Teletherapy for Concussions & Traumatic Brain Injury Treatment

Concussions and Traumatic Brain injuries (TBIs) occur when there is a bump, blow, or injury to the head. These traumas can range in severity from a mild concussive TBI to a severe catastrophic TBI. Each severity level can experience different symptoms and difficulties unique to each casualty.

Generally, TBI’s can cause speech, language, memory, thinking, executive functioning, and swallowing issues. These impairments may translate into daily struggles with school, work, and everyday life activities. TBIs are a serious public health concern associated with significant impairments and if left untreated can result in a lifelong disability. Seeking treatment with a Speech-Language Pathologist (SLP) can provide the tools and tips needed to improve one’s quality of life.

Recently there is a growing number of professional organizations beginning to use the teletherapy service delivery model to treat TBIs. Teletherapy for TBI sufferers provides increased access to SLP services, facilitates a greater continuum of care and enhances patient outcomes.

Teletherapy entails rehabilitation through a safe, secure, video-conferencing platform to provide services remotely. The clinician and the client will engage in auditory, visual and verbal interactions similar to a face-to-face therapy session. As the road to improved communication for TBI sufferers is a long one; teletherapy reigns as a great option for ongoing, consistent, convenient, effective treatment.

Related article: Teletherapy… Is It For Me?

 

Considerations for TBIs and Teletherapy

To benefit the most from teletherapy some considerations must be made. Proper selection for teletherapy services specific to TBIs should be based on patient factors, such as:

• Physical and sensory abilities (vision & hearing)
• Cognitive, behavioural and motivational characteristics
• Communication skills and auditory comprehension
• Availability of technology, resources and support

In addition, your clinician will consider each patient’s unique set of needs, severity of injury, specific deficits, and rehabilitation goals to determine if teletherapy is the right option. If the patient does not fulfill all of the above criteria, an aid or family member may be able to help facilitate successful teletherapy. 

 

Proper TBI Assessment

In order to determine candidacy for regular teletherapy one must first receive a proper assessment. A typical assessment for TBI would be conducted face-to-face. However, new research shows that this assessment can be done remotely. Published peer-reviewed studies show an equivalent assessment in intervention outcomes across teletherapy and in-person services. Results for TBI assessments reveal an inter-rater agreement of 80-100% for reliability in teletherapy conditions.

Once a client has been determined appropriate for teletherapy an assessment is vital. A teletherapy assessment is said to be less stressful and tiresome and allows a more accurate picture of strengths and weaknesses. Planning, organizing and travelling to a face-to-face appointment can be extremely challenging for TBI clients. Therefore, a teletherapy assessment might be a more appropriate choice in these cases. 

 

Teletherapy Rehabilitation Sessions

Positive gains have been recognized when TBI clients access regular teletherapy. These positive effects have been seen in a generalization of behaviour, functional outcomes, self-management, work/school results and client satisfaction. Neurorehabilitation via teletherapy can potentially enhance the timing, frequency, and duration of services. Other noted benefits of teletherapy for TBI clients are as follows:

• Cost-effectiveness   
• Generalizing treatment effects
• Increasing the quality of care
• Supporting and optimizing functional outcomes
• Uninterrupted treatment flexibility
• And a less restrictive, natural environment

When teletherapy is used properly and optimal outcomes are achieved this can increase the TBI sufferer’s quality of life. It will also familiarize them with technology, assist them in attaining independence, and set them up for more promising future work and home prospects.

 

Conclusion

Millions of new TBI cases arise annually that have many associated deficits from mild to severe. Implications of findings outline that similar treatment outcomes can be achieved for TBI clients using teletherapy. Teletherapy can also address SLP shortages, financial constraints, inadequate transportation, and limited physical access to quality services. Occasionally, some individuals may benefit from initial clinic-based cognitive rehabilitation or a technology training session before transitioning to teletherapy.

At Therapy Spot, we have a skilled team of clinicians who can assess your specific case and determine if you are right for a teletherapy approach. If you are interested in learning more about teletherapy, please do not hesitate to contact us at 416-546-3044 for a free 15-minute consultation.

Related article: Teletherapy for Children: Childhood Reading, Writing & Literacy

 

Reference:

Bergquist, T., Gehl, C., Mandrekar, J., Lepore, S., Hanna, S., Osten, A., & Beaulieu, W. (2009). The effect of internet-based cognitive rehabilitation in persons with memory impairments after severe traumatic brain injury. Brain Injury, 23(10), 790–799. DOI: 10.1080/02699050903196688

Coleman, J. J., Frymark, T., Franceschini, N. M., & Theodoros, D. G. (2015). Assessment and Treatment of Cognition and Communication Skills in Adults With Acquired Brain Injury via Telepractice: A Systematic Review. American Journal of Speech-Language Pathology, 24(2), 295–315. DOI: 10.1044/2015_ajslp-14-0028

Dial, H., Hinshelwood, H., Grasso, S., Hubbard, H. I., Gorno-Tempini, M.-L., & Henry, M. (2019). Investigating the utility of teletherapy in individuals with primary progressive aphasia. Clinical Interventions in Aging, Volume 14, 453–471. DOI: 10.2147/cia.s178878

Edwards, M., Stredler-Brown, A., & Houston, K. T. (2012). Expanding Use of Telepractice in Speech-Language Pathology and Audiology. The Volta Review, 112(3), 227–242. DOI: 10.17955/tvr.112.3.m.704

Hines, M., Lincoln, M., Ramsden, R., Martinovich, J., & Fairweather, C. (2015). Speech pathologists’ perspectives on transitioning to telepractice: What factors promote acceptance? Journal of Telemedicine and Telecare, 21(8), 469–473. DOI: 10.1177/1357633×15604555

Mashima, P. A., & Doarn, C. R. (2008). Overview of Telehealth Activities in Speech-Language Pathology. Telemedicine and e-Health, 14(10), 1101–1117. DOI: 10.1089/tmj.2008.0080

Sicotte, C., Lehoux, P., Fortier-Blanc, J., & Leblanc, Y. (2003). Feasibility and outcome evaluation of a telemedicine application in speech-language pathology. Journal of Telemedicine and Telecare, 9(5), 253–258. DOI: 10.1258/135763303769211256

Theodoros, D. (2012). A new era in speech-language pathology practice: Innovation and diversification*. International Journal of Speech-Language Pathology, 14(3), 189–199. DOI: 10.3109/17549507.2011.639390