Defense Date


Graduation Date

Summer 1-1-2016


Worldwide Access

Submission Type


Degree Name



Speech-Language Pathology (SLP)


Rangos School of Health Sciences

Committee Chair

Sarah Wallace

Committee Member

Diane Williams

Committee Member

Caterina Staltari


AAC, augmentative and alternative communication, multimodal, TBI, traumatic brain injury, treatment


People affected by severe traumatic brain injury (TBI) often live with co-occurring speech and language deficits, including apraxia of speech and dysarthria. Using augmentative and alternative communication (AAC) strategies (e.g., gesturing, writing, speech generating devices and applications) to communicate can help people with TBI compensate for deficits. The most effective method to teach people with TBI to use multiple strategies in resolving communication breakdowns has not been determined. However, recent research suggests the most effective method for teaching with people with aphasia to use AAC strategies to resolve communication breakdowns is an integrated multimodal treatment approach. This study used a multiple baseline, single participant design with 2 participants to measure the outcomes of an integrated multimodal treatment approach implemented with people with severe TBI. Therefore, the purpose of this study was to measure the effectiveness of a multimodal treatment designed to increase communication breakdown resolution and use of alternative communication modalities by individuals with severe TBI. The study included a total of 27 sessions comprised of 4 pretreatment sessions, 20 treatment sessions, and 3 post-treatment sessions. The dependent variables included the total number of modalities produced in a modality probe task and three measures of communication breakdown resolution during a structured, functional task. The results of the study will lead to future research to improve communication treatment for people with TBI. After implementation of the multimodal treatment, both participants increased the number of modalities they produced during the modality probe. However, these changes only resulted in small or absent effects in communication breakdown resolution variables. Visual analysis suggests that the absence of significant effects may relate to the variability in the participants’ performance and some potential gains were noted. Future research should examine use of external aids and cognitive profiles in relation to modality use and success of communicative repair for people with severe TBI.