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Background: Dysarthria, aphasia and executive processes have been examined for their role in producing impaired communicative competence post traumatic brain injury (TBI). Less understood is the role of emotional dysregulation, that is, apathy and disinhibition, and social cognition, that is, reading and interpreting social cues. Methods & Procedures: In this study, we examined 49 adults with moderate to severe TBI and 18 neurologically healthy adults. We hypothesised that apathy and disinhibition would predict communication outcomes as would social cognition. We also predicted that apathy and disinhibition would influence social cognition. Communication outcomes were measured by the La Trobe Communication Questionnaire (LCQ) and the Social Skills Questionnaire‐TBI (SSQ‐TBI). Apathy and disinhibition were measured by the Frontal Systems Behavior Scale (FrSBe). We measured four aspects of social cognition: emotion perception and theory of mind using The Awareness of Social Inference Test (TASIT) and the Complex Audio‐Visual Evaluation of Affect Test (CAVEAT), empathy using the Questionnaire of Cognitive and Affective Empathy (QCAE) and the Balanced Emotional Empathy Scale (BEES), and alexithymia using the Toronto Alexithymia Scale (TAS‐20) and the Bermond–Vorst Alexithymia Questionnaire. Outcomes & Results: Consistent with predictions, the LCQ and SSQ‐TBI were associated with disinhibition and the LCQ was also associated with apathy. The LCQ was associated with the full range of social cognition constructs although the SSQ‐TBI was not. Finally, apathy and disinhibition predicted a number of social cognition measures. Conclusions and Implications: These results are discussed in relation to understanding the nature of communication disorders following TBI and how they are measured, as well as the interrelation between emotion dysregulation and social cognition. What this study adds: What is already known on this subject: The role of emotional dysregulation and social cognition in producing impaired communicative competence post traumatic brain injury (TBI) is not well understood. Although most adults with severe TBI have minimal or possibly no language impairment, they often struggle with functional communication in everyday situations. Many have been reported to be overtalkative, insensitive, childish and self‐centred, displaying an inappropriate level of self‐disclosure and making tangential and irrelevant comments. Conversely, some speakers with TBI have been noted to have impoverished communication, producing little language either spontaneously or in response to the speaker's questions and prompts. What this paper adds to existing knowledge: We found that both apathy and disinhibition were strongly associated with the Latrobe Communication Questionnaire both empirically and conceptually, despite the LCQ being developed from a different, pragmatic orientation. Disinhibition was also associated with the Social Skills Questionnaire for TBI. We also found that poor social cognition scores predicted communication difficulties. Finally, we found that behavioural dysregulation itself, i.e., both apathy and disinhibition, predicted poor social cognition. What are the potential or actual clinical implications of this work?: Our findings highlight the central role that apathy and disinhibition play in both communication and social cognition. These insights point to the importance of remediation to target behavioural and autonomic dysregulation as a means to improve everyday social function. [ABSTRACT FROM AUTHOR]

Background: Training conversation partners of people with aphasia who use facilitative communication strategies is one method that can improve access to healthcare for people with aphasia. However, the efficacy of communication partner training (CPT) has been investigated almost exclusively in the context of face‐to‐face (F2F) delivery. Online training may offer more cost‐effective and accessible options to a wider range of conversation partners, including student healthcare professionals. Aims: To conduct a pilot randomized controlled trial with student healthcare professionals comparing (1) an online aphasia CPT program, (2) a F2F CPT program and (3) no program (control group) on outcomes relating to attitudes and knowledge of aphasia. Methods & Procedures: A 45‐min introductory aphasia CPT program was developed using the theories and techniques of Supported Conversations for Adults with Aphasia (SCA)™. A total of 30 first‐year undergraduates studying occupational therapy at The University of Sydney were randomly allocated to one of three conditions: online CPT delivery, F2F delivery or delayed training control (no program). Outcomes measures included pre‐post‐testing with the Aphasia Attitudes, Strategies and Knowledge (AASK) survey. Outcomes & Results: A significant difference existed for the AASK survey pre‐post‐change scores between the online, F2F and control groups (χ2(2) = 20.038, p = 0.000). Post‐hoc analysis revealed that, compared with the control (Ctrl) group, participants in both the online and F2F groups had significantly higher knowledge of aphasia (Online versus Ctrl: p = 0.000; F2F versus control: p = 0.002), knowledge of facilitative strategies (Online versus Ctrl: p = 0.000; F2F versus Ctrl: p = 0.002), and positive attitudes towards aphasia (Online versus Ctrl: p = 0.031; F2F versus Ctrl: p = 0.032). No significant difference was observed between the online and F2F groups for the Total or any subtotals (p = 1.000). Conclusions and Implications: The results from this pilot randomized controlled trial indicate that online delivery of the 45‐min introductory CPT is equally as efficacious as F2F delivery, and thus may be a viable mode of delivery for future aphasia CPT programs. These pilot results pave the way for a larger study that will comprehensively evaluate the efficacy of an online aphasia CPT program for improving attitudes, knowledge and skills in a broad range of student healthcare professionals. What this paper addsWhat is already known on this subjectThe efficacy of F2F CPT for aphasia is well established. Online delivery of CPT programs may offer more cost‐effective and accessible services when compared with F2F approaches; however, there is a need to explore the efficacy of online programs.What this paper adds to existing knowledgeThe 45‐min online aphasia CPT program was found to be efficacious for improving student healthcare professionals' knowledge and attitudes towards aphasia and communication, and produced equally successful outcomes when compared with F2F delivery. This is the first study to report the efficacy of an online CPT program that is aligned with SCA for use with student healthcare professionals that also uses a self‐report outcome measure with validated psychometric properties.What are the potential or actual clinical implications of this work?Online CPT programs may be useful in both clinical and education contexts to support improved efficiency of services and to enhance communication environments for people with aphasia in healthcare contexts. [ABSTRACT FROM AUTHOR]