The Department of Hearing and Speech Sciences has conducted research to better understand how individuals with traumatic brain injury (TBI) have adapted to the COVID-19 pandemic. Researchers think the findings may apply to many disability populations in future crises.
More than 6 million Americans sustain TBIs every year, resulting in long-term disability. TBI has been called an “invisible injury” because in many cases, disability after TBI is not physical, instead relating to changes in cognition and communication skills. However, TBIs are frequently treated as short-term injuries, meaning many patients do not receive the long-term medical support they need to cope with a life-long disability. Adding a large-scale disaster such as a pandemic into the mix may leave patients with TBI vulnerable.
“People with TBI can struggle with being flexible and adaptive in their thinking and behavior,” said Melissa Duff, PhD, associate professor of Hearing and Speech Sciences and director of the Communication and Memory Lab. “When there’s a sudden change in how we live our lives, like a mass evacuation, a natural disaster or COVID, that’s when we really need to be thinking about this community.”
People with disabilities, including TBIs, may rely on medical, educational and rehabilitation professionals to build individualized support systems. These established systems help people remain successful in their classrooms, homes and communities.
“When big changes in day-to-day life happen, like with COVID, we need to tailor those support systems accordingly,” said Emily Morrow, MS, co-author and student in Duff’s lab.
In their study, Duff and Morrow found that people with TBI particularly struggled with making the shift from in-person communication to virtual communication — partly due to difficulty with social communication that may result from TBI.
“It’s harder to transition to Zoom if you already struggle to read and respond to social cues in person,” said Morrow. “As medical and rehabilitation professionals, we have to think about how to support patients in making these broad changes.”
In the survey, people with TBI reported less pandemic-related behavior changes to their daily habits, such as wearing masks, than their peers without TBI. Study participants cited reduced visibility of facial expressions and hearing loss as primary barriers to masking.
Study participants with and without TBI rated health care providers as the most trustworthy source of public health information. Duff and Morrow say this result highlights the importance of health care professionals providing information in a way that is accessible and attainable.
They also suggest that health care providers prioritize frequent check-ins with patients who have disabilities, as providers are uniquely qualified to understand the challenges patients face. “It’s about considering this problem, asking patients about it, and using our expertise to support people in responding to crises and making changes in their routines,” Morrow said.
Although this study focused on people with TBI, Duff and Morrow believe the findings have implications for other disability populations, as well.
“We need to think about disability in our public health messaging around the pandemic and tailor our messages for specific groups,” Morrow said. “We should consider these findings in our response to the pandemic and other future crises.”
These results were published in the Archives of Physical Medicine and Rehabilitation in December 2020 with co-author Nirav Patel.
