Adolescents' experiences of communication following acquired brain injury.

BACKGROUND: Paediatric acquired brain injury (ABI) is one of the leading causes of neurodisability in childhood. The long-term effects of ABI on cognition, behaviour and emotions are well documented. Previous research has found that communication is difficult for adolescents with ABI compared with typically developing peers. Quantitative studies have identified deficits in specific domains of speech and language, but no research studies have sought to capture adolescents' lived experiences of communication or explored the multidimensional nature of this. AIMS: To explore adolescents' everyday experiences of communication following ABI. This research also offered adolescents an opportunity to give their views on an issue that has not previously been explored in relation to paediatric ABI. METHOD & PROCEDURES: A qualitative study was undertaken using interpretative phenomenological analysis (IPA) for in-depth exploration of the lived experiences of communication following ABI. Participants were recruited from an NHS Trust in England. Six adolescents (aged 11-18 years) participated in semi-structured interviews. Data analysis followed the guides for IPA. OUTCOMES & RESULTS: The data revealed three main themes: the social world; communication competence; and life in the classroom. Adolescents experienced communication changes and challenges, which affected functioning and participation. Difficulties with communication affected identity, learning, relationships and confidence. CONCLUSIONS & IMPLICATIONS: These findings provide an insight into how communication is experienced in everyday life from the perspectives of adolescents with ABI. The study revealed that adolescents' individual experiences of communication were dependent on contextual factors. Sensitivity to communication changes was associated with the age when the ABI occurred. Difficulties with communication impacted on identity. Negative communication experiences at school affected a sense of belonging; peer group support helped some adolescents to cope with the communication challenges they faced. Further research is needed to explore how participation in communication is affected by paediatric ABI and what could be done to support this. It is recommended that increased attention should be paid by professionals to the psychological impact of communication changes and difficulties experienced by this population.

Play Experiences of Children With a High Level of Physical Disability.

IMPORTANCE: This research provides practitioners with an understanding of play from the perspective of children with a high level of physical disability. OBJECTIVE: To explore the experience of play for children who have a high level of physical disability as a result of cerebral palsy. DESIGN: Interpretative phenomenological analysis. Children participated in three interviews each to discuss their experience of play. Visual methods, such as use of video and drawings, enabled a greater depth of discussion. SETTING: Participants' homes. PARTICIPANT: : Six children ages 6-11 yr with a high level of physical disability, recruited via snowball sampling and charities working with children with cerebral palsy. RESULTS: We found that making choices and controlling play were important for the children, that they often experienced play differently than their peers, and that they connected with others in play through humor and communication skills. CONCLUSIONS AND RELEVANCE: Occupational therapy practitioners can respond to the findings by understanding the embodied unit, recognizing vista play, enabling expression of each child's imagined self, supporting negotiation of identity and disability, recognizing participation in play through watching, enabling opportunities for belonging, enabling development of component skills for play, and supporting strategies for connection. WHAT THIS ARTICLE ADDS: This article provides occupational therapy practitioners and other professionals with an understanding of play from the perspective of children who have a high level of physical disability.