Najenson, T., Sazbon, L., Fizelson, J., Becker, E., & Schechter, I.  (1978).  Recovery of communicative functions after prolonged traumatic coma. Scandinavian Journal of Rehabilitation Medicine, 10, 15-21.
 
Type of
Study
Longitudinal research study
Subjects 15 patients with prolonged coma after craniocerebral injury; 9 males; 6 females; 19-61 years old at the time of injury
Diagnoses 13 suffered blunt trauma; 2 depressed fractures
Speech
Condition
6 remained in vegetative state
8 of 9 remained dysarthric

3 remained aphasic
Purpose To determine which communication skills may be the most critical in determining quality of survival after prolonged traumatic coma.
Methods The patients underwent weekly neurologic exams and communication skills evaluations.  Communication skills were divided into 6 categories:  auditory comprehension, visual comprehension, speech, oral expression, reading, and writing. 
Results 6 remained in a vegetative state
9 experienced notable recovery

6 of the 9 showed complete recovery of semantic functions, 3 remained aphasic

Communicative recovery paralleled improvement in ADL and motor skills 

Positive outcome depended on observation of sweating and restlessness

Less favorable outcomes depended on observation of excessive salivation, snout reflex, retractory nystagmus, and stereotypic movements
Treatment
Implications
Possible predictors of favorable and unfavorable communication outcomes can be monitored throughout recovery. 
 
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