Research Reports - Job stability in skilled work and communication ability after moderate-severe traumatic brain injury

Disabil Rehabil. 2015 May 11:1-10

Meulenbroek P(1), Turkstra LS

PURPOSE: Communication deficits may play a critical role in maintaining
employment after traumatic brain injury (TBI), but links between specific
communication deficits and employment outcomes have not been determined. This
study identified communication measures that distinguished stably employed versus
unstably employed adults with TBI.
METHODS: Participants were 31 adults with moderate-severe TBI who were employed
full-time for at least 12 consecutive months before injury in skilled jobs and
had attempted return to skilled jobs after injury. Sixteen had achieved stable
employment (SE) post-injury, defined as full-time employment for ≥12 consecutive
months; and 15 had unstable employment (UE). Participants completed a battery of
communication tests identified in a prior qualitative study of communication
skills required for skilled work.
RESULTS: Measures of spoken language comprehension, verbal reasoning, social
inference, reading and politeness in spoken discourse significantly discriminated
between SE and UE groups. Two nested models were completed and compared. The
first model excluded discourse data because of missing data for two UE and one SE
participant. This model revealed that measures of verbal reasoning speed
(β = -0.18, p = 0.05) and social inference (β = 0.19, p = 0.05) were predictive
independent of the overall model. The second model included discourse politeness
data and was a better overall predictor of group membership (Likelihood ratio
test, Model 1: 3.824, Model 2: 2.865).
CONCLUSION: Communication measures were positively associated with SE in skilled
jobs after TBI. Clinicians should include assessment of communication for adults
attempting return to work after TBI, paying specific attention to social
inference and speed of verbal reasoning skills. Implications for Rehabilitation
Traumatic brain injury (TBI) often results in communication impairments
associated with the cognitive skills underlying interpersonal skills.
Communication impairment after TBI has been anecdotally associated with job
instability. This research associate communication functioning with work
stability after TBI in skilled jobs. These findings indicate that communication
impairment should be assessed in persons with TBI returning to skilled employment
after injury.

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