Cognitive and communication difficulties that occur after a concussion or mild brain injury are expected to resolve within three months  in most cases. However approximately 15% of individuals have persisting difficulties after mild brain injuries sustained in sports, motor vehicle crashes, falls, or combat related injuries .  Until recently the evidence showed that rest and education were the best available interventions. Certainly rest and education are an important and well supported first step. But then what?  What can be offered to individuals who still experience difficulties after the prescribed period of rest and gradual return to activity as tolerated? Until recently research for cognitive and communication interventions,  specifically after mild brain injury,  was lacking.  A recent survey of the research indicates that it’s time to update our view on what treatments can be offered to those with mild brain injuries.  Below are a few of the studies supporting mild brain injury interventions by speech-language pathologists and psychologists:

Complex Comprehension

  • Interventions to help improve gist reasoning (Vas et al, 2015)

Memory

  • Use of internal memory strategies (O’Neil Pirozzi et al, 2010)
  • Use of spaced retrieval (Bourgeois et al, 2007)
  • External memory compensations (Cicerone et al, 2011)

Reasoning, Problem Solving, Executive Functions  

  • Use of metacognitive strategies, problem solving strategies, and executive functions training such (Wade et al, 2015; Riegler et al, ; Twamley et al, 2014; Navakovic Agopian et al, 2011; Kennedy et al, 2008; Levine et al, 2000)

Reading Comprehension

  • Training in use of individualized reading strategies (Griffiths et al, 2015; Sohlberg et al, 2014)

Social Communication

  • Group training with individualized goals for discourse and social skills (Braden et al, 2010;

Written Expression

  • Provision of writing strategies (Wheeler et al, 2014)

Attention

  • Use of attention strategies, metacognitive strategy instruction, direct attention training (Lee et al, 2013; Sohlberg et al, 2005; Cicerone, 2002)

 Fatigue Management

  • Provision of fatigue management strategies for client and family by the speech-language pathologist (Hicks et al, 2007)

Combined Approaches

  • Provision of combined approaches Attention training, Problem solving training, emotional regulation training. (Cantor et al, 2014)

Evidence is building that there are an increasing number of treatments to assist individuals with mild brain injury or  concussion. It’s time for an updated review to assist clinicians in offering the best available treatments for those they serve.