Traumatic brain injury (TBI) is the leading cause of disability among young adults in the United States. A major negative outcome from TBI is loss of employment, which is a source of diminished quality of life and economic stress for TBI survivors, their families, caregivers, and society, which often has to bear the costs. There is clear evidence that communication skills are important for successful employment in general, but little progress has been made in specifying the types of communication skills necessary for successful return to work in adults with TBI. In addition, based on literature searches, there have been no published studies characterizing the communication demands of different types of occupations. This proposal uses a combination of qualitative and quantitative methods to address this gap in knowledge by first identifying communication demands of one specific category of occupation, semi- professional work (Aim 1), then identifying the communication predictors of return to that type of work following TBI (Aim 2). Semi-professional employment is important because semi-professional workers are highly likely to attempt to return to that occupation following TBI. Although communication variables are thought to be an important predictor of return to work, the current state of the science in this area does not allow for hypothesis testing of specific communication variables in workplaces. Therefore, Aim 1 will use qualitative interview and field observation procedures to identify the most relevant communication variables in the semi-professional workplace. These variables will then be matched to standardized tests of communication functions, which will be used to test the hypothesis in Aim 2.
For Aim 2, a sample of 40 participants with TBI will be divided into two groups: successfully employed adults with TBI vs. those who were unsuccessful in maintaining semi-professional employment post-injury. Both groups will be administered the tests identified in Aim 1, and discriminant analysis using logistic regression will be used to test the hypothesis that communication variables differentiate between the two groups and thus are linked employment outcome. Findings from this study will make a substantive contribution to research on outcomes from TBI and address translation of laboratory-based measures to outcomes in everyday life. The results also will have clinical utility, allowing for improved targeting of treatment approaches for individuals with communication deficits following TBI. This proposal starts a line of research that will ultimately not only inform theories of outcome after TBI but also generate a taxonomic classification of occupations according to communication demands that can be used to study individuals with a wide variety of communication disorders.
This study will identify communication skills necessary for maintaining professional and skilled employment in persons with traumatic brain injury. By linking knowledge of cognition and workplace behavior this project will improve the ability of healthcare providers to place persons with traumatic brain injury into competitive jobs;improving health outcomes by reducing the burden of their disability on society and improving the quality of their participation in daily life.