Speech-language pathologists see potential in VR for TBI cognitive-communication work - if training, guidelines, and evidence catch up
How this was rated
Robust qualitative design with thematic analysis across SLPs and VR researchers. Sample is predominantly Australian, so findings are most transferable to similar clinical contexts. Not intended to estimate effects - findings describe perspectives, which the method supports well.
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A qualitative study of 14 speech-language pathologists and 3 VR researchers explored attitudes toward using VR with adults who have cognitive-communication difficulties after traumatic brain injury. Participants were broadly positive about VR as a way to rehearse real-world communication, but raised concrete concerns about safety, access, cost, and the absence of clinical guidelines. The study surfaces what clinicians need before VR can move from interesting to routine.
SLPs are interested in VR for post-TBI cognitive-communication work but need training, population-specific guidelines, and clearer evidence before adoption becomes practical. A VR tool designed with clinician workflow in mind - with safety, flexibility, and cost considered upfront - has a receptive audience.
Key findings
- Three themes emerged: perceived potential of VR, red flags around safety and implementation, and practical solutions to adoption barriers
- SLPs saw VR as a way to create realistic practice contexts for community re-integration - a known gap in clinic-based therapy after TBI
- Barriers cited: cost, lack of guidelines, training gaps, cybersickness risk, and uncertainty about who VR suits
- Participants called for population-specific guidance and training resources to translate VR potential into clinical practice
Background
Adults recovering from traumatic brain injury often experience cognitive-communication difficulties - changes in attention, memory, processing speed, social communication, and executive function that affect everyday conversations, work meetings, and community participation. A long-standing challenge in this area is translating what someone can do in the clinic into what they can do in the community. VR has been proposed as a bridge, but the perspectives of the clinicians who would actually use it have rarely been studied.
What the researchers did
Brassel and colleagues conducted semi-structured online interviews and focus groups via Zoom with 14 speech-language pathologists who work with adults post-TBI and 3 virtual reality researchers. Participants were recruited through professional networks using a maximum variation purposive sampling approach. Transcripts were analyzed thematically to identify patterns in how clinicians see the potential, risks, and practical requirements of VR in cognitive-communication therapy.
What they found
Three themes emerged. First, participants saw clear potential - VR could offer controlled, realistic practice in situations that therapy rooms cannot recreate. Second, red flags: cost, cybersickness, lack of population-specific evidence, no clinical guidelines, and concerns about who the technology suits. Third, suggestions - training, co-design with clinicians, clearer evidence, and employer support were all cited as needed to move VR from promising to practical.
Why this matters
This study captures clinician readiness honestly. It does not promise that VR works post-TBI; it asks what SLPs would need in order to try. That framing is useful for anyone introducing VR into cognitive-communication services - the barriers named here are specific and actionable.
Limitations
The sample is small, geographically concentrated, and skews toward clinicians already curious about technology. Perspectives of individuals with TBI and their families were not included. Findings do not speak to clinical effectiveness.
Implications for practice
For clinicians working with adults post-TBI: VR fits most naturally as a rehearsal tool for community situations that are hard to replicate in a therapy room - ordering in a cafe, navigating a work meeting, a phone conversation. Before introducing VR with someone recovering from TBI, screen for cybersickness susceptibility, photosensitivity, and balance concerns; start with short low-pressure exposures and keep an easy exit. The study's call for guidelines is still unmet - when using VR in this population, document what works and share it.
Implications for research
Co-design research involving SLPs, VR specialists, and adults with TBI is needed to build usable clinical protocols. Population-specific efficacy trials remain a gap - existing evidence is largely from other rehabilitation areas. Implementation studies that track adoption, not just efficacy, would strengthen the practical evidence base.
Cite this study
If you reference this study in your work, the canonical citation formats are:
@article{brassel2023,
author = {Brassel, S. and Brunner, M. and Power, E. and Campbell, A. and Togher, L.},
title = {Speech-Language Pathologists' Views of Using Virtual Reality for Managing Cognitive-Communication Disorders Following Traumatic Brain Injury},
journal = {American Journal of Speech-Language Pathology},
year = {2023},
doi = {10.1044/2022_AJSLP-22-00077},
url = {https://withvr.app/evidence/studies/brassel-2023}
}TY - JOUR
AU - Brassel, S.
AU - Brunner, M.
AU - Power, E.
AU - Campbell, A.
AU - Togher, L.
TI - Speech-Language Pathologists' Views of Using Virtual Reality for Managing Cognitive-Communication Disorders Following Traumatic Brain Injury
JO - American Journal of Speech-Language Pathology
PY - 2023
DO - 10.1044/2022_AJSLP-22-00077
UR - https://withvr.app/evidence/studies/brassel-2023
ER - Know of research that should be in this hub? If a relevant peer-reviewed study is not listed here, send the reference to hello@withvr.app. The hub is kept up to date as the literature grows.
Funding & independence
No withVR BV involvement in funding, study design, or authorship. Summary prepared independently by withVR using the published paper.