Traumatic brain injury (TBI) is a form of nondegenerative acquired brain injury, resulting from an external physical force to the head (e.g., fall) or other mechanisms of displacement of the brain within the skull (e.g., blast injuries).

Roles and Responsibilities of the SLP

Speech-language pathologists (SLPs) play a central role in the screening, assessment, and treatment of persons with TBI. The professional roles and activities in speech-language pathology include clinical/educational services (assessment, planning, and treatment), prevention, and advocacy, as well as education, administration, and research. See ASHA’s Scope of Practice in Speech-Language Pathology (ASHA, 2007).

Appropriate roles for SLPs include:

• identifying risk factors for TBI, taking into account variability among individuals from different racial and ethnic backgrounds and culturally and linguistically diverse populations;

providing prevention information to individuals and groups known to be at risk for TBI as well as to individuals working with those at risk;

• screening individuals with TBI for hearing, speech, language, cognitive-communication, and swallowing difficulties;

• determining the need for further assessment and/or referral for other services;

conducting a comprehensive assessment and diagnosing speech, language, cognitive-communication, and swallowing disorders associated with TBI with sensitivity to individual differences, including cultural and linguistic variations;

• developing and implementing treatment plans involving direct and indirect intervention methods for maintaining functional speech, language, cognitive-communication, and swallowing abilities at the highest level of independence, with sensitivity to individual, cultural/linguistic variations;

gathering and reporting treatment outcomes, documenting progress, and determining appropriate discharge criteria;

• facilitating access to comprehensive services, including referral to other professionals as necessary;

counseling persons with TBI and their families regarding impairments across the SLP scope of practice and providing education aimed at preventing further complications relating to TBI;

consulting and collaborating with other professionals to facilitate program development and to provide supervision, evaluation, and/or expert testimony, as appropriate;

remaining informed of research in the area of TBI and helping advance the knowledge base related to the nature and treatment of TBI;

serving as an integral member of an interdisciplinary team working with individuals with TBI and their families/caregivers;

advocating for individuals with TBI and their families and educating other professionals, third-party payers, and legislators about the needs of persons with TBI and the role of SLPs in diagnosing and managing speech, language, cognitive-communication, and swallowing disorders associated with TBI;

providing quality control and risk management.