Abstract
Purpose: This retrospective case series utilized clinical data mining (CDM) to understand the potential key components in an integrated treatment approach delivered by speech-language pathologists (SLPs) treating adolescents experiencing persistent cognitive effects postconcussion. The first purpose was to describe the profiles of students treated in our clinic, how they were treated, and the nature of multidisciplinary communication. The second purpose was to generate testable hypotheses about effective intervention options for this population.
Methods: Fifteen students aged 13-18 years experiencing prolonged concussion symptoms (PCS) were referred to our SLP graduate training clinic by a local pediatric neuropsychologist for cognitive rehabilitation services. Clinical data mining extracted clinical data in 4 main categories: (a) student characteristics, (b) SLP treatment parameters, (c) clinical outcomes following SLP treatment, and (d) the nature of multidisciplinary communication between practitioners.
Results: Aligned with risk factors for PCS as reported in the literature, data on student characteristics revealed that the majority of students had sustained multiple previous concussions and reported a history of depression/anxiety. Data on SLP treatment parameters identified metacognitive strategy instruction and the training of assistive technology for cognition as the most frequent interventions selected to address academic goals. Data showing the frequency and type of multidisciplinary communication revealed that SLPs communicated most often with the pediatric neuropsychologist and educational liaison. Clinical outcome data revealed that 12 of the 15 students achieved their academic goals at the time of discharge.
Conclusions: Overall, CDM results suggested that when working in a multidisciplinary team, SLPs can provide cognitive rehabilitation, support symptom reduction, and deliver psychoeducation potentially effective for students experiencing PCS. Key treatment and outcome measurement issues important for developing testable interventions are discussed.