Developing a Social Communication Screener for Traumatic Brain Injury

Purpose: While speech-language pathologists (SLPs) play a pivotal role in identifying and treating social communication impairment in traumatic brain injury (TBI), there has been limited adoption of standardized assessments. SLPs report a lack of time as well as a lack of competence in the administration of social communication assessments as primary barriers. Developing a feasible and valid screening tool may help to address these barriers. The present study investigates a transcription-less rating scale as a screening tool for social communication impairment in TBI. Method: In a single-blind study, N = 38 graduate clinicians listened to and rated 6-min conversation samples from 10 speakers (five TBI speakers and five control speakers [neurotypical]). Graduate clinician ratings were analyzed to determine if there were between-group differences in TBI and control speakers' conversations and whether raters had high agreement regarding speaker impairment. In addition, social communication ratings from the screener were compared to a gold standard of social communication measurement derived from transcribed analysis of the conversation samples. Results: Graduate clinicians significantly differentiated TBI from control speakers using the transcription-less rating scale, and the ratings corresponded to patterns identified in the transcribed analyses. Given an exploratory “cutoff” score, raters identified TBI speakers with 80% accuracy. Conclusion: These preliminary findings indicate that a brief, transcription-less rating scale holds promise to screen for social communication impairment in TBI to determine whether further assessment is warranted.