Introduction: Current tools available to assess pragmatics in people with a TBI are difficult to access, not person-centred and have a high risk of clinician bias. The Pragmatics Profile of Everyday Communication Skills was revised in 2020 and is a freely available online pragmatic assessment tool that responds to the limitations of current tools. The revised version was created by a group of clinicians working in the disability sector.
Aim: To adapt the Pragmatics Profile for people with TBI based on recommendations and consensus from experienced clinicians and researchers in the field.
Methods: A three-round modified Delphi methodology was used and included a panel of sixteen experts. Participants were invited to comment anonymously on the suitability of each question from the Pragmatics Profile. Responses were analysed using descriptive statistics and thematic analysis until ≥ 80% agreement was reached.
Results: Thirteen participants completed round one, nine completed round two and ten completed round three. Consensus was achieved on all 64 questions from the Pragmatics Profile after three rounds. Qualitative analysis illuminated themes of modifying the tool to be appropriate for adults with TBI and their specific pragmatic difficulties as well as ensuring accessibility and useability for speech pathologists with different levels of experience.
Conclusions: The outcome of this project was a freely available, online, revised version of the Pragmatics Profile that is well suited to the TBI population. The project highlighted the utility of adapting disability-developed assessment tools for the TBI population.
Keywords: Traumatic Brain Injury, Assessment, Pragmatics,
Submission Statement:
Our study responds to the need for pragmatic assessment tools that consider the personal contexts of people with communication difficulties following a brain injury. The tool’s creation responds to the needs of clinicians and represents an advancement of pragmatic assessment practices for clinicians working with brain injury.

Introduction: Individuals with cognitive-communication disorder (CCD) after right hemisphere stroke (RHS) struggle to communicate effectively in everyday interactions such as conversations. Conversations enable us to engage in valued life activities such as maintaining personal relationships and work, therefore CCD can have a devastating impact on the individual, family, and friends. Despite conversation being underpinned by both discourse comprehension and production, research to date appears to focus on discourse production alone. This study examined discourse comprehension abilities in people with CCD after RHS compared to neurotypical controls and explored the association between cognitive and discourse comprehension abilities.
Method: Two groups of participants completed the Discourse Comprehension Test and cognitive measures of memory, attention, and executive function. Eighteen individuals with CCD after RHS (mean age 65.9±9.2 years) were matched for age, gender, and education to a group neurotypical controls (mean age 67.9±7.9 years).
Results: The groups differed significantly in overall discourse comprehension abilities (p<.001). MANOVAs revealed individuals with CCD scored significantly lower on questions about story details and main ideas (p=.003), and stated and implied content within stories (p=.001). Of the cognitive measures only short-term memory abilities were significantly correlated with discourse comprehension abilities.
Conclusions: Inclusion of discourse comprehension assessment in post-stroke care should be a standard for people with CCD after RHS. Analysis of error patterns highlights comprehension deficits are beyond understanding the gist of discourse and inferred language, but also comprehension of details. Further investigation of the role cognitive abilities such as memory may play in discourse comprehension is warranted.


Keywords - stroke, cognitive-communication disorder, discourse, cognition

Submission Statement: Practitioners working clinically with stroke clients know the impact that communication changes after right hemisphere stroke can have on the person, family and friends. Reflecting on the absence of an evidence base to support this population, this team is responding to cry for research to guide practice.

Introduction
Attention and communication are concepts familiar to speech-language pathologists (SLPs) within neurorehabilitation, however, the nature of this relationship continues to be a challenge when discerning the specific role of each type of attention on the resulting communication difficulty following traumatic brain injury (TBI).

Aim
This study aimed to explore the relationship between attention and communication, and create a guide for clinicians to connect communication difficulties with the corresponding clinical attention skill.

Methods
A mixed method was used to capture the perspectives of health professionals through an international survey and two focus groups. Reflexive thematic analysis was used to analyse the qualitative data, and cumulative percentage was used to analyse the quantitative data.

Results
The survey had 164 respondents, who were largely SLPs (63%) with the remainder being allied health professionals from all disciplines within neurorehabilitation. The participants were from seven countries, with the majority from New Zealand. Three qualitative themes were generated that define the communication skills most related to attention being 1) social communication 2) discourse, and 3) linguistic abilities.

Conclusions
Despite wide-ranging views on the array of communication behaviours that could be related to attention, there was general agreement and confirmation that attention is the foundation for effective communication. This presentation will summarize the findings in a dynamic and visual form to guide SLPs in their clinical practice when working with clients following TBI. Specifically, it will add clarity for SLPs discerning the best way to approach the connection between communication and attention.

Keywords: Attention, Cognitive Communication, TBI, Discourse, Social Communication

Submission Statement: This abstract is part of a larger project that has responded to the gap in the literature related to how SLPs identify and treat attention-related communication difficulties following TBI. This project uses practice base evidence and respects that health professionals knowledge and perspectives represent the immediate need within practice.

Introduction / Rationale: A significant number of Australian children and adolescents experience cognitive-communication disorders (CCDs) from mild- moderate-, and severe traumatic brain injuries (TBIs) each year. The assessment of CCDs is an important part of clinical practice, however to date there has been no investigation into the barriers and facilitators that clinicians encounter when performing this activity with paediatric populations.

Aim(s): To explore Australian SLPs’ measurement practices when assessing CCDs in children and adolescents with TBI; and (2) to understand the barriers and facilitators to optimal assessment using the Theoretical Domains Framework.

Methods: SLPs undertook an online, cross-sectional survey containing quantitative and qualitative questions informed by behaviour change theory. Results were analysed using descriptive statistics and qualitative content analysis.
 
Results: Participating SLPs (n = 111) reported measuring 28 constructs with 52 unique measurement instruments. SLPs’ professional role, identity and optimism were reported to be facilitators of CCD assessment, while behavioural regulation and emotion were barriers. That is, SLPs reported optimism for the value and benefits of CCD assessments in children and adolescents with TBI and identified themselves as important professionals in this clinical activity. SLPs identified the need for more tertiary training and professional development opportunities, regardless of workplace sector or years of experience.

Conclusions:  Results from this study reinforce the need for more research on the topic of paediatric CCDs, and ultimately, the need for greater guidance to inform the ongoing measurement that occurs across a child or adolescent’s rehabilitation and developmental journey following their TBI.

Keywords: Cognitive-communication, assessment, paediatric, traumatic brain injury, measurement

Submission statement: This presentation will reflect and respond to the needs of the significant number of Australian children and adolescents that sustain CCDs each year, as well as the needs of SLPs who support this population despite a lack of comprehensive guidance to inform this complex area of clinical practice.

Background:
Augmentative and alternative communication (AAC) is often used to address communication changes following an acquired brain injury (ABI). Speech pathologists play a key role in assessing and supporting the AAC needs of people with ABI. To date, however, there has been no Australian research investigating the perspectives of speech pathologists working with people with ABI using AAC.
Method:
A qualitative research design with semi-structured interviews was used. Seven Australian speech pathologists were interviewed and a thematic analysis was conducted. One co-researcher contributed reflections on the data as a person with lived experience of ABI and AAC use.
Results:
Seven themes were identified, related to four of the five domains of the World Health Organisation’s 5P Assistive Technology Model. Themes included that AAC introduction needs to be person-centred; consideration of both cognitive-behavioural changes and adjustment, grief and loss must be considered; AAC needs to be supported in environments in which it is to be used, can include both mainstream and specialised products, and is part of a suite of communication strategies for people with ABI; and timely and adequate access to ACC product and service funding is necessary.
Conclusion:
This research provides clinical insights for AAC provision, and lived experience reflections of AAC use after ABI. Considerations for the person, AAC products, personnel and policies are highlighted.

Background and context: Technologies like Augmented and Virtual Reality (AR/VR), smart speakers, and eye gaze have a growing role in communication, education, leisure, and workplace activities. Speech pathologists lack familiarity and opportunity to “get their hands on” these devices. However, with increased exposure, speech pathologists can become more involved as new applications are co-designed for use with populations with communication or swallowing disability.

Learning outcomes:
(i) learn about VR/AR, Smart Speakers, and Eye Gaze tech by using these devices.
(ii) identify key relevant features of technologies and software applications.
(iii) understand how to trial these technologies with people with communication disability.
(iv) together, create a feasible strategy for the adoption of innovative technologies in clinical practice based on an understanding of local barriers and facilitators.

Assumed knowledge or experience: None.

Outline of activities: Participants will test and trial VR/AR, Smart Speakers, and eye-gaze technologies in small groups, supported by workshop team members. Each group will create and demonstrate an activity to illustrate how they consider the device could be used in a clinical session. A large group conversation will focus on building a feasible strategy for implementing more of these technologies into clinical practice, including troubleshooting and identifying solutions to support technology access.

Implications for practice: Experience and confidence will support speech pathologists to adopt and implement new technology as it emerges. The skills and knowledge to overcome barriers will enable clinicians to support their clients with communication disability to access information and communication technologies, and associated opportunities for participation.

Keywords: Technology, Communication, Access, Implementation, Innovation

Submission Statement: The workshop will involve hands-on experience with innovative technology to encourage informed and guided reflection on technology implementation. Participants will develop knowledge in technology, respecting the right of people with disability to access technology. They will overcome challenges, providing responsive services in an evolving technological landscape.