{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T06:05:54Z","timestamp":1782281154405,"version":"3.54.5"},"reference-count":51,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,3,14]],"date-time":"2023-03-14T00:00:00Z","timestamp":1678752000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Lang &amp;amp; Comm Disor"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Spoken discourse impairments post\u2010traumatic brain injury (TBI) are well\u2010documented and heterogeneous in nature. These impairments have chronic implications for adults in terms of employment, socializing and community involvement. Intervention delivered by a speech\u2013language pathologist (SLP) is recommended for adults with discourse impairments post\u2010TBI, with an emphasis on context\u2010sensitive treatment. The developing evidence base indicates a wide array of treatment components for SLPs to evaluate and implement within their clinical practice. However, there is limited insight into how SLPs are currently treating discourse impairments and the rationales informing clinical practice.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To explore the under\u2010researched area of clinical practice for spoken discourse interventions with adults post\u2010TBI, including treatment components and clinician rationales, and to contribute towards a shared knowledge base.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods &amp; Procedures<\/jats:title><jats:p>Participants were recruited via purposeful sampling strategies. Six SLPs participated from Australia, the United Kingdom (UK) and the United States (US). Semi\u2010structured interviews were conducted via Zoom. Interviews were manually transcribed, coded and analysed via a qualitative content analysis approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Outcomes &amp; Results<\/jats:title><jats:p>:Participants described discourse treatment practices across various settings and TBI recovery stages. Results indicated that SLPs used numerous treatment activities, resources and outcome measures. Intervention approaches primarily targeted social communication skills, strategy development\/utilization and insight\u2010building. Clinical practice conformed to available guidelines where possible, reflected best practice and incorporated components of the research literature. Participants reported using individualized treatment activities aimed at addressing client\u2010specific factors and rationales prioritized tailored, context\u2010sensitive and goal\u2010directed treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions &amp; Implications<\/jats:title><jats:p>This study provided insight into a previously under\u2010researched area. It highlighted a wide range of treatment activities and factors informing current SLPs\u2019 treatment of spoken discourse impairment post\u2010TBI. Overall, clinical practice and rationales discussed in this study were aligned with best practice and emphasized a contextualized, individualized approach to discourse treatment across service settings and stages of recovery. Participants identified areas requiring further support, including access to training, resources and research, and the challenge of finding suitable outcome measures. Further investigation into discourse management post\u2010TBI, from initial assessment to outcome measurement, may help inform clinical decision\u2010making and the transfer of research to practice.<\/jats:p><\/jats:sec><jats:sec><jats:title>WHAT THIS PAPER ADDS<\/jats:title><jats:sec><jats:title>What is already known on the subject<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>Spoken discourse impairments occur in dialogic and monologic productions post\u2010TBI. Interventions targeting both genres are detailed within the research literature; however, studies exploring clinical practice and decision\u2010making for discourse interventions post\u2010TBI are limited.<\/jats:p><\/jats:list-item><\/jats:list><\/jats:p><\/jats:sec><jats:sec><jats:title>What this paper adds to existing knowledge<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>This study provides new insight into the current treatment targets, activities, resources and outcome measures employed by clinicians supporting adults with discourse impairment post\u2010TBI. It details the factors that influence clinical decision\u2010making for this caseload and identifies an emphasis on client priorities and the value of clinician experience.<\/jats:p><\/jats:list-item><\/jats:list><\/jats:p><\/jats:sec><jats:sec><jats:title>What are the potential or actual clinical implications of this work?<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>This study identifies the broad and complex considerations required to deliver context\u2010sensitive discourse intervention post\u2010TBI. It indicates the need for an in\u2010depth review from assessment to treatment outcomes to better understand and support this area of practice and to direct future research. This study also highlighted the role of clinician experience in discourse intervention and the value of sharing clinical knowledge and resources within and across the profession to support all levels of clinician experience.<\/jats:p><\/jats:list-item><\/jats:list><\/jats:p><\/jats:sec><\/jats:sec>","DOI":"10.1111\/1460-6984.12866","type":"journal-article","created":{"date-parts":[[2023,3,15]],"date-time":"2023-03-15T05:19:24Z","timestamp":1678857564000},"page":"608-622","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["A qualitative exploration of speech\u2013language pathologists\u2019 approaches in treating spoken discourse post\u2010traumatic brain injury"],"prefix":"10.1111","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3567-7495","authenticated-orcid":false,"given":"Rhianne","family":"Hoffman","sequence":"first","affiliation":[{"name":"University of Newcastle  Callaghan NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Spencer","sequence":"additional","affiliation":[{"name":"University of Newcastle  Callaghan NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5478-5865","authenticated-orcid":false,"given":"Joanne","family":"Steel","sequence":"additional","affiliation":[{"name":"University of Newcastle  Callaghan NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,3,14]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Beeke S. 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