Thread by @nm_gilmore

Proud to announce the final paper of my dissertation is out @ASHAJournals 🎉

Here, we aimed to assess longitudinal performance in language and other cognitive domains important for academic success in young adults with acquired brain injury (ABI) participating in intensive rehab

22 young adults with ABI (#stroke, traumatic brain injury (#TBI), tumor, encephalitis) attended ≥ 12-week semester of the Intensive Cognitive and Communication Rehabilitation program. The program (lectures, individual therapy, tech. training), was held 6 hours/day, 4 days/week.

14 young adults with ABI served as deferred treatment/usual care control participants. All participants demonstrated language and/or other cognitive impairment on a standardized assessment battery (WAB, RBANS, SCCAN, DCT) administered before/after each semester.

Items from the standardized assessment battery were classified into one of ten domains: orientation, attention, memory, problem solving, verbal expression, auditory comprehension, reading, writing, visuospatial/constructional, or limb/facial/instrumental apraxia.

Generalized linear mixed effects models were used to assess for differences in the rate of change between groups in overall item accuracy and on language and other cognitive domains over time. Within-group GLMMs were also conducted to explore gains in each group separately.

We found that

Between-group GLMMs:
1) There was an overall effect of treatment (tx).

2) The tx group improved at a significantly faster rate in verbal expression than the deferred tx control group and showed sig. gains in writing & visuo/const that did not survive correction.

Within-group GLMMs:

3) The tx group improved significantly over time in verbal expression, writing, memory, and problem solving.

4) The control group showed significant gains in auditory comprehension that did not withstand correction.

5) There was no significant difference in the effect of the intervention for participants with TBI vs non-TBI.

6) No evidence of a ceiling or "room to grow" effect. Some domains w/high starting accuracy improved significantly; some domains w/low starting accuracy were stable.

Overall, these findings show that young adults in the chronic phase of ABI can improve in #language and other #cognitive domains with intensive academic #rehabilitation, and to a greater extent, than deferred treatment/usual care control participants with ABI.

They also encourage a paradigm shift in #cognitive #rehabilitation for young adults with #ABI interested in college. It will be important to follow these individuals long-term in the future to understand how the program may support successful completion of a #college semester.

Also, there is a tendency to segregate #SLP intervention by etiology. Yet, this paper shows that individuals with #TBI and non-TBI benefitted similarly from the #intervention—an important finding in that young adults with #stroke often struggle to find a peer group in #rehab.

Full paper here: tinyurl.com/ykpa54zw, including some code 😉 PM me if you need access. Incredibly grateful for the guidance @DanMirman @AphasiaLab & members of the lab provided during the project. Much appreciation to the clinicians & students who helped collect these data.

Finally, thank you to the individuals and families who volunteered their time to participate in the program! Your extraordinary motivation continues to inspire me!

Interested in enrolling in Intensive Cognitive and Communication Rehabilitation? Go here: tinyurl.com/5n6twet6

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