title: Job stability in skilled work and communication ability after moderate-severe traumatic brain injury.
abstract: OBJECTIVE
  Communication deficits may play a critical role in maintaining employment after traumatic brain injury (TBI), but links between specific communication deficits and employment outcomes have not been determined. This study identified communication measures that distinguished stably employed versus unstably employed adults with TBI.
  
  
  METHODS
  Participants were 31 adults with moderate-severe TBI who were employed full-time for at least 12 consecutive months before injury in skilled jobs and had attempted return to skilled jobs after injury. Sixteen had achieved stable employment (SE) post-injury, defined as full-time employment for ≥12 consecutive months; and 15 had unstable employment (UE). Participants completed a battery of communication tests identified in a prior qualitative study of communication skills required for skilled work.
  
  
  RESULTS
  Measures of spoken language comprehension, verbal reasoning, social inference, reading and politeness in spoken discourse significantly discriminated between SE and UE groups. Two nested models were completed and compared. The first model excluded discourse data because of missing data for two UE and one SE participant. This model revealed that measures of verbal reasoning speed (β = -0.18, p = 0.05) and social inference (β = 0.19, p = 0.05) were predictive independent of the overall model. The second model included discourse politeness data and was a better overall predictor of group membership (Likelihood ratio test, Model 1: 3.824, Model 2: 2.865).
  
  
  CONCLUSIONS
  Communication measures were positively associated with SE in skilled jobs after TBI. Clinicians should include assessment of communication for adults attempting return to work after TBI, paying specific attention to social inference and speed of verbal reasoning skills.
  
  
  CONCLUSIONS
  Traumatic brain injury (TBI) often results in communication impairments associated with the cognitive skills underlying interpersonal skills. Communication impairment after TBI has been anecdotally associated with job instability. This research associate communication functioning with work stability after TBI in skilled jobs. These findings indicate that communication impairment should be assessed in persons with TBI returning to skilled employment after injury.
authors.affiliation: a Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine , Northwestern University , Chicago , IL , USA .|b The Rehabilitation Institute of Chicago , Chicago , IL , USA , and.
authors.forename: Peter
authors.initials: P
authors.lastname: Meulenbroek
authors.affiliation: c Department of Communication Sciences and Disorders , University of Wisconsin - Madison , Madison , WI , USA.
authors.forename: Lyn S
authors.initials: LS
authors.lastname: Turkstra
mesh_terms: D000328:Adult; D001930:Brain Injuries / Q000534:rehabilitation*; D002322:Career Mobility; D003142:Communication; D003147:Communication Disorders / Q000534:rehabilitation*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D055815:Young Adult
keywords: Communication; employment; language; traumatic brain injury; vocational rehabilitation; work