Facial Affect Recognition Training Through Telepractice: Two Case Studies of Individuals with Chronic Traumatic Brain Injury


  • John Williamson Northern Arizona University
  • Emi Isaki Northern Arizona University




The use of a modified Facial Affect Recognition (FAR) training to identify emotions was investigated with two case studies of adults with moderate to severe chronic (> five years) traumatic brain injury (TBI).  The modified FAR training was administered via telepractice to target social communication skills.  Therapy consisted of identifying emotions through static facial expressions, personally reflecting on those emotions, and identifying sarcasm and emotions within social stories and role-play.  Pre- and post-therapy measures included static facial photos to identify emotion and the Prutting and Kirchner Pragmatic Protocol for social communication.  Both participants with chronic TBI showed gains on identifying facial emotions on the static photos. 




Author Biography

Emi Isaki, Northern Arizona University

Dept. of Communication Sciences & Disorders Associate Professor


American Speech-Language-Hearing Association. (2010). Professional issues in telepractice for speech-language pathologists [Professional Issues Statement]. Available from www.asha.org/policy.

Angeleri, R., Bosco, F.M., Zettin, M., Sacco, K., Colle, L., & Bara, B.G. (2008). Communicative impairment in traumatic brain injury: A complete pragmatic assessment. Brain & Language, 107, 229-245.

Bornhofen, C., & McDonald, S. (2008). Training deficits in emotion perception following traumatic brain injury. Neuropsychological Rehabilitation, 18(1), 22-44.

Braden, C., Hawley, L., Newman, J., Morey, C., Gerber, D., & Harrison-Felix, C. (2010). Social communication skills group treatment: A feasibility study for persons with traumatic brain injury and co-morbid conditions. Brain Injury, 24, 1298-1310.

Byom, L.J., & Turkstra, L. (2012). Effects of social cognitive demand on theory of mind in conversations of adults with traumatic brain injury. International Journal of Language & Communication Disorders, 47, 310-321.

Douglas, J.M. (2010). Relation of executive functioning to pragmatic outcome following severe traumatic brain injury. Journal of Speech, Language, and Hearing Research, 53, 365-382.

Faul, M.D., Wald, M.M., Xu, L., & Coronado, V.G. (2010). Traumatic brain injury in the United States: Emergency department visits, hospitalizations, and deaths, 2002-2006 (CDC Publication ID 211298). Retrieved from http://stacks.cdc.gov/view/cdc/5571/

Garcia-Molina, A., Rajo, P.R., Sanchez-Carrion, R., Pulido, A.G., Ensenyat, A., Rudolph, A.G., & Roig, T. (2010). Clinical program of cognitive tele-rehabilitation for traumatic brain injury. e-Challenges e-2010 conference proceedings. Retrieved from http://www.echallenges.org/e2010/default.asp?page=paper-login

Gur, R.C., Sara, R., Hagendoorn, M., Marom, O., Hughett, P., Macy, L., & Gur, R.E. (2002). A method for obtaining 3-dimensional facial expressions and its standardization for use in neurocognitive studies. Journal of Neuroscience Methods, 115, 137-143.

Helffenstein, D.A.. & Wechsler, F.S. (1982). The use of interpersonal process recall (IPR) in the remediation of interpersonal and communication skills deficits in the newly brain-injured. Clinical Neuropsychology, 4, 139-142.

Henry, J.D., Phillips, L.H., Crawford, J.R., Ietswaart, M., & Summers, F. (2006). Theory of mind following traumatic brain injury: The role of emotion recognition and executive dysfunction. Neuropsychologia, 44, 1623-1628.

Martin, I., & McDonald, S. (2003). Weak coherence, no theory of mind, or executive dysfunction? Solving the puzzle of pragmatic language disorders. Brain and Language, 85, 451-466.

Mashima, P.A., Birkmire-Peters, D.P., Syms, M.J., Holtel, M.R., Burgess, L.P.A., & Peters, L.J. (2003). Telehealth: Voice therapy using telecommunications technology. American Journal of Speech-Language Pathology, 12, 432-439.

Prutting, C.A., & Kirchner, D.M. (1987). A clinical appraisal of the pragmatic aspects of language. Journal of Speech and Hearing Disorders, 52, 105-119.

Radice-Neumann, D., Zupan, B., Tomita, M., & Willer, B. (2009). Training emotional processing in persons with brain injury. Journal of Head Trauma and Rehabilitation, 24, 313-323.

Riegler, L.J., Neils-Strunjas, J., Boyce, S., Wade, S.L., & Scheifele, P.M. (2013). Cognitive intervention results in web-based videophone treatment adherence and improved cognitive scores. Medical Science Monitor, 19, 269-275.

Spikman, J.M., Milders, M.V., Visser-Keizer, A.C., Westerhof-Evers, H.J., Herben-Dekker, M., & van der Naalt, J. (2013). Deficits in facial emotion recognition indicate behavioral changes and impaired self-awareness after moderate to severe traumatic brain injury. PLoS ONE, 8(6), e65581.

VSee (2014). Retrieved from http://vsee.com



How to Cite

Williamson, J., & Isaki, E. (2015). Facial Affect Recognition Training Through Telepractice: Two Case Studies of Individuals with Chronic Traumatic Brain Injury. International Journal of Telerehabilitation, 7(1), 13–20. https://doi.org/10.5195/ijt.2015.6167



Case Studies

Most read articles by the same author(s)