Assessing Cognitive Communication Disorders for Return to Work Following Acquired Brain Injury: A Mixed Methods Investigation of Clinical Experiences and Perspectives

BACKGROUND: Cognitive communication changes are common after acquired brain injury (ABI) and can impact a person's ability to return to and sustain work. AIMS: To understand the practices and experiences of speech-language pathologists (SLPs) involved in assessing cognitive communication skills for return to work (RTW) after ABI. METHODS & PROCEDURES: An explanatory sequential mixed methods design was used, involving sequential data collection points of a benchmarking survey followed by expert opinion focus groups. Descriptive statistics and content analysis were used to analyse the data. RESULTS: Thirty-four SLPs completed an online survey. Six participants took part in focus groups. Findings suggest SLPs are currently involved in assessing the communication skills of individuals aiming to RTW after an ABI, and that they use a variety of approaches, including standardised and informal or dynamic assessments. They may benefit from training resources, and support to integrate into interprofessional teams. CONCLUSION & IMPLICATIONS: This study emphasises the need to prioritise assessing cognitive communication skills for individuals aiming to RTW post injury. While SLPs provide assessment for this population, improving their integration in interprofessional teams, training and detailed clinical resources will be valuable. PRACTITIONER POINTS: SLPs have specialised expertise that can be applied to assessing cognitive communication skills for return to work (RTW). Practice guidelines that are specific to cognitive-communication assessment for RTW are needed to support decision-making and ensure greater practice consistency and confidence. Interdisciplinary collaboration and involvement of SLPs in the RTW process can ensure communication skills are appropriately assessed. WHAT THIS PAPER ADDS: What is already known on the subject It is known that cognitive and social communication changes following ABI can impact a person's ability to return to and maintain work. Existing guidelines, such as the International Cognitive Rehabilitation Guidelines for Cognitive Rehabilitation following Traumatic Brain Injury, models such as the Model of Cognitive Communication Competence and professional associations such as Speech Pathology Australia (SPA) and the American Speech Language Hearing Association (ASHA) support the role of SLPs in assessing cognitive communication disorders that impact return to work (RTW) after ABI. These however, provide general advice rather than specific clinical practice information or training resources. There are a variety of cognitive communication assessments but there is a limited understanding of how these are applied in practice. What this paper adds to the existing knowledge This study identifies current RTW cognitive communication assessment practice challenges and opportunities for improvement. What are the potential or actual implications of this work? Findings provide additional support for the role of SLPs in RTW teams. It provides an overview of what is currently occurring in clinical practice and offers guidance on areas for development including functional assessment approaches and interprofessional collaboration.