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BACKGROUND: Adults with TBI often report reduced social participation and loss of friends, but little is known about quality of friendship after TBI. Our objective was to characterize social participation, friendship quantity, and friendship quality of adults with traumatic brain injury (TBI) and a comparison group of uninjured adults. METHODS: Participants included 18 adults with moderate to severe TBI and 16 of their informant friends; 18 uninjured adults and 11 of their informant friends. The main measures used were the Participation Assessment with Recombined Tools-Objective (PARTO), the Social Network Questionnaire (SNQ), and the McGill Friendship Questionnaire (MFQ). RESULTS: Participants with TBI reported significantly less social participation. The adults with TBI had fewer total friends, although this difference was not statistically significant. Adults with TBI differed from their friends on one measure of friendship quality, but reports for friendship quality were high in both groups. CONCLUSION: Adults with TBI overall reported high levels of friendship quality despite having lower levels of social participation compared with uninjured adults. Future research should investigate the how the balance of quantity and quality of friendships relates to satisfaction with social participation and overall quality of life.

Considerable effort has been directed at understanding the nature of the communicative deficits observed in individuals with acquired brain injuries. Yet several theoretical, methodological, and clinical challenges remain. In this article, we examine distributed cognition as a framework for understanding interaction among communication partners, interaction of communication and cognition, and interaction with the environments and contexts of everyday language use. We review the basic principles of distributed cognition and the implications for applying this approach to the study of discourse in individuals with cognitive-communication disorders. We also review a range of protocols and findings from our research that highlight how the distributed cognition approach might offer a deeper understanding of communicative mechanisms and deficits in individuals with cognitive communication impairments. The advantages and implications of distributed cognition as a framework for studying discourse in adults with acquired brain injury are discussed.

The assessment of individuals with cognitive-communication disorders after traumatic brain injury can present a major challenge to speech-language pathologists. For this reason, the Academy of Neurologic Communication Disorders and Sciences Practice Guidelines Group dedicated a specific writing committee to this topic. This article summarizes the writing committee's efforts related to the use of standardized, norm-referenced tests. The article begins with the key questions speech-language pathologists might ask in choosing a standardized test. We then provide a summary of the results of the writing committee's data-gathering activities and a brief description of the tests that appeared to meet most established criteria for validity and reliability for use with this clinical population. The article concludes with the identification of areas in which instruments and additional normative data are needed.

Mark Ylvisaker inspired many people to believe they had the skills to help children and adults with brain injury live a meaningful life. He was thoroughly multidisciplinary in his approach, but also felt strongly that communication was the cornerstone of effective behavior management and that speech-language pathologists could make a unique contribution in the everyday lives of individuals with cognitive-communication disorders. This article recognizes his profound influence on the author's research, teaching, and clinical practice and was written in the spirit of paying forward the knowledge he shared.

Specialists in communication disorders who work with individuals who have traumatic brain injury (TBI) often focus their rehabilitative efforts on the cognitive, social, and behavioral dimensions of disability. These domains of functioning are included in the scope of practice of the American Speech-Language and Hearing Association because of their close associations with communication effectiveness. This article summarizes relevant research findings and clinical perspectives in the areas of intervention for disorders of behavioral self-regulation and social-interactive competence after TBI. This clinical summary is associated with a systematic evidence review sponsored by the TBI Practice Guidelines Group of the Academy of Neurologic Communication Disorders and Sciences (ANCDS).

Nonstandardized assessment procedures serve a variety of purposes, including determining competencies in domains for which there are no standardized tests, describing performance in the context of real-world settings and activities, and exploring the effects of systematic changes in communication and cognitive demands and partner supports. This article reviews evidence on the use of nonstandardized procedures for the assessment of individuals with traumatic brain injury and offers recommendations for the use of the procedures that are supported by the available evidence.

Historical approaches to memory therapy have focused on rehearsal or "relearning" of memory skills and on compensation for impairments. Whereas the use of rehearsal-based approaches has received little empirical support, the use of external compensatory devices has proved helpful to patients with a variety of neurogenic communication disorders. More recent approaches have capitalized on advances in cognitive psychology, permitting the identification of strengths and weaknesses in specific memory functions, and increasing our understanding of the role of response errors in the therapy process. These advances, together with applied behavioral analysis, allow therapy to be tailored to the cognitive profile of an individual patient, and help explain the successes and failures of earlier techniques. In this article, both historical and current approaches are discussed, and memory therapy guidelines are suggested.