Do you have specific suggestions for dealing with vague, tangential or verbose discourse with TBI? How can we train clients to self‑monitor this?
I think most of the work that has been done has actually used videotaping. Actually, we have seen quite a bit of success for individuals who have their own iPhone®s or iPad®s and can video tape themselves in real-time outside of treatment which allows us to look at carryover.
The first step is actually having them self-identify the behavior outside of the moment that it's actually occurring. Of course for some patients this requires quite a bit of prompting from you to get it started. But once they are more consistent with identifying their own behaviors offline, in a video situation, then have them try and problem solve what strategy would work for them. Surprisingly, most patients can do this with some redirection. Then have them take that self-identified strategy and use it in real-time.
Angela Hein Ciccia, Ph.D., CCC-SLP is an Assistant Professor in the Communication Sciences Program, Department of Psychological Sciences at Case Western Reserve University. Her research focuses on the area of social information processing, or social cognition, in the school-age and adolescent TBI population. Clinically Dr. Ciccia sees patients with a variety of neurogenic communication disorders across the lifespan.