Speak Out October 2020 DIGITAL EDITION FINAL

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Staying connected HOW TELEHEALTH COMMUNICATION GROUPS HAVE HELPED INDIVIDUALS WITH TRAUMATIC BRAIN INJURY (TBI) PRACTICE THEIR SOCIAL COMMUNICATION SKILLS WITH ONE ANOTHER. New ways of working

by Matthew Fong

In the midst of the Coronavirus (COVID-19) pandemic, the resulting lockdown restrictions have resulted in countless people feeling socially isolated. With many of us unable to see our friends or family in person, effective communication skills have never been more important as we seek to connect whilst being physically apart. For individuals who have sustained a traumatic brain injury (TBI), these feelings of social isolation may be magnified during COVID-19 as a result of cognitive-communication difficulties. A cognitive-communication disorder is defined as difficulty with any aspect of communication as a result of a cognitive impairment, such as reduced attention, memory, organisation, problem solving or executive functioning. While basic communication skills are generally intact after TBI, a person’s social communication skills are often affected, which can manifest in difficulties such as lack of eye contact, impaired turn taking, poor topic maintenance and reduced initiation of conversational topics. Most devastatingly, individuals with a TBI can experience diminished social relationships, significantly reduced return to work outcomes, difficulties reintegrating back into the community, and overall, poorer social participation and quality of life. Knowing what we know about the impact of TBI on social participation outcomes, a significant question was posed to rehabilitation clinicians when the first COVID-19 restrictions hit Melbourne in March, 2020—‘"How can we continue to help our clients with their social and community access goals when we were all being asked to stay inside our homes?" At Independent Rehabilitation Services (IRS), we sought to answer this question whilst making the transition to the (relatively) unknown world of providing telehealth services. IRS is a community-based private practice consisting of occupational therapists,

physiotherapists and speech pathologists, based in Ashburton, Victoria. The practice specialises in neurological and general rehabilitation, and clinicians routinely travel to client’s residences, workplaces or their communities in metropolitan and outer suburban Melbourne, in order to help them achieve their functional and participation-related goals. For many of our clients, the first stage of lockdown restrictions were a major disruption to their weekly routines. Many of the social opportunities that they had to practice their communication skills in a functional setting, such as attending local community groups or volunteering at organisations, had been suspended. Regular face-to- face sessions with allied health clinicians were now taking place over a computer screen, and for some clients who were already socially isolated and living alone before COVID-19, this meant that they no longer had anyone who could check in on them physically at home. There was a significant risk that our clients with TBI would now be more isolated and experience greater emotional distress, as a result of the lockdown restrictions. During a one-to-one telehealth speech pathology session, a client raised the question of whether he could be connected with another person who also had a TBI so that he could continue to practice his communication skills with other people. His goal was to remain on topic during conversations, something that he had previously been practising at work but could no longer do due to his workplace being shut down. Although he was still able to practice this skill in telehealth sessions with his speech pathologist, now that he was spending most of his day at home by himself, there was limited opportunity for carry over and he was worried that his social communication skills might regress without regular practice. So, when this

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Speak Out | October 2020