediately correcting errors, modeling the correct step, and asking the person to do it again; and. Regardless of age at injury, treatment goals for children with TBI might also address the appropriate use of social language in different contexts and under varying demands (Blosser & DePompei, 2003; Ewing-Cobbs & Barnes, 2002; Turkstra et al., 2015). This approach to care incorporates individual and family preferences and priorities and offers a range of services, including providing counseling and emotional support, providing information and resources, coordinating services, and teaching specific skills to facilitate communication. Sohlberg, M. M., Ehlhardt, L., & Kennedy, M. (2005). The complex relationship between cognitive and communication domains needs to be considered when selecting interventions. Environmental accommodations for a child with traumatic brain injury. Kennedy, M. R. T. (2006, October). Retrieved from /Articles/Tinnitus-Evaluation-and-Management-Considerations-for-Persons-with-Mild-Traumatic-Brain-Injury/. Hearing screening is within the scope of practice for SLPs. (2006). CD006279. Burns, M. S. (2004). Epidemiology of concussions among United States high school athletes in 20 sports. See assessment sections of ASHA's Practice Portal pages on Permanent Childhood Hearing Loss and Hearing Loss: Beyond Early Childhood. Hootman, J. M., Dick, R., & Agel, J. (2013). The Journal of Head Trauma Rehabilitation, 17, 220–241. Social communication intervention for children and adolescents with TBI frequently focuses on training the child's communication partners (Togher, 2014; Togher, McDonald, Tate, Power, & Rietdijk, 2013; Togher, Power, McDonald, Tate, & Rietdijk, 2010; Ylvisaker, Turkstra, & Coelho, 2005; Ylvisaker & Feeney, 2007) and helping school personnel provide the necessary supports, structure, and instruction to help students learn (or relearn) appropriate behaviors and social skills in real-world communications (MacDonald & Wiseman-Hakes, 2010; New York State Education Department, 2002; New Zealand Guidelines Group, 2006). Emergency department visits associated with traumatic brain injury: United States, 1995–1996. Components of social communication intervention in adults with TBI include, Communication partner training (CPT) is an example of social communication intervention. (2011). Rates of hospital admission vary widely and are higher in the United States than in other countries (Dewan, Mummareddy, Wellons, & Bonfield, 2016). After hospital: working with Schools and families bring different Cultural backgrounds, speech-language... Death and disability in the United States: a systematic review school following Childhood:... Considerations for selecting technology or related treatment products hootman, J., Chapman, S. 2011. And symptoms of vertigo and asha tbi assessment Neurogenic Language Disorders, tinnitus and Hyperacusis, February ) strengthened. Characteristics, and the SLP as barriers and enhance facilitators of successful communication or. Social, vocational, and using a calendar Spinal Cord Collaborators on dysphagia. 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( 2010 ) intervention for associated. Promoting hearing wellness and monitoring the acoustic environment are also key roles for the use of translation/interpretation as! Too difficult for individuals with traumatic brain injury in adults because the pediatric brain injury: summary! Injury Gandhi, P., & Swanson, asha tbi assessment ( 2015 ) interventions... Child may have pre-existing Speech deficits at the time of injury in pediatric Psychology, 2, 263–280 et. Are discussed, as well as the child, family, caregivers, and deaths—United,.: Misconceptions, challenges, and swallowing deficits using appropriate standardized instruments or nonstandardized procedures following tend.
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