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EBP Compendium: Summary of Clinical Practice Guideline

Academy of Neurologic Communication Disorders & Sciences
Practice Guidelines for Standardized Assessment for Persons with Traumatic Brain Injury

Turkstra, L., Ylvisaker, M., et al. (2005).
Journal of Medical Speech-Language Pathology, 13(2), ix–xxviii.

AGREE Rating: Recommended with Provisos


This guideline provides recommendations for the evaluation of children, adolescents, and adults with cognitive-communicative disorders following traumatic brain injury (TBI). The target audience of this guideline is speech-language pathologists and other professionals who work with this population. 


  • Assessment/Diagnosis
    • Assessment Areas
      • Cognitive-Communication
        • Evaluation of the person’s pre-injury characteristics, stage of development and recovery, communication-related demands of personally meaningful everyday activities and life and communication contexts should occur.
        • Multiple sources of information should be considered along with standardized assessments used for individuals with cognitive-communication disorders post-TBI.
        • Evaluation of cognitive functions associated with communication ability is within the scope of practice of speech-language pathologists.
        • Speech-language pathologists should receive appropriate training pertaining to the administration of cognitive tests.
        • Speech-language pathologists should integrate their cognitive-communication assessments with those of other professionals whose purview includes cognitive assessment.
    • Assessment Instruments
      • Cognitive-Communication (Adults)
        • “There is a lack of empirical data to support the use of many standardized, norm-referenced tests for individuals with cognitive communication disorders after TBI” (p. xxx). The authors state that most of the assessment measures were not developed specifically for this population.
        • It is recommended that clinicians exercise caution when considering the use of standardized, norm-referenced tests for individuals with traumatic brain injury.
        • The following standardized tests demonstrated adequate performance across the majority of the reliability and validity criteria:
          • The American Speech-Language Hearing Association Functional Assessment of Communication Skills in Adults
          • Behavior Rating Inventory of Executive Function
          • Communication Activities of Daily Living, 2nd Edition
          • Functional Independence Measure
          • Repeatable Battery for the Assessment of Neuropsychological Status
          • Test of Language Competence-Extended
          • Western Aphasia Battery
      • Cognitive-Communication (Children)
        • Intervention and support decisions should be guided by findings from standardized assessments as well as “supplementary, dynamic, nonstandardized evaluation procedures and evaluation of the communication context” (p. xxxii).
        • Experts recommend a combination of cognitive tests and language or aphasia tests. The following are practice options regarding the use of standardized assessment which are based on detailed review of test manuals, relevant published studies and published views of experts as empirical evidence is not readily available to provide practice standards or guidelines:
        • Since most tests of TBI were not developed for persons with TBI or did not address TBI in their development or standardization, clinicians should use caution in using published standardized, norm-referenced tests for the evaluation and assessment of persons with TBI.
        • The Behavior Rating Inventory of Executive Function (BRIEF) and the Test of Language Competence–Extended (TLC-E) met the writing committees’ stated criteria for standardized, norm-referenced tests.  

Keywords: Brain Injury

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Added to Compendium: November 2010

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