Lauren Crumlish, Anthony J Angwin, Bridget Burton, Sarah J Wallace
{"title":"创伤性脑损伤后儿童和青少年认知沟通障碍的重要结局：一项国际多视角共识研究","authors":"Lauren Crumlish, Anthony J Angwin, Bridget Burton, Sarah J Wallace","doi":"10.1044/2025_AJSLP-24-00516","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to reach consensus among researchers, clinicians, and service managers on the most important outcomes of cognitive-communication treatments for children and adolescents (ages 5-18 years) with traumatic brain injury, in the postacute stage of rehabilitation and beyond.</p><p><strong>Method: </strong>This is an international three-round e-Delphi study. In Round 1, participants answered three open-ended questions, generating important treatment outcomes at three stages of development (5-11, 12-15, and > 15-18 years). Results were analyzed using qualitative content analysis and combined with outcomes from a previous scoping review. In Rounds 2-3, outcome importance was ranked on a 9-point scale. Consensus was defined a priori with outcomes rated as being \"essential\" (7-9) by at least 70% of respondents and rated 1-3 by less than 15% of respondents. Consensus outcomes were linked to the International Classification of Functioning, Disability and Health (ICF).</p><p><strong>Results: </strong>A total of 360 outcomes met consensus for all age groups. For 5- to 11-year-old children, important outcomes linked almost equally to the Body Functions (<i>n</i> = 52, 13.1%) and Activity/Participation (<i>n</i> = 50, 12.6%) components of the ICF. Outcomes of \"successful start to school,\" \"return to school,\" and \"school functioning\" were uniquely important. For older children and adolescents, outcomes linked to the Activity/Participation component of the ICF most frequently (12-15 years: <i>n</i> = 62, 15.6%; > 15-18 years: <i>n</i> = 73, 18.4%). For older cohorts, unique outcomes of \"emotional safety,\" \"employment,\" and \"life skill development\" met consensus.</p><p><strong>Conclusions: </strong>Participants consider many outcomes, spanning most of the ICF, to be important for children and adolescents with cognitive-communication disorders (CCDs). As children and adolescents age, the importance of ICF components shifts, and distinct outcomes emerge, highlighting the necessity of developmentally relevant rehabilitation. The broad range of outcomes reaching consensus reflects pediatric CCD complexity and the need for holistic, person-centered care. Future research should explore the priorities of children and adolescents with CCDs and their families.</p>","PeriodicalId":49240,"journal":{"name":"American Journal of Speech-Language Pathology","volume":" ","pages":"1-30"},"PeriodicalIF":2.5000,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Important Outcomes for Children and Adolescents With Cognitive-Communication Disorders After Traumatic Brain Injury: An International Multiperspective Consensus Study.\",\"authors\":\"Lauren Crumlish, Anthony J Angwin, Bridget Burton, Sarah J Wallace\",\"doi\":\"10.1044/2025_AJSLP-24-00516\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>The aim of this study was to reach consensus among researchers, clinicians, and service managers on the most important outcomes of cognitive-communication treatments for children and adolescents (ages 5-18 years) with traumatic brain injury, in the postacute stage of rehabilitation and beyond.</p><p><strong>Method: </strong>This is an international three-round e-Delphi study. In Round 1, participants answered three open-ended questions, generating important treatment outcomes at three stages of development (5-11, 12-15, and > 15-18 years). Results were analyzed using qualitative content analysis and combined with outcomes from a previous scoping review. In Rounds 2-3, outcome importance was ranked on a 9-point scale. Consensus was defined a priori with outcomes rated as being \\\"essential\\\" (7-9) by at least 70% of respondents and rated 1-3 by less than 15% of respondents. Consensus outcomes were linked to the International Classification of Functioning, Disability and Health (ICF).</p><p><strong>Results: </strong>A total of 360 outcomes met consensus for all age groups. For 5- to 11-year-old children, important outcomes linked almost equally to the Body Functions (<i>n</i> = 52, 13.1%) and Activity/Participation (<i>n</i> = 50, 12.6%) components of the ICF. Outcomes of \\\"successful start to school,\\\" \\\"return to school,\\\" and \\\"school functioning\\\" were uniquely important. For older children and adolescents, outcomes linked to the Activity/Participation component of the ICF most frequently (12-15 years: <i>n</i> = 62, 15.6%; > 15-18 years: <i>n</i> = 73, 18.4%). For older cohorts, unique outcomes of \\\"emotional safety,\\\" \\\"employment,\\\" and \\\"life skill development\\\" met consensus.</p><p><strong>Conclusions: </strong>Participants consider many outcomes, spanning most of the ICF, to be important for children and adolescents with cognitive-communication disorders (CCDs). As children and adolescents age, the importance of ICF components shifts, and distinct outcomes emerge, highlighting the necessity of developmentally relevant rehabilitation. The broad range of outcomes reaching consensus reflects pediatric CCD complexity and the need for holistic, person-centered care. Future research should explore the priorities of children and adolescents with CCDs and their families.</p>\",\"PeriodicalId\":49240,\"journal\":{\"name\":\"American Journal of Speech-Language Pathology\",\"volume\":\" \",\"pages\":\"1-30\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2025-09-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American Journal of Speech-Language Pathology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1044/2025_AJSLP-24-00516\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Speech-Language Pathology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1044/2025_AJSLP-24-00516","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY","Score":null,"Total":0}
Important Outcomes for Children and Adolescents With Cognitive-Communication Disorders After Traumatic Brain Injury: An International Multiperspective Consensus Study.
Purpose: The aim of this study was to reach consensus among researchers, clinicians, and service managers on the most important outcomes of cognitive-communication treatments for children and adolescents (ages 5-18 years) with traumatic brain injury, in the postacute stage of rehabilitation and beyond.
Method: This is an international three-round e-Delphi study. In Round 1, participants answered three open-ended questions, generating important treatment outcomes at three stages of development (5-11, 12-15, and > 15-18 years). Results were analyzed using qualitative content analysis and combined with outcomes from a previous scoping review. In Rounds 2-3, outcome importance was ranked on a 9-point scale. Consensus was defined a priori with outcomes rated as being "essential" (7-9) by at least 70% of respondents and rated 1-3 by less than 15% of respondents. Consensus outcomes were linked to the International Classification of Functioning, Disability and Health (ICF).
Results: A total of 360 outcomes met consensus for all age groups. For 5- to 11-year-old children, important outcomes linked almost equally to the Body Functions (n = 52, 13.1%) and Activity/Participation (n = 50, 12.6%) components of the ICF. Outcomes of "successful start to school," "return to school," and "school functioning" were uniquely important. For older children and adolescents, outcomes linked to the Activity/Participation component of the ICF most frequently (12-15 years: n = 62, 15.6%; > 15-18 years: n = 73, 18.4%). For older cohorts, unique outcomes of "emotional safety," "employment," and "life skill development" met consensus.
Conclusions: Participants consider many outcomes, spanning most of the ICF, to be important for children and adolescents with cognitive-communication disorders (CCDs). As children and adolescents age, the importance of ICF components shifts, and distinct outcomes emerge, highlighting the necessity of developmentally relevant rehabilitation. The broad range of outcomes reaching consensus reflects pediatric CCD complexity and the need for holistic, person-centered care. Future research should explore the priorities of children and adolescents with CCDs and their families.
期刊介绍：
Mission: AJSLP publishes peer-reviewed research and other scholarly articles on all aspects of clinical practice in speech-language pathology. The journal is an international outlet for clinical research pertaining to screening, detection, diagnosis, management, and outcomes of communication and swallowing disorders across the lifespan as well as the etiologies and characteristics of these disorders. Because of its clinical orientation, the journal disseminates research findings applicable to diverse aspects of clinical practice in speech-language pathology. AJSLP seeks to advance evidence-based practice by disseminating the results of new studies as well as providing a forum for critical reviews and meta-analyses of previously published work.
Scope: The broad field of speech-language pathology, including aphasia; apraxia of speech and childhood apraxia of speech; aural rehabilitation; augmentative and alternative communication; cognitive impairment; craniofacial disorders; dysarthria; fluency disorders; language disorders in children; speech sound disorders; swallowing, dysphagia, and feeding disorders; and voice disorders.
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