MacDonald

The article discusses the development of a new model, the model of cognitive-communication competence, to assist in understanding communication impairments after acquired brain injury (ABI) and the analysis of evidence-based interventions. The model comprises seven domains, seven competencies, and 47 factors related to communication functioning and intervention. The article highlights the evidence-to-practice gaps in communication interventions, including under-identification of communication deficits, infrequent referrals, and inadequate treatment to realize functional communication outcomes. The article proposes that the new model could bridge evidence to practice by promoting a comprehensive and consistent view of communication competence for evidence synthesis, clinical decision-making, outcome measurement, and interprofessional collaboration.effort to create a comprehensive and integrated model of cognitive-communication competence for individuals with acquired brain injury (ABI). The model aims to highlight the central role of communication skills in all interactions, depict communication as a complex and multifaceted construct, synthesize existing evidence relevant to communication disorders, integrate interdisciplinary fields of inquiry, denote the importance of context in communication competence, and promote communication competence in real-world settings as the desired outcome of communication intervention. The model was developed through a process that involved defining, reviewing, and quantifying the full range of communication impairments after ABI, reviewing existing models of communication, selecting domains and factors relevant to communication competence, and conducting multiple literature searches to provide an overview of the evidence base for each factor and its relationship to communication competence. The resulting model includes seven domains and 47 factors and provides a structure for ongoing development of best practices for communication interventions.The model of cognitive-communication competence is a result of an iterative and cyclical process that involved reviewing studies and consulting with experts, researchers, clinicians, and individuals with ABI. The model incorporates seven domains of functioning that contribute to communication success in seven key areas of communication competence. These domains include individual factors, contextual or environmental factors, and cognitive factors such as control functions and speed of processing. The model aims to provide a rationale for the inclusion of each factor in the model and is grounded in analysis of an individual's unique characteristics, needs, life contexts, goals, and skills. The model also emphasizes the need to consider communication demands, involve communication partners, and evaluate, support, and stimulate communication in communication contexts that are as similar as possible to the contexts of the individual's life.This article discusses a model of cognitive-communication competence after acquired brain injury (ABI). The model includes six domains: cognitive, control/self-regulation, linguistic, social-emotional, context, and communication. Attention, working memory, memory, social cognition, reasoning and problem solving, auditory comprehension, verbal expression and discourse, and pragmatics and social interaction are discussed in detail as components of the model. The article stresses the importance of evaluating each of these components to develop optimal therapeutic instruction and improve communication competence after ABI. Evidence-based interventions for each component are also discussed.