Development and Evaluation of a Clinical Assessment Tool of TBI-Related Social Communication

TITLE: Development and Evaluation of a Clinical Assessment Tool of TBI-Related Social Communication
Adults with traumatic brain injury (TBI) are at risk for communication impairments that negatively affect return
to work, family, and community roles. TBI-related social communication impairments (TBI-SCI) are
characterized by ineffective, disorganized, and inappropriate verbal communication and reduced capacity to
understand others’ non-literal and non-verbal messages. Despite the importance of social communication to
daily life, TBI-SCI are under-diagnosed and under-treated because speech-language pathologists (SLPs) lack
clinical assessment tools that are quick, reliable, valid, and inform person-centered treatment planning. The
objective of the proposed K23 career development award is to address this gap by developing, refining, and
evaluating patient- and caregiver-reported TBI-SCI assessment tools that meet the needs of SLPs and adults
with TBI. Patient-reported outcome measures facilitate personalized rehabilitation and rigorously assess
health-related outcomes and treatment effects. Guided by person-centered rehabilitation theory and existing
assessment tools, we will conduct a prospective qualitative study to identify social communication skills and
mediating factors that stakeholders (adults with TBI, family members, and SLPs) perceive as important to TBI-
SCI rehabilitation. Findings will inform the content and structure of parallel patient- and caregiver-reported
clinical assessment tools. We will refine the tools using iterative cognitive interviewing to ensure the tools
capture the most important factors to TBI-SCI rehabilitation (i.e., are content valid) and are easy to
comprehend. Preliminary psychometric testing will be conducted on tool responses from a diverse sample of
100 adults with TBI and 150 caregivers to evaluate tool validity and reliability. This work supports NIDCD’s
strategic priority to develop and test improved diagnostic tools that will provide communication treatment
targets and will inform a subsequent R01 application to conduct large-scale psychometric testing and to test
the feasibility of clinical implementation. Completion of the proposed research and career development
activities will equip Dr. Byom with in-depth knowledge and comprehensive training in clinical assessment tool
development, including qualitative research methodology, quantitative tool evaluation, and principles of
implementation science. With this training, Dr. Byom will be uniquely poised to translate her training in social
communication theory, TBI-SCI, and clinical TBI communication rehabilitation to development and evaluation
of clinically feasible SLP practices to support adults with TBI.

Grant Number: 5K23DC020244-05
NIH Institute/Center: NIH
Principal Investigator: Lindsey Byom