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likelihood and extent of communication breakdown. These
actions included avoiding negative or difficult communi-
cation situations, accepting Mandy’s communication errors,
and using other forms of interaction with which Mandy felt
more confident, such as online chat.
Although this study identified part of the impact of social
communication impairment for Mandy, the limitations of the
research must be acknowledged. This study involved only
one adolescent, her mother, and her friend. Thus, while
the experiences of participants in this study may resonate
with other adolescents with TBI and their significant others,
the current findings cannot be generalised to other people
in this population. Another limitation was that participants
were not interviewed individually. Although this was the
wish of Mandy, Vivienne, and Bridget, the joint interviews
could have impacted upon the degree to which they felt
comfortable giving open and honest responses.
Neither the literature nor the participants in this study
identified strategies for developing effective social
communication skills that allowed Mandy to be more
self-aware and in control of her communication, such as
learning to be more attentive, to recognise the effects
of fatigue on her interactions, and to better interpret
what someone was saying. Rather, the strategies used
by study participants focused on avoiding or ignoring
the impairment. Contemporary literature that addresses
social communication training post-TBI focuses on
communication partner training (see for example Togher,
McDonald, Tate, Power & Reitdjik, 2013); however,
findings of this study suggest that a hybrid approach that
targets individual coping and conversation repair skills
as well as communication partner skills could be useful.
Mandy and her communication partners may benefit from
developing and implementing strategies that improve her
communicative abilities in collaborative verbal interactions,
particularly as these abilities may be necessary as she
grows older, leaves her school and home environment, and
has to communicate with a broad range of people.
The findings of this research provide insight into the
impact of having a social communication deficit post-TBI,
and highlight the tendency of Mandy and her parents/
friends to avoid or ignore her deficit rather than work on
strategies to improve her communication abilities. The study
findings add credence to the small amount of literature that
discusses social communication impairment in adolescents
post-TBI. The limited strategies identified and used by
Mandy, her mother, and friend further highlight the need
for clinicians to identify social communication impairment
in adolescents with TBI and assist the adolescent,
their family, and friends to develop effective strategies
to maintain and support everyday conversations. The
case study presented illustrates the need for therapeutic
interventions that increase an individual’s ability to recognise
and repair communication breakdown, and that provide
communication partners with strategies that can be used
to maintain conversational flow. Such an approach will
help ensure that Grice’s (1975) conversational maxims are
maintained. As the period of adolescence is fraught with
social and relationship demands, any support rehabilitation
professionals can provide to manage social communication
impairment should be implemented.
References
Anderson, V., Beauchamp, M., Rosema, S., & Soo, C.
(2013). A theoretical approach to understanding social
dysfunction in children and adolescents with TBI. In S.
