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Preliminary framework for Familiar Auditory Sensory Training (FAST) provided during coma recovery

Preliminary framework for Familiar Auditory Sensory Training (FAST) provided during coma recovery.

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Preliminary framework for Familiar Auditory Sensory Training (FAST) provided during coma recovery

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  1. Preliminary framework for Familiar Auditory Sensory Training (FAST) provided during coma recovery Theresa Louise-Bender Pape, DrPH, MA, CCC-SLP/L; Joshua M. Rosenow, MD, FACS; Brett Harton, BS; Vijaya Patil, MD; Ann Guernon, MS; Todd Parrish, PhD; Kathleen Froehlich, OTR/L; Catherine Burress, DPT; Shane McNamee, MD; Amy A. Herrold, PhD; Bessie Weiss, RN, MS, CCNS, CCRN, CNRN; Xue Wang, PhD

  2. Aim • Describe preliminary framework for Familiar Auditory Sensory Training (FAST) protocol, which synthesizes principles of plasticity and capabilities of brain to automatically and covertly process sensory input. • Relevance • Despite scarce evidence regarding therapeutic efficacy, sensory stimulation is customarily provided to patients in states of seriously impaired consciousness.

  3. Description of Experimental Intervention • Researcher initiates dialog with 3 storytellers (identified by participant’s legal representative). • Stories are recorded using handheld digital voice recorder, then edited for length and sound quality (volume level: 50 to 75 dB). • Total duration of FAST protocol is 1,680 min of familiar auditory sensory material provided daily for 6 weeks. • 40 min of stories provided 4 times daily in 10 min segments at least 2 h apart.

  4. Results: Lessons Learned • Each patient/family circumstance is unique, so creating stories is not always simple. • Challenges include: • Potential storytellers’ stage of coping with traumatic event that caused participant’s injuries. • Quality of relationships between storytellers. • Having enough content for stories. • Motivation to generate stories. • Engagement • Storytellers felt like they contributed and had some control over participant’s rehabilitation.

  5. Conclusion • FAST protocol theorized to extract consistent response across subjects, but only constants are duration, familiarity, and emotion. • FAST protocol is customized for each subject and differs according to structure of auditory stimulation (e.g., speech rate, prosody). • We theorize that customized structure will therapeutically affect how injured brain processes and responds to stimulation. • Ongoing trial will identify whether brain responds and how this relates to neurobehavioral changes. • Future research should identify FAST parameters that promote behavioral gains.

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