Ann GuernonBy Ann Guernon, MS, CCC-SLP, CCRC 

I am thrilled to be sharing my research background with the Early Career membership. My clinical background is in Speech-Language Pathology, with a strong focus working with adults experiencing cognitive-communication impairments following neurological injury. In addition to my clinical experience, I have been involved in clinical research for more than 15 years. I am currently pursuing my doctoral degree in Health Studies at Northern Illinois University. The body of research that I currently contribute to focuses on traumatic brain injury in the areas of measurement, neuromodulation and qualitative discovery. Below, I share some highlights of research I am currently involved with for each of these areas.

Measurement

Development of a bedside measure for disorders of consciousness (the Disorders of Consciousness Scale) is how I was introduced to the clinical research world. Working with Dr. Theresa Pape and Dr. Trudy Mallinson, I have learned how important psychometric properties and indicators of change are for the disordered consciousness population. We are currently working to develop more precise indices and better understand the minimally detectable change and minimally clinically important differences in these clinician-reported outcomes. These measures are important so that clinicians and families can determine when changes are clinically meaningful or beyond measurement error. These activities advance the clinical understanding and application of these measures and enable more precise measurement necessary for clinical trial outcomes to demonstrate effects from treatments. These activities are funded by DoD CDMRP Award W81XWH-14-1-0568 and JWMRP Award W81XWH-16-2-0023.

Neuromodulation

Advancement of treatment modalities for persons living with cognitive sequelae following traumatic brain injury is an area I am passionate about. Neuromodulation techniques applied to traumatic brain injury patients for cognitive impairments is relatively new and exploits the function of neuroplasticity principles to recovery. Currently, I am involved in studies addressing potential treatments for patients across the spectrum of TBI severity using a variety of neuromodulatory techniques to improve function. Related to severe TBI and disordered consciousness, I am working with Dr. Pape on a study involving transcranial magnetic stimulation as a treatment to improve levels of awareness and function for persons who remain in a vegetative or minimally conscious state for up to two years following severe TBI. This study is also funded by DoD CDMRP Award W81XWH-14-1-0568 and JWMRP Award W81XWH-16-2-0023.

Working with a group of researchers at Marianjoy Rehabilitation Hospital led by Dr. Eric Larson, we are studying how the use of transcranial direct current stimulation paired with Attention Process Training-III (developed by Sohlberg and Mateer) may impact cognitive impairments in persons with chronic effects of moderate to severe TBI one year or more after injury. This study is funded by an NIH subaward through the National Center of Neuromodulation for Rehabilitation MUSC 17-075-8B465.

Finally, in the neuromodulation area, I am involved with Dr. Pape’s team at the Hines VA and Northwestern University in a study exploring the use of intermittent theta burst stimulation paired with Attention Process Training-III (Sohlberg & Mateer) as a treatment for persons experiencing cognitive impairments for at least one year after mild TBI with co-occurring Post-Traumatic Stress Disorder. This study is funded by DoD CDMRP Award W81XWH-15-1-0516.

Qualitative Discovery

Mentored by Dr. Christina Papadimitriou, my doctoral research involves qualitative exploration of how key stakeholders in youth sport related concussion make decisions about removal from play, return to play and return to learn. I am especially interested in how available educational programs impact decision making of coaches (both professional and volunteer) and parents. Additionally, I am interested in establishing a better understanding of how current legislation impacts the practices of these stakeholders. This work is currently not funded.

In addition to my doctoral work, I am involved with Drs. Papadimitriou, Mallinson and Pape in qualitative studies to better understand how clinicians and caregivers make sense of changes they see in persons with disordered states of consciousness. We strive to better understand how clinicians and caregivers perceive change. This work is also funded by JWMRP Award W81XWH-16-2-0023.

In closing, my portfolio of research involvement is dedicated to the field of traumatic brain injury. Through the combination of measurement, neuromodulation and qualitative discovery, I hope to make a meaningful impact in the field by influencing clinical practice and public policy.

My advice to other early career researchers would be to find a group of mid-career and seasoned researchers with similar interests and involve yourself in their work. Find a way to be involved that complements your own career goals. Patience is a virtue and like many things in life, your research investment will build and develop in ways you couldn’t envision at the beginning of the journey.