Cases reported "Brain Damage, Chronic"

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11/16. Vocational communication Group treatment in an outpatient head injury facility.

    A challenging goal for clients with brain injury is to obtain employment and maintain the position. The New Medico Neurologic System at Nassau (NMNS) focuses on strengthening communication skills prior to placement in the work site. A three-phase programme is described which is designed to assist clients in integrating specific educational training and performance objectives in each. A case study is presented to illustrate a successful outcome. Factors between group components and successful outcomes are discussed, including the programme design, specific strategies and the possible role of self-confidence. Future research is recommended.
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ranking = 1
keywords = communication
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12/16. Incidental teaching for training communication in individuals with traumatic brain injury.

    Although significant gains in acquisition of a variety of skills following traumatic brain injury have been demonstrated, generalization of acquired skills presents a formidable challenge. Incidental teaching procedures refer to a sequence of interactions between a trainer and a learner which take advantage of teaching opportunities that arise naturally in unstructured situations and appear to be particularly applicable to communication deficits common to persons with traumatic brain injury. This paper presents an overview of incidental teaching procedures and a case study in which incidental teaching procedures were utilized in a multiple-baseline fashion across three sequential environments to increase complete requesting skills. Results show that complete requesting increased to nearly 100% of the trials in each new environment upon procedural implementation, compared to extremely low baseline levels. In addition, significant increases in independently initiated, rather than cued, requests occurred within the first few treatment sessions. Implications of incidental teaching procedures and case study results are discussed with suggestions for future research.
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ranking = 5
keywords = communication
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13/16. Whatever happened after the 'return from silence'?

    A case is presented of a child who, following unexpected rapid recovery of functional communication skills 9 months post-severe closed head injury, continued to progress in speech and language skills even 4 years post-injury. Although the child did not recover to premorbid levels of functioning, her recovery over such a protracted period proved quite remarkable. The case is considered in the light of recent findings on the recovery of linguistic skills subsequent to childhood closed head injury.
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ranking = 1
keywords = communication
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14/16. Assessment of pragmatic communication skills in adolescents after traumatic brain injury.

    Deficits in pragmatic communication ability have a significant impact on functional outcome from traumatic brain injury (TBI), particularly during adolescence, when sophisticated social communication skills are developing. There are few published tests designed to assess pragmatic skills in this age group. In the present study, four tasks designed to tap various aspects of pragmatic communication ability were administered to three brain-injured adolescents and 36 of their uninjured peers aged 15-18 years. The tasks evaluated the ability to negotiate, hint, describe a simple procedure, and understand sarcasm. The four tasks were found to tap distinct aspects of pragmatic ability in control subjects. Further, within the control group, task performance was related more to non-verbal reasoning ability than vocabulary skills. Scores for two of the three TBI subjects were poorer than those of their peers, while a third mildly injured subject performed within normal limits. Pragmatic task scores were consistent with the results of neuropsychological testing in the three TBI subjects. Implications for clinical management and recommendations for future research are discussed.
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ranking = 7
keywords = communication
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15/16. Treatment of motor aprosodia with pitch biofeedback and expression modelling.

    In motor aprosodia, imitation and production of emotional prosody and facial gestures are compromised. Despite the frequency with which aprosodia occurs after brain damage, and its potential to cause social and vocational disability, no formal treatments are available for this disorder. A case of motor aprosodia treated with voice pitch biofeedback and modelling of affective communication is presented. Utilizing the patient as her own control, the affective communication treatment was compared to traditional rehabilitation therapy. The results obtained suggest that affective communication treatment has potential in improving affective communication in brain-injured patients. Also notable was the fact that the improvements in emotional expression were stable over a 2-month follow-up period, and could not be attributed to recovery of function as a result of time passage, the effect of traditional rehabilitation, the effect of the extra attention paid to the patient, or examiner bias.
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ranking = 4
keywords = communication
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16/16. Confabulation, memory deficits, and frontal dysfunction.

    This paper explores potential cognitive deficits underlying confabulation of patient, G.S., following an anterior communication artery aneurysm. G.S.'s performance on tasks assessing memory for temporal duration, temporal order, and speaker identification is examined as is his recollection of autobiographical events. We compare G.S. with three nonconfabulating patients matched with him for age, education, and neuropsychological measures of memory and frontal deficits and with three age- and education-matched control subjects. Like frontal control patients, G.S. underestimated temporal durations and showed poor source monitoring (speaker identification). In addition, G.S. showed an even more pronounced deficit in recall of autobiographical memories and relatively more detailed reports of laboratory-induced memories for imagined events. We suggest that this configuration of deficits rather than any single factor accounts for G.S.'s tendency to confabulate.
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ranking = 1
keywords = communication
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