Purpose: Traumatic brain injury (TBI) is a non-degenerative acquired brain injury resulting from a blow to the head, a concussion, or a penetrating head injury that disrupts normal brain function. TBI can cause focal, diffuse, or both brain damage. Symptoms may vary depending on the location of the lesion, the extent of brain damage, and the child's age or developmental stage. TBI can result from either a primary injury or a secondary injury. TBI severity can be categorized as mild, moderate, or severe based on the extent and nature of injury, duration of loss of consciousness, posttraumatic amnesia, and severity of confusion at initial evaluation during the acute phase of injury. This review aims to present language, cognitive-communication, and behavioral assessments and intervention methods in pediatric TBI.
Method: A traditional review method was used in this study. The literature review was conducted through the academic database PubMed and the Google Scholar search engine using the terms "pediatric traumatic brain injury" "cognitive communication" "assessment and intervention in pediatric traumatic brain injury".
Results: Comprehensive evaluation of children with TBI is conducted through parent interviews, formal assessments, informal assessments, and behavioral observations. It includes case history, cognitive communication, motor speech, voice, written language, social communication, feeding and swallowing, augmentative and alternative communication systems assessment. Standardized cognitive communication assessments for children and adolescents with TBI are quite limited. It is often difficult to perform a standardized assessment for children with severe TBI. Tests used for children with moderate or severe TBI may not identify the subtle deficits seen in children with mild TBI. Some formal tests used include: Pediatric Test of Brain Injury, Cognitive and Linguistic Scale-CALS, The Behavior Rating Inventory of Executive Function-2nd Edition-(BRIEF2). For children with TBI, speech and language therapists (SLTs) plan interventions in the areas of augmentative and alternative communication system, behavioral, cognitive communication, language, social communication, speech, feeding and swallowing depending on the deficits. Cognitive communication, language and behavioral interventions were discussed in detail within the scope of this review. Cognitive communication interventions include: computer-assisted therapies, direct attention training, drill and practice, dual-task training, errorless learning, external and internal aids, metacognitive skills training, sensory stimulation.
Conclusion: This traditional review thoroughly addresses the definition, classification, etiology, incidence, prevalence, signs and symptoms of TBI, as well as the assessment and intervention practices of SLTs. SLTs are responsible for screening children with TBI for hearing, speech, language, cognitive communication and swallowing difficulties, conducting a comprehensive assessment, and developing and implementing therapy plans that include direct and indirect intervention methods for these children. Therefore, SLTs need to have comprehensive knowledge and experience in the field of pediatric TBI and choose the most appropriate therapy method.
Keywords
pediatric traumatic brain injury, cognitive communication, assessment, intervention
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