Socially appropriate part II: therapy for people with TBI
Reviewed by Anna Volkmer

Social communication is a complex behaviour comprising social and cognitive communication skills. Providing speech and language therapy (SLT) interventions for people with social communication difficulties following traumatic brain injury (TBI) requires the clinician to understand how ingredients from an evidence-based approach can be adapted for the individual they are working with and their environment. Systematic reviews are often not designed to uncover these treatment elements, particularly the hypothesised rationales for why treatment ingredients promote behavioural change, that would enable the clinician to adapt their intervention appropriately. This paper describes a mapping review of the direct social communication literature for adults with TBI analysed using the Rehabilitation Treatment Specification System (RTSS). A total of 21 articles were explored for this mapping review. Articles were examined and a data extraction sheet used to document the RTSS components for each study (i.e. social communication theory, treatment aim, treatment theory or rationale, treatment ingredients, proposed mechanisms of action, and treatment target(s)). Results highlighted that there was a consistent lack of explicit connections between social communication interventions and underlying theories of social communication. Instead treatment theories clustered around five themes: behavioural, cognitive, group process, educational, and psycho-emotional. Overwhelmingly, there was a lack of reporting on mechanisms of action across studies. The review highlights that working in natural contexts, with systematic instruction and practice opportunities, role-play, peer group interactions, as well as education, will support maintenance and generalisation of these types of interventions. The authors advocate that understanding the rehabilitation interventions, the theories that inform the mechanism of action and the key treatment targets will enable speech and language therapists to better collaborate and plan an intervention with a person with a TBI.

Social communication following traumatic brain injury part 2: Identifying effective treatment ingredients.
Meulenbroek P, Ness B, Lemoncello R, et al.
INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY
2019;21(2):128-42.