Getting Back to Work: Cognitive-Communicative Predictors for Work Re-entry Following Traumatic Brain Injury

Return to work following a Traumatic Brain Injury (TBI) is affected by deficits across the cognitive, psycho-social and physical domains. The specific role of cognitive -communicative abilities influencing work re-entry is understudied. This study aimed at identifying the cognitive-communicative predictors for work re-entry following TBI. Thirty patients with TBI employed pre morbidly were categorized into two groups- ‘14’ employed and ‘16’ unemployed post TBI. Those having sustained mild, moderate or severe head injury and in the post injury period of 6–48 months were recruited and majority belonged to skilled/ professional type of premorbid occupational status. They underwent a detailed assessment of cognition, language and communication using NIMHANS Neuropsychology Battery, Indian adapted versions of Western Aphasia Battery and La Trobe Communication Questionnaire (LCQ) respectively. Patients employed post TBI had better Aphasia Quotient (AQ) and better performance on all the cognitive domains and few domains of LCQ than those who remained unemployed. On step-wise Discriminant Function Analysis (DFA), injury severity and AQ could significantly differentiate between the two groups with an overall accuracy of 80%. Severity of head injury is a significant predictor for employability post TBI and evaluation of language along with cognitive abilities is crucial for patients with TBI for work re-entry. The study highlights the importance of a multi-disciplinary team in the assessment and management of cognitive-communication impairments following a TBI.